Eye in Danger of ENT: Role of External Ethmoidectomy in Orbital Decompression due to Ethmoiditis

Abstract

Background: To high-light the role of External Ethmoidectomy in decompressing the orbit to relieve proptosis and prevent loss of vision due to any pathology extending from ethmoids into the orbit. Methods: Ten patients who presented in the OPD of Holy Family Hospital Rawalpindi with proptosis and change in vision of eye due to infective ethmoiditis were included in this study . Two(20%) had change in colour vision indicating that their vision was at stake . These two patients had emergency external ethmoidectomy performed to save the eye while the rest of the patients were electively prepared for this operation. All patients had pre operative CT scan of Nose , PNS , Orbit and Brain and all gave informed consent regarding the eye All underwent external ethmoidectomy operation via Lynch Howarth approach which not only addressed the Ethmoids but also the orbit and provided a direct deep in depth view of both the structures Results:. Colour vision, vision acuity all returned to normal in 100% patients within days. Proptosis also disappeared in all the patients. . There were no major post operative complications and the minor complications like external scar , lacrimation and anterior nasal discharge resolved completely Conclusion : Orbital complications due to ethmoiditis should be timely diagnosed to prevent blindness .They should be treated with such an approach which offers not only access and illumination to this area but also a good perception of depth in ethmoids and orbit to prevent complications like external scar, hemorrhage and blindness.

Keywords

• Ethmoidectomy,
• Orbital compression
• ethmoditis