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A Journal on Surgery

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Chirurgia 2008 June;21(3):159-62

language: English

Postoperative visual loss in head and neck microsurgery

Agostini T.

Department of Plastic and Reconstructive Surgery University of Florence, Florence, Italy


Few cases of postoperative visual loss in head and neck microsurgery are described in literature and the all of these are related to internal jugular veins ligation. Two patients undergone microsurgical reconstruction after oral cancer resection, have had severe, unexpected visual field deficit in the postoperative. In both cases the internal jugular veins have been spared. The potential aetiology, diagnosis and management are discussed. A promptly ophthalmologic consultation has been request: a diagnosis of ischemic optic neuropathy in the first case has been rendered and a diagnosis of retinal arterial occlusion with permanent visual deficit has been rendered in the second case. A series of preventing procedures have to be adopted in head and neck microsurgery including careful preoperative risk factors and morbidity evaluation and protective eyes’ patients glasses. Strictly pressure and intraoperative fluid loss monitoring and correction represent the main weapon to reduce the incidence of postoperative visual loss.

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