J Korean Ophthalmol Soc > Volume 60(12); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(12):1295-1300.
DOI: https://doi.org/10.3341/jkos.2019.60.12.1295    Published online December 15, 2019.
Loss of Reflex Tearing after Maxillary Orthognathic Surgery Case Report and Literature Review.
So Ra Bang, Tae Eun Lee, In Cheon You, Nam Chun Cho, Min Ahn
1Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea. ahnmin@jbnu.ac.kr
2Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.
3Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.
양악수술 후 발생한 반사적 눈물분비의 소실 증례 보고 및 문헌 고찰
방소라1 · 이태은1,2,3 · 유인천1,2,3 · 조남천1,2,3 · 안 민1,2,3
전북대학교 의학전문대학원 안과학교실1, 전북대학교 임상의학연구소2, 전북대학교병원 의생명연구원3
Correspondence:  Min Ahn,
Email: ahnmin@jbnu.ac.kr
Received: 25 April 2019   • Revised: 17 June 2019   • Accepted: 6 December 2019
Abstract
PURPOSE
To report a case of unilateral loss of reflex tearing after double-jaw surgery with anatomy and mechanism. CASE SUMMARY: A 32-year-old woman complained of a 3-year history of loss of tearing in her left eye. She had undergone double-jaw surgery 3 years prior to correct her malocclusion. In orbital computed tomography (CT) images, there were no specific findings, with the exception of a fractured left pterygoid plate, possibly caused by the double-jaw surgery. The tear break-up times of both eyes were similar, with non-specific findings on slit lamp examination. We diagnosed loss of reflex tearing due to pterygopalatine ganglion injury based on her history, physical examination and orbital CT findings. CONCLUSIONS: Nerve damage due to artificial fracture may occur during double-jaw surgery and may result in loss of reflex tearing, thus, pre-operative evaluation of basic lacrimal secretion and a reflex tearing test are important. Once the loss of reflex tearing due to nerve injury occurrs, orbital CT scans are needed for diagnosis. Ophthalmologist examination is necessary to confirm the mechanism of loss of reflex tearing and changes in the anatomical structure.
Key Words: Absent reflex;Orthognathic surgery;Postoperative complication;Pterygopalatine fossa


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