Visual loss following head and neck surgery

Non-arteritic ischaemic optic neuritis is a known post-operative complication of ophthalmological and maxillofacial surgery, but has not been widely described as a potential consequence of head and neck surgery. To highlight non-arteritic ischaemic optic neuritis as a potential risk in patients unde...

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Bibliographic Details
Published in:Journal of laryngology and otology 2012-04, Vol.126 (4), p.418-420
Main Authors: Crockett, A J B, Trinidade, A, Kothari, P, Barnes, J
Format: Article
Language:English
Subjects:
Atherosclerosis
Biological and medical sciences
Blindness - etiology
Carcinoma, Squamous Cell - surgery
Diabetes
Diseases of visual field, optic nerve, optic chiasma and optic tracts
Dissection
Field study
Fistula
Hemostasis, Surgical - methods
Humans
Hypertension
Hypotension
Hypoxia - complications
Ischemia
Jugular Veins - injuries
Jugular Veins - surgery
Laryngeal Neoplasms - surgery
Laryngectomy - adverse effects
Male
Medical personnel
Medical sciences
Middle Aged
Neck Dissection - adverse effects
Ophthalmology
Optic Nerve - blood supply
Optic Neuritis - etiology
Otorhinolaryngology. Stomatology
Patients
Postoperative Hemorrhage - complications
Postoperative Hemorrhage - surgery
Surgery
Veins & arteries
Vision disorders
Visual acuity
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Summary:Non-arteritic ischaemic optic neuritis is a known post-operative complication of ophthalmological and maxillofacial surgery, but has not been widely described as a potential consequence of head and neck surgery. To highlight non-arteritic ischaemic optic neuritis as a potential risk in patients undergoing head and neck surgery. Case report of a 60-year-old man undergoing total laryngectomy and bilateral neck dissection for laryngeal squamous cell carcinoma. On day 14 post-operatively, the patient suffered substantial oral bleeding secondary to an internal jugulo-neopharyngeal fistula. Following emergency haemostatic measures, the patient was immediately aware of visual disturbances. The ophthalmologists concluded that these were due to non-arteritic ischaemic optic neuritis, caused by acute hypoxaemia secondary to substantial blood loss. The prognosis of non-arteritic ischaemic optic neuritis is poor. Thus, it is crucial that otolaryngologists are aware of this complication of head and neck surgery, as immediate diagnosis and treatment can help prevent worsening visual loss.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215111002854