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Unilateral blindness: a unique complication of choanal atresia surgery

Published online by Cambridge University Press:  10 January 2014

L D'Ascanio  and
E Rebuffini
L D'Ascanio*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Carlo Poma Civil Hospital, Mantova, Italy
E Rebuffini
Affiliation:
Department of Maxillo-Facial Surgery, University of Ferrara, Italy
*
Address for correspondence: Dr Luca D'Ascanio, Department of Otolaryngology – Head and Neck Surgery, Carlo Poma Civil Hospital, Strada Lago Paiolo, 10-46100 Mantova, Italy Fax: +39 (0)854214566 E-mail: [email protected]
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Abstract

Objective:

To report a unique case of unilateral blindness secondary to transnasal endoscopic surgery and stenting for right choanal atresia.

Case report:

A 24-year-old man was referred with right eye blindness and acute headache, occurring immediately after transnasal endoscopic surgical repair of unilateral right choanal atresia with placement of an endonasal stent. Maxillo-facial computed tomography with three-dimensional reconstruction showed the endonasal stent entering the right nostril, passing through the lamina papyracea into the orbit and running anterior to the optic foramen towards the superior orbital fissure. Despite stent removal and medical treatment (ceftriaxone and dexamethasone), permanent right eye blindness secondary to an irreversible lesion of the optic nerve was diagnosed. At three-month follow up, an uncommon, complete fibrous obliteration of the right nasal fossa was noticed.

Conclusion:

To the best of our knowledge, this is the only published report of unilateral blindness following transnasal endoscopic stenting for right choanal atresia. Causes of this complication, and ways of avoiding it, are discussed.

Keywords

Nasal Surgical ProceduresNasal CavityAdultChoanal AtresiaComplicationsBlindness
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 1 , January 2014 , pp. 101 - 103
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Otto, AW, Lehrbach, DER. Anatomical Pathology of Humans and Animals [in German]. Berlin: Recker, 1830;1:181–3Google Scholar
2Ramsden, JD, Campisi, P, Forte, V. Choanal atresia and choanal stenosis. Otolaryngol Clin North Am 2009;42:339–52Google Scholar
3Hengerer, AS, Brickman, TM, Jeyakumar, A. Choanal atresia: embryologic analysis and evolution of treatment, a 30-year experience. Laryngoscope 2008;118:862–6Google Scholar
4Park, AH, Brockenbrough, J, Stankiewicz, J. Endoscopic versus traditional approaches to choanal atresia. Otolaryngol Clin North Am 2000;33:77–90Google Scholar
5Durmaz, A, Tosun, F, Yldrm, N, Sahan, M, Kvrakdal, C, Gerek, M. Transnasal endoscopic repair of choanal atresia: results of 13 cases and meta-analysis. J Craniofac Surg 2008;19:1270–4Google Scholar
6Pirsig, W. Surgery of choanal atresia in infants and children: historical notes and updated review. Int J Pediatr Otorhinolaryngol 1986;11:153–70CrossRefGoogle ScholarPubMed
7Khafagy, YW. Endoscopic repair of bilateral congenital choanal atresia. Laryngoscope 2002;112:316–19Google Scholar
8Uri, N, Greenberg, E. Endoscopic repair of choanal atresia: practical operative technique. Am J Otolaryngol 2001;22:321–3Google Scholar
9Corrales, CE, Koltai, PJ. Choanal atresia: current concepts and controversies. Curr Opin Otolaryngol Head Neck Surg 2009;17:466–70Google Scholar