Headset-Related Sensory and Motor Neuropathies in Image-Guided Sinus Surgery

Abstract

Complications related to the use of image-guided systems in sinus surgery are fortunately rare. We report a case series of 6 patients who experienced facial neuropathies (both sensory and motor) related to the use of a headset for electromagnetic-based image-guided surgery. The auriculotemporal nerve was the most common sensory nerve involved, and the buccal branch of the facial nerve was implicated in a case of motor weakness. The cause of the complication appears to be a pressure neuropathy caused by a tight-fitting headset against the external auditory meatus and temporomandibular joint. Additional risk factors for headset-related neuropathy may relate to body habitus, length of surgical procedure, and patient positioning. All patients' neuropathies resolved completely without intervention. Headset-related complications appear to be uncommon but may be an important consideration in counseling patients who are candidates for image-guided sinus surgery.

Image‐Guidance for Endoscopic Sinus Surgery

“…Fried et al 3 observed a reduced complication rate with the use of IGS in a retrospective series of 97 consecutive patients, but at the expense of predictably increased operative time and blood loss. Minor complications, such as transient facial neuropathies related to the use of registration headsets, were also reported 38 …”

Evaluation of the Framelock Reference‐Arc Fixation Device for Image‐Guided Surgery

“…The literature also reports that some patients have postoperative pain with friction fit devices. 5 The FF was tolerated very well by all patients. The rubber cups fit snugly, but resulted in no pressure injury to the skin or complaints of postoperative discomfort.…”

Electronically Linked

“…There are limitations, however, to this particular system. There are theoretical concerns of patient privacy, excessive daily noise exposure, 6 and headset‐related sensory and motor neuropathies caused by tight‐fitting headsets against the ear 7 . A recent study also reported recovery of bacteria from headset devices; another study reported external otitis after airline headset use 8,9 …”