Abstract
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 ima- ging 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.
Highlights
Nasal and paranasal diseases can have orbital complications and cause visual impairment owing to their adjacent locations
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
Summary
We have reported a case of intracranial aneurysm diagnosed when diplopia developed 2 weeks after ESS had been performed. Possible factors in the growth of the aneurysm were an indirect effect of surgery, perioperative or previously unnoticed hypertension, and bacterial sinusitis. Intracranial aneurysms are asymptomatic unless they cause a mass effect or rupture and are difficult to detect with non–contrast-enhanced CT. A thorough examination, including intracranial imaging, should be performed if diplopia develops after ESS
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