Ophthalmic complications of endoscopic sinus surgery

Malgorzata Seredyka-Burduk, Pawel Krzysztof Burduk, Malgorzata Wierzchowska, Bartlomiej Kaluzny, Grazyna Malukiewicz

The proximity of the paranasal sinuses to the orbit and its contents make the possibilities of injury both in primary or revision surgery. The majority of orbital complications are minor. The major ones are seen in 0.01-2.25% and some of them could be serious, leading to permanent dysfunction. The aim of this study was to find the risk and type of ophthalmic complications among patients operated because of chronic rhinosinusitis. We performed a retrospective study of 1658 patients who underwent endoscopic sinus surgery for chronic rhinosinusitis with or without polyps or mucocele. Surgery was performed under general anesthesia in all cases and consisted of polyps' removal, followed by middle metal antrostomy, partial or complete ethmoidectomy, frontal recess surgery and sphenoid surgery if necessary. The ophthalmic complications were matched with type, frequency and clinical findings. In our material 32.68% of the patients required revision surgery and only 10.1% had been done previously in our Department. Overall complications occurred in 11 patients (0.66%). A minor complications was observed in 5 patients (0.3%) with the most frequent being periorbital ecchymosis with or without emphysema. Major ones were observed in one patient (0.06%) and were referred to lacrimal duct injury. A serious complication occurred in 5 cases (0.3%) and referred to retroorbital hematoma (2 cases), optic nerve injury (2 cases) and one case of extraocular muscle injury. Orbital complications of endoscopic nasal surgery are rare. The incidence of serious complications, causing permanent disabilities is less than 0.3%. The most important parameters responsible for complications are extension of the disease, previous endoscopic surgery and coexisting anticoagulant treatment.