Death Related to Nasal Surgery

Abstract

The investigation of deaths that are suspected to be related to medical therapy present several challenges for the forensic pathologist. In all such cases, it is important for the pathologist to understand the therapy/procedure that may have played a role in death. As such, review of medical records and possible consultation with various medical specialists before autopsy can provide valuable information to ensure proper evaluation in any given case.Herein, we describe a rare death occurring as a complication of septoplasty, nasal polypectomy, and intranasal endoscopic ethmoidectomy, which are common surgical procedures performed by otolaryngology/head and neck surgeons. An otherwise healthy 58-year-old woman underwent the elective surgical procedures for a deviated nasal septum, multiple nasal polyps, and chronic ethmoid sinusitis. Following surgery, the patient never awoke from general anesthesia, and further evaluation before death revealed a basilar subarachnoid hemorrhage. Autopsy disclosed basilar subarachnoid hemorrhage, a traumatic defect of the right cribiform plate, and associated anterior cerebral artery injury with frontal lobe damage. No vascular anomalies were present. The cause of death was attributed to complications related to nasal surgery, and the manner of death was ruled "accident."Following the presentation of this case, the authors discuss these common nasal surgical procedures, including a summary of their known complications. In addition, the authors address and review the topic of deaths related to medical therapy.

A Case Report of Intracranial Complication Following Septorhinoplasty

“…Death related to nasal surgery is also rare. In India, Alexander et al (2008) reported that a healthy 58-year-old woman who underwent nasal polypectomy, septoplasty, and intranasal endoscopic ethmoidectomy died 2 days after surgery due to the following brain injuries: subarachnoid hemorrhage, intraventricular hemorrhage, and hydrocephalous, all related to damage of the cribriform plate (5) fered a ventricular hemorrhage and hydrocephalous due to a skull base injury after septoplasty, and died 1 month later (6). Here, we describe a very rare intracranial complication after septorhinoplasty, as awareness of these rare complications can help physicians in prevention, early detection, and appropriate treatment of life-threatening complications.…”