OPHTHALMIC COMPLICATIONS OF ENDOSCOPIC ETHMOID SURGERY AND THEIR MANAGEMENT

Purpose: The proximity of the paranasal sinuses to the orbit puts the anterior visual pathways at risk during sinus surgery. Although the op hthalmic complications of sinus surgery are well known to the otolaryn gologist, they are rarely encountered in clinical practice. Several re commendations will help the surgeon performing intranasal sinus surger y. Materials and Methods: To study the incidence of orbital complicati ons of intranasal ethmoid surgery, a retrospective review of 372 cases , most of them bilateral, was performed, Results: Our series of 372 pa tients who underwent endoscopic sinus surgery showed five orbital comp lications. Conclusion: Several recommendations may help the surgeon to avoide any ophthalmic complication. When orbital wall dehiscence is s uspected, either by CT scan or at surgery, especially in a previously operated case, extreme care should be taken not to penetrate the perio rbita. If orbital fat protrudes into the operative field, it should no t be pulled or twisted in an attempt to remove it. The surgeon should seek the cooperation of the anesthesiologist working the case. A knowl edge of the variable anatomy is essential to avoid iatrogenic injury. The surgeon should be aware of the different complications for early r ecognition and management. Copyright (C) 1996 by W.B. Saunders Company .