Temporäre Amaurose bei mikrochirurgischer endonasaler Ethmoid- und Saccus-Iacrimalis-Operation in Lokalanästhesie*

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Abstract
After injection of 1-2 cc Scandicaine and Suprarenin into the ethmoidalis vessels a female patient developed protrusio bulbi combined with amaurosis. After endonasal lacrimal sac operation with decompression of the orbita the protrusio bulbi disappeared without change in the amaurosis. Under the operating microscope no hematoma was found in the ethmoid or in the orbita; 35-40 min after an injection for blockage of the ganglion stellatum, the patient could discern light and subsequently recovered normal vision. Lacrimal sac operations (96) and 225 endonasal microsurgical ethmoid resections were performed. After more than 8000 ethmoid surgical procedures, a similar complication was observed in only 1936 cases. No persistent amaurosis was noticed. As amaurosis is extremely rare statistically with endonasal microsurgical ethmoid resections under reduction of blood pressure, there is no reason why the patient should be informed preoperatively about this rare complication.

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