Constance Delmotte1,2, Arnaud Depeyre3,4,5,6,7, Isabelle Barthelemy3,4,8, Joel Ferri1,2,6,7. 1. Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille. 2. Lille University, Lille. 3. Oral and Maxillofacial Department, Estaing Hospital, CHU Clermont Ferrand, Clermont Ferrand. 4. Auvergne University, Faculty of Medicine, Clermont-Ferrand. 5. Auvergne University, CROC Laboratory EA 3847, Faculty of Dental Surgery, Clermont-Ferrand. 6. Inserm, U1008, Controlled Drug Delivery Systems and Biomaterials, Lille. 7. International Association of Oral and Maxillofacial Medicine (IAOMM), Villeneuve d'Ascq. 8. Inserm U1107 Neuro-Dol, Trigeminal Pain and Migraine, Faculty of Dental Surgery, Clermont-Ferrand, France.
Abstract
INTRODUCTION: Blindness after orthognathic surgery may be the result of the surgical procedure itself or the consequence of factors induced by general anesthesia. However, the exact mechanism between is not known. The purpose of this article is to present a case of a postoperative visual loss after orthognathic surgery under general anesthesia concluding with a brief literature review about this topic. REPORT OF CASE: We report the case of a patient who suffered unilateral blindness with homolateral frontal paresthesia after orthognathic procedure in 2 steps. He presented intraoperative bradycardia with a potential undiagnosed hypertension, associated with significant blood loss and volume resuscitation by colloids and cristalloids.Postoperative examination concluded to posterior ischemic optic neuropathy. DISCUSSION AND CONCLUSION: By a systematic literature review, we discuss about surgical and anesthesic causes of postoperative visual loss, and particularly pathophysiology mechanism of posterior ischemic optic neuropathy. Some predisposition and risk factors have been identified and need to be taken into account.
INTRODUCTION: Blindness after orthognathic surgery may be the result of the surgical procedure itself or the consequence of factors induced by general anesthesia. However, the exact mechanism between is not known. The purpose of this article is to present a case of a postoperative visual loss after orthognathic surgery under general anesthesia concluding with a brief literature review about this topic. REPORT OF CASE: We report the case of a patient who suffered unilateral blindness with homolateral frontal paresthesia after orthognathic procedure in 2 steps. He presented intraoperative bradycardia with a potential undiagnosed hypertension, associated with significant blood loss and volume resuscitation by colloids and cristalloids.Postoperative examination concluded to posterior ischemic optic neuropathy. DISCUSSION AND CONCLUSION: By a systematic literature review, we discuss about surgical and anesthesic causes of postoperative visual loss, and particularly pathophysiology mechanism of posterior ischemic optic neuropathy. Some predisposition and risk factors have been identified and need to be taken into account.
Authors: Luana Lima Bulgarelli; Dov Charles Goldenberg; Rafael Maffei Loureiro; Andre Felix Gentil; Roberto Franco Morgulis; Eduardo Carvalhal Ribas Journal: Plast Reconstr Surg Glob Open Date: 2022-08-19