| Objective: To summarize and analyze the clinical characteristics and treatment of vision loss after endoscopic surgery of chronic sinusitis.Methods: A case of patient who developed binocular blindness after endoscopic sinus surgery admitted to the First Affiliated Hospital of Chongqing Medical University in February 2018 was retrospectively analyzed.The literatures on the vision loss after endoscopic surgery for chronic sinusitis were reviewed.The data including gender,side,anesthesia,residual vision,treatment plan and prognosis were sorted out and statistically analyzed.Results: The middle-aged female patient,who was diagnosed with chronic sinusitis and underwent endoscopic sinus surgery under general anesthesia in a local hospital,developed bilateral vison loss soon after the surgery.After treated with steroids,circulation improvement and other conservative treatment and optic nerve decompression surgery,her right eye vision slightly restored,left eye is still blind.Then we analyzed literatures.A total of 26 literatures with detailed data were included in thestudy.There were 41 cases and 45 eyes of patients with vision loss after endoscopic surgery of chronic sinusitis in total.Bilateral visual acuity decreased in 4 cases.Left side 15 cases,right side 21 cases,side unknown3 cases.The most common concomitant symptoms were exophthalmos(37.5%),ocular movement disorder(32.5%),eyelid edema and swelling(30%),periorbital ecchymosis(22.5%).The residual visual acuity after nasal endoscopic surgery is the risk factors to the visuaI prognosis(P <0.05),but the time of vision loss,the treatment plan and the time of reoperation are not risk factors to the visual prognosis(P > 0.05).Conclusion: Visual impairment or even blindness is a rare but extremely serious complication of surgery of chronic sinusitis and its prognosis is poor.For patients with vision loss after endoscopic sinus surgery,it is necessary to observe the changes and progress of the disease timely,identify the cause as soon as possible,and deal with the cause at an early stage.For patients with no obvious improvement after drug conservative treatment,early orbital decompression or optic nerve decompression can be performed to improve vision.Those with residual vision had better prognosis. |
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