Rhinology Online (Nov 2020)

A case of cavernous carotid aneurysm diagnosed when diplopia developed after endoscopic sinus surgery

  • Masayoshi Tei,
  • Eri Mori,
  • Hiromi Kojima,
  • Nobuyoshi Otori

DOI
https://doi.org/10.4193/RHINOL/20.076
Journal volume & issue
Vol. 3
pp. 178 – 183

Abstract

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Background: Visual complications of endoscopic sinus surgery usually occur during or immediately after the surgery. We report a case of cavernous carotid aneurysm which developed and gradually worsened after endoscopic sinus surgery was performed. Case presentation: A 63-year-old woman with chronic rhinosinusitis resistant to conservative treatment underwent endoscopic sinus surgery. Despite the surgery being successful and without complications, diplopia developed 2 weeks later. Intracranial imaging revealed a giant cavernous carotid aneurysm as a likely cause of the diplopia. The patient underwent endovascular stenting treatment, and the diplopia was consequently reduced. Conclusions: We experienced a rare case of cavernous carotid aneurysm which started to develop 2 weeks after endoscopic sinus surgery. Possible causes of the aneurysm in this patient are an indirect effect of surgery, such as perioperative hypertension, and bacterial sinusitis.

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