Orbital hemorrhage during ethmoid sinus surgery.

Orbital hemorrhage is an unusual complication of ethmoid surgery. A case of intraoperative orbital hemorrhage occurring during a medial maxillectomy and one occurring during a transethmoid sphenoidotomy are presented. The pathogenesis of this potentially serious complication is discussed. A sequential treatment algorithm is presented, consisting of medial orbitotomy, lateral canthotomy and inferior cantholysis, and inferior orbital decompression, along with concomitant medical management with mannitol, acetazolamide, and dexamethasone.