Avoiding blindness in managing epistaxis for a child with Duane's Retraction Syndrome

Navid Ahmadi; June Huang; Hannah Jd North; David Lord; Alan T Cheng

doi:10.1016/j.ijporl.2019.109615

Avoiding blindness in managing epistaxis for a child with Duane's Retraction Syndrome

Int J Pediatr Otorhinolaryngol. 2019 Nov:126:109615. doi: 10.1016/j.ijporl.2019.109615. Epub 2019 Jul 29.

Authors

Navid Ahmadi¹, June Huang², Hannah Jd North², David Lord³, Alan T Cheng⁴

Affiliations

¹ Department of Pediatric ENT, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia. Electronic address: [email protected].
² Department of Pediatric ENT, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
³ Pediatric Interventional Radiology, Division of Medical Imaging, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
⁴ Department of Pediatric ENT, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.

PMID: 31416016
DOI: 10.1016/j.ijporl.2019.109615

Abstract

Duane's Retraction Syndrome (DRS), a congenital cranial dysinnervation disorder, accounts for 5% of all strabismus. A vascular anomaly in DRS, which became clinically relevant in the context of significant epistaxis, is presented. A 15-year-old girl with DRS underwent a rhinological procedure for traumatic nasal deformity and suffered large volume epistaxis. Using angiography, an anatomical variation was identified, noting the ophthalmic artery was supplied by branches from the sphenopalatine artery, facial artery, and middle meningeal artery; not from the internal carotid artery. Hence epistaxis control was achieved via alternative methods, and unilateral blindness was avoided.

Keywords: Duane; Embolization; Epistaxis; Haemorrhage; Ophthalmic artery; Sphenopalatine artery ligation.

MeSH terms

Adolescent
Angiography
Blindness / prevention & control*
Carotid Artery, Internal / diagnostic imaging
Duane Retraction Syndrome / complications*
Embolization, Therapeutic / methods*
Epistaxis / etiology
Epistaxis / therapy*
Female
Humans
Nasal Obstruction / complications
Nasal Obstruction / surgery*
Ophthalmic Artery / abnormalities*
Ophthalmic Artery / diagnostic imaging
Postoperative Cognitive Complications / therapy*
Rhinoplasty / adverse effects
Strabismus / etiology