Blindness after bilateral radical neck dissection is a rare complication. A recent patient, who suffered total blindness after simultaneous bilateral radical neck dissection, is the fifth case reported. It is, however, the first with pathological study of the optic tracts. Detailed microscopic examination revealed bilateral intraorbital hemorrhagic optic nerve infarction without evidence of embolization or ophthalmic artery occlusion. The probable etiology of this event is an episode of prolonged hypotension. An additional etiologic factor may be increased resistance to blood flow caused by venous hypertension, resulting from bilateral internal jugular vein ligation. HEAD & NECK 12:342-345, 1990
Bilateral radical neck dissection has been a controversial procedure throughout the history of head and neck surgery. In the past, fears of sudden elevations of intracranial pressure with catastrophic outcome discouraged this procedure. In the period from 1900 to 1910, 6 cases of bilateral jugular vein ligation without full neck dissection were reported, with mortality in 3.l The first successful simultaneous bilateral radical neck dissection was not reported until 194&i 2 This pa-From the