Acute Vision Loss Following Endoscopic Sinus Surgery

A 41-year-old female with a history of uterine cancer and Celiac and Raynaud’s Disease presented to our institution with frequent migraines and nasal congestion. She underwent functional endoscopic sinus surgery (FESS) and experienced acute unilateral vision loss postoperatively. Rapid recognition o...

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Main Authors: Serena Byrd, Adnan S. Hussaini, Jastin Antisdel
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Otolaryngology
Online Access:http://dx.doi.org/10.1155/2017/4935123
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author Serena Byrd
Adnan S. Hussaini
Jastin Antisdel
author_facet Serena Byrd
Adnan S. Hussaini
Jastin Antisdel
author_sort Serena Byrd
collection DOAJ
description A 41-year-old female with a history of uterine cancer and Celiac and Raynaud’s Disease presented to our institution with frequent migraines and nasal congestion. She underwent functional endoscopic sinus surgery (FESS) and experienced acute unilateral vision loss postoperatively. Rapid recognition of the etiology and effective treatment are paramount given the permanent and irreversible vision loss that can result. Arterial vasospasm following FESS is rare. Patients with autoimmune diseases have perhaps an increased risk for vasospasm secondary to an increased vasoreactive profile. We present the first documented case of nitroglycerin sublingual therapy to successfully treat ophthalmic artery vasospasm following FESS. Nitroglycerin sublingual therapy is a promising treatment for ophthalmic vasospasm secondary to its ability to cross the blood-ocular barrier, its rapid onset of action, and its ability to promote relaxation of vascular smooth muscle.
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spelling doaj-art-00b755a44dd8436786a4e6aee948ca622025-08-20T02:03:13ZengWileyCase Reports in Otolaryngology2090-67652090-67732017-01-01201710.1155/2017/49351234935123Acute Vision Loss Following Endoscopic Sinus SurgerySerena Byrd0Adnan S. Hussaini1Jastin Antisdel2Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, MO, USADepartment of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, MO, USADepartment of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, MO, USAA 41-year-old female with a history of uterine cancer and Celiac and Raynaud’s Disease presented to our institution with frequent migraines and nasal congestion. She underwent functional endoscopic sinus surgery (FESS) and experienced acute unilateral vision loss postoperatively. Rapid recognition of the etiology and effective treatment are paramount given the permanent and irreversible vision loss that can result. Arterial vasospasm following FESS is rare. Patients with autoimmune diseases have perhaps an increased risk for vasospasm secondary to an increased vasoreactive profile. We present the first documented case of nitroglycerin sublingual therapy to successfully treat ophthalmic artery vasospasm following FESS. Nitroglycerin sublingual therapy is a promising treatment for ophthalmic vasospasm secondary to its ability to cross the blood-ocular barrier, its rapid onset of action, and its ability to promote relaxation of vascular smooth muscle.http://dx.doi.org/10.1155/2017/4935123
spellingShingle Serena Byrd
Adnan S. Hussaini
Jastin Antisdel
Acute Vision Loss Following Endoscopic Sinus Surgery
Case Reports in Otolaryngology
title Acute Vision Loss Following Endoscopic Sinus Surgery
title_full Acute Vision Loss Following Endoscopic Sinus Surgery
title_fullStr Acute Vision Loss Following Endoscopic Sinus Surgery
title_full_unstemmed Acute Vision Loss Following Endoscopic Sinus Surgery
title_short Acute Vision Loss Following Endoscopic Sinus Surgery
title_sort acute vision loss following endoscopic sinus surgery
url http://dx.doi.org/10.1155/2017/4935123
work_keys_str_mv AT serenabyrd acutevisionlossfollowingendoscopicsinussurgery
AT adnanshussaini acutevisionlossfollowingendoscopicsinussurgery
AT jastinantisdel acutevisionlossfollowingendoscopicsinussurgery