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Blindness due to electrocoagulation following functional endoscopic sinus surgery
D Vanden Abeele1, A Clemens, M J Tassignon
1Department of Otorhinolaryngology, University Hospital Antwerp/Edegem, Belgium.
The Journal of Laryngology and Otology
|March 1, 1996
Summary
A rare case of blindness and visual field loss occurred after functional endoscopic sinus surgery (FESS) due to electrocoagulation. This highlights the risks of electrocoagulation during FESS, especially with poor visualization.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Surgical Complications
Background:
- Functional endoscopic sinus surgery (FESS) is a common procedure for sinonasal diseases.
- Post-operative bleeding can occur, necessitating intervention.
- Visual complications are rare but serious risks associated with FESS.
Observation:
- A patient developed irreversible blindness in one eye and infratemporal visual field restriction in the other.
- These visual deficits resulted from electrocoagulation used to manage delayed post-operative bleeding after FESS.
- Literature review found no similar reported cases linking electrocoagulation post-FESS to such visual outcomes.
Findings:
- Electrocoagulation for managing delayed bleeding after FESS can lead to severe, irreversible visual impairment.
- The risk is amplified in situations with compromised visualization, common during post-operative bleeding management.
- This case represents a unique and severe complication not previously documented in recent literature.
Implications:
- Strongly discourages the use of electrocoagulation for managing post-operative bleeding in FESS, particularly when visualization is limited.
- Emphasizes the need for alternative, safer hemostatic techniques in endoscopic sinus surgery.
- Highlights the critical importance of surgical technique and careful instrument use to prevent devastating visual complications.