Periorbital Ecchymosis and Subconjunctival Hemorrhage following Ear Surgery

Objective. To evaluate the occurrence of two periorbital complications of surgery for Chronic Suppurative Otitis Media (CSOM) and discuss the potential pathophysiologic mechanisms. Materials and Methods. This is a retrospective review of the CSOM surgeries performed between Oct, 2005, and Jan, 2011, in our hospital. The early postoperative conditions of the patients were scrutinized to identify periorbital ecchymosis and subconjunctival hemorrhage. Results. Eight cases out of 756 patients were noted to have periorbital ecchymosis, and two of the patients also had simultaneous subconjunctival hemorrhage. All cases in which the complications occurred had undergone tympanoplasty, and in three patients mastoidectomy had also been performed. The age of the affected patients ranged from 24 to 70 years old. In all of them the condition ensued the day after the surgery and became better within 5 to 10 days. Complete recovery took approximately 1 month. Conclusion. Periorbital ecchymosis and subconjunctival hemorrhage are rare but safe complications of ear surgeries. The conditions are self-limiting and no management is necessary. 1. Introduction Chronic Suppurative Otitis Media (CSOM) is a fairly common disease, and it is usually managed with surgery. In most otology wards the most common surgical procedures are those performed on patients with CSOM and, like any other medical intervention, complications can happen. These complications include those related to anesthesia, as well as otologic and intracranial complications. Problems related to the skin and wound healing such as infection, hematoma, and dehiscence are considered minor complications in CSOM surgeries. There have been various case reports on rare, out of the ordinary mishaps, in these surgeries. Here, we describe periorbital ecchymosis with or without subconjunctival hemorrhage as a rather rare complication of ear surgeries. Although a familiar condition in nose and sinus operations to the extent of our knowledge, periorbital problems in otologic surgeries were first brought up by Rudnick et al. who described 4 cases of periorbital edema and cellulitis in 97 patients with cochlear implants [1]. Herein, we discuss periorbital ecchymosis, which is a more complex condition compared to edema and/or erythema of the orbital area. 2. Materials and Methods This is a retrospective review of the occurrence of periorbital ecchymosis and/or subconjunctival hemorrhage as a complication following ear surgeries including tympanoplasty with or without mastoidectomy in our university hospital, which is a tertiary