Our Summary

This paper talks about a case where a 29-year-old patient lost his vision immediately after having a common surgical procedure called septoplasty (surgery to fix a deviated nasal septum). Medical tests showed that his optic canal (a tunnel in the skull that the optic nerve passes through) had been directly injured during the surgery and his optic nerve (which sends visual information from the eye to the brain) was inflamed and swollen. Despite doctors performing another surgery to try and fix the optic nerve, the patient’s vision did not get better. The paper notes that blindness after septoplasty is extremely rare but can be a severe side effect. There are only a few reported cases where a direct injury from the surgery has caused damage to the optic nerve.

FAQs

  1. What is septoplasty and what complications can arise from it?
  2. What were the circumstances surrounding the case of the 29-year-old patient who lost his vision after septoplasty?
  3. How common is blindness as a complication after septoplasty?

Doctor’s Tip

One helpful tip a doctor might tell a patient about septoplasty is to carefully follow all post-operative instructions, including avoiding strenuous activities and refraining from blowing your nose for a certain period of time. This can help reduce the risk of complications and promote proper healing. Additionally, it is important to report any unusual symptoms, such as persistent pain or changes in vision, to your doctor promptly.

Suitable For

Patients who are typically recommended for septoplasty are those who experience symptoms such as nasal congestion, difficulty breathing through the nose, frequent nosebleeds, and recurring sinus infections due to a deviated septum. Septoplasty is often recommended for patients with a deviated septum that is causing significant nasal obstruction and impacting their quality of life. However, it is important for patients to be aware of the potential risks and complications associated with the procedure, including rare but serious complications such as optic nerve injury leading to blindness.

Timeline

Before septoplasty:

  1. Patient experiences symptoms of a deviated septum such as difficulty breathing, frequent sinus infections, and nasal congestion.
  2. Patient consults with an otolaryngologist (ENT) who recommends septoplasty to correct the deviated septum.
  3. Patient undergoes pre-operative assessments and consultations to ensure they are a suitable candidate for surgery.
  4. Surgery is scheduled and patient is instructed on pre-operative preparations such as fasting and medication adjustments.

After septoplasty:

  1. Patient undergoes septoplasty surgery to correct the deviated septum.
  2. Patient may experience post-operative symptoms such as nasal congestion, headaches, and facial swelling.
  3. Patient is discharged from the hospital or surgical center and instructed on post-operative care including pain management and nasal irrigation.
  4. Patient attends follow-up appointments with their ENT to monitor healing and address any concerns.
  5. Patient gradually experiences improved nasal breathing and reduced symptoms of a deviated septum.
  6. Patient resumes normal activities and enjoys the benefits of improved nasal function and overall quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with septoplasty, including the risk of blindness?
  2. How often do serious complications, such as optic nerve injury, occur after septoplasty?
  3. What steps will be taken during the surgery to minimize the risk of complications?
  4. How will my vision be monitored during and after the procedure?
  5. What symptoms should I watch out for in the days following surgery that may indicate a complication, such as optic nerve injury?
  6. What is the recommended course of action if I experience any concerning symptoms after the surgery?
  7. Are there any specific factors or pre-existing conditions that may increase my risk of complications from septoplasty?
  8. How experienced is the surgeon performing my septoplasty procedure in avoiding complications and managing them if they arise?
  9. What alternative treatment options are available if I am concerned about the potential risks associated with septoplasty?
  10. Is there any additional information or research that I should consider before making a decision about undergoing septoplasty?

Reference

Authors: Kilavuz AE, Yildirim D, Serin GM, Kaytaz A. Journal: J Craniofac Surg. 2017 Oct;28(7):e634-e636. doi: 10.1097/SCS.0000000000003329. PMID: 28437265