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Bilateral blindness following anterior nasal packing in a case of nasopharyngeal angiofibroma

Published online by Cambridge University Press:  08 November 2016

A K Sahoo
Affiliation:
ENT Department, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
C Preetam*
Affiliation:
ENT Department, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
R Kumar
Affiliation:
ENT Department, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
D K Samal
Affiliation:
ENT Department, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
*
Address for correspondence: Dr C Preetam, ENT Department, All India Institute of Medical Science, Bhubaneswar, Odisha, India E-mail: [email protected]

Abstract

Background:

Epistaxis is the most common ENT emergency encountered in the Emergency Department. Most cases can be managed by simple anterior nasal packing. This is usually a safe and very effective option in an emergency situation, requiring minimal expertise and infrastructure. This paper describes a rare instance of a serious complication following anterior nasal packing in a case of nasopharyngeal angiofibroma.

Case report:

A 27-year-old man diagnosed with nasopharyngeal angiofibroma presented to the Emergency Department with bilateral epistaxis. The patient was stabilised and anterior nasal packing was performed, which controlled the bleeding. Three hours later, the patient developed complete blindness in both eyes. Aggressive medical management was initiated immediately, but failed to restore the patient's vision.

Conclusion:

Anterior nasal packing is a simple and minimally invasive procedure practised regularly in an Emergency Department setting. However, it can occasionally lead to serious complications such as blindness. Thus, obtaining informed consent is essential to avoid medico-legal consequences in high-risk cases.

Type
Clinical Record
Copyright
Copyright © JLO (1984) Limited 2016 

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