Abstract:ObjectiveTo investigate the treatment and prevention of intraorbital complications caused by anterior ethmoidal artery (AEA) injury endoscopic sinus surgery (ESS).MethodsThe clinical characteristics, treatment and prognosis of 2 case of intraorbital complications caused by AEA injury in ESS were analyzed retrospectively. The highrisk factors and preventive measures of AEA injury in ESS were summarized with review of literatures.ResultsPostoperative increased intraorbital pressure, chemosis and impaired vision occurred in both patients. All the symptoms were considered to be caused by intraorbital hematoma due to intraoperative injury of the AEA. After timely orbital decompression and AEA electrocoagulation, vision of one patient gradually returned to normal, while that of the other patient could not be effectively restored.ConclusionsCareful evaluation of computerized tomography (CT) imagines is recommended before ESS. For patients with high freeness of AEA, or with destroyed bone and wrapping AEA by tumor, cautious identification of AEA is required intraoperatively to avoid AEA injury. In case of intraoperative arterial injury, timely hemostasis should be performed. The possibility of intraorbital hematoma caused by AEA injury should be considered in patients with postoperative increase of orbital pressure and dramatic decrease of visual acuity, and orbital decompression as well as electrocoagulation of the AEA should be performed timely.
