Anterior ischemic optic neuropathy after unilateral radical neck dissection: Case report and review

Abstract

Background Blindness or visual deterioration after neck dissection is a known and a rare complication of the operation. Visual impairment usually occurs immediately after bilateral radical neck dissections either performed synchronously or in a stepwise manner, resulting in permanent blindness. Hypotension and blood loss during long operations, elevated venous pressure postoperatively result in optic neuropathies, which are anterior ischemic optic neuropathy (AION) or mostly posterior ischemic optic neuropathy (PION) affecting different portions of the nerve. Methods Review of literature and case report. Results To date there are only three cases of AION after neck dissection reported in the literature, with a different visual prognosis. Conclusion Vision loss may be reversible when both internal jugular veins are preserved, but permanent when any of them are resected. Here we present the first case of anterior ischemic optic neuropathy developed after unilateral radical neck dissection, resulting in partial visual deterioration.