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Peter H. Hwang, MD; Mendy Maccabee, MD; John A. Lindgren, MD

Arch Otolaryngol Head Neck Surg. 2002;128:589-591.

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.

From the Department of Otolaryngology–Head & Neck Surgery, Oregon Health & Science University, Portland (Drs Hwang and Maccabee). Dr Lindgren is in private practice in Portand, Ore.