Annals of Otolaryngology Head and Neck Surgery (ISSN 2835-7132) | Volume 2, Issue 3 | Case Report | Open Access

Orbital Compartment Syndrome and Unilateral Amaurosis After Spine Surgery in A Patient with Polyostotic Fibrous Dysplasia

Giorgio Fabiani^*

Department of Neurology, Internal Medicine, Federal University of Paraná, Brazil

^*Correspondence to: Giorgio Fabiani 

Abstract

Polyostotic Fibrous dysplasia is a bone disorder showing intramedullary lesions. Orbital compartment syndrome is an uncommon complication of polyostotic Fibrous dysplasia. Patients typically present with acute visual impairment. We describe an 11-year-old male with polyostotic Fibrous dysplasia that developed periorbital bruising and amaurosis affecting the left eye after thoracolumbar arthrodesis. The fundoscopy showed optic disc oedema, a "cherry red" macula and pallor in the posterior pole of the retina. The patient was diagnosed with nonarteritic anterior ischemic optic neuropathy (NAION) and central retinal arterial occlusion (CRAO). The Brain CT delineated the morphological osseous changes of bone, and the MRI demonstrated that the optic nerve was thickened. Polyostotic Fibrous dysplasia can lead to orbital compartment syndrome, especially in a prone position. The long duration of the surgery, the prone position and the pre-existing pathology in this patient were decisive in the disastrous outcome. We suggest intraoperative eye pressure monitoring with decompression before 100 minutes in patients with polyostotic Fibrous dysplasia.

Keywords:

Polyostotic fibrous dysplasia; Acute visual impairment; Orbital compartment syndrome; Spine surgery and non-arteritic anterior ischemic optic neuropathy

Citation:

Giorgio Fabiani, Mario Teruo Sato.Orbital Compartment Syndrome and Unilateral Amaurosis After Spine Surgery in A Patient with Polyostotic Fibrous Dysplasia. Annal of Otol Head and Neck Surg. 2023;2(3):1-4.