ORBITAL HEMORRHAGE DURING RHINOPLASTY

The most common complication of rhinoplasty is perioperative and posto perative hemorrhage. We present two patients who experienced intraoper ative orbital hemorrhage during rhinoplasty. Patients with a history o f previous nasal trauma, because of scarring/altered anatomy, may be m ore prone to this serious complication. A precise and well-placed oste otomy must be done to avoid aberrant anatomy and complications, The pr oposed mechanism for orbital hemorrhage is shearing or tearing of fibr ovascular scar tissue involving the angular vessels during the surgica l dissection. Prompt recognition and management of an orbital hemorrha ge during or following rhinoplasty is necessary to prevent possible oc ular injury and loss of vision, A management algorithm for orbital hem orrhage is presented along with a discussion of surgical techniques to prevent this complication, Surgeons performing rhinoplasty should be cognizant of this type of intraoperative complication along with its m edical and surgical management.