0:00

Sinusitis itself can have numerous orbital

0:04

complications, which actually I'll describe shortly.

0:09

But I do wanna mention a few of the potential

0:11

complications that can occur with respect to the

0:15

endoscopic sinus surgery.

0:17

So some things you have to look at on those post-op

0:20

scans include orbital hematomas, and they may occur

0:24

because of the presence of the small, anterior

0:28

and posterior ethmoidal arteries, which penetrate

0:32

from the sinus and enter the orbit or vice versa.

0:36

So in doing the sinus surgery, occasionally they will

0:40

injure the anterior-posterior ethmoidal artery that

0:44

artery then retracts into the orbit and continues

0:47

to bleed, and that can lead to an orbital hematoma.

0:51

So it's important to, uh, recognize for this

0:54

endoscopic sinus surgeon, the entries of

0:58

these anterior and posterior ethmoidal arteries,

1:00

which I'll show in a subsequent

1:02

case. I mentioned also the potential

1:05

injury to the optic nerve.

1:06

That's usually where there is a dehiscence

1:08

in the posterior ethmoid or sphenoid sinus.

1:11

That's another potential orbital complication.

1:15

Inflammation or hematoma can

1:18

occur in a subperiosteal location.

1:20

And, of course, you can have the complications post-op

1:24

where there's superimposed inflammation of the

1:27

orbit or the periorbital region

1:29

from the sinus infection spread.

1:31

So this is just one example of a patient where

1:34

you can see has had extensive surgery with the

1:37

middle turbinates, the uncinate process,

1:39

the ethmoids have been removed and what we see

1:42

are these orbital collections of air, which

1:46

are seen above the superior rectus muscle.

1:50

These are communicating with the frontal sinuses,

1:53

and this is a complication in the extra-conal

1:57

orbital region of fluid collections that can

2:00

occur secondary to the surgical procedure.