# An Innovative Use of Point-of-Care Ultrasound for Identification and Management of a Rare and Uncommon Perioperative Complication: Periorbital Emphysema Following Sinus Surgery in a Pediatric Patient

## TL;DR

A rare case of periorbital emphysema after sinus surgery in a child was quickly diagnosed and managed using point-of-care ultrasound.

## Contribution

The paper highlights the innovative use of point-of-care ultrasound in diagnosing and managing a rare perioperative complication.

## Key findings

- Point-of-care ultrasound enabled prompt diagnosis of periorbital emphysema in a pediatric patient.
- Conservative management with regular eye exams was effective following the diagnosis.
- Vigilance during sinus surgery and perioperative imaging are emphasized to prevent sight-threatening complications.

## Abstract

Periorbital emphysema is a rare complication following functional endoscopic sinus surgery (FESS) with potential sight-threatening consequences. We present a case of an eight-year-old male who developed periorbital emphysema after FESS for allergic fungal sinusitis. Prompt diagnosis was made using point-of-care ultrasound (POCUS), facilitating timely intervention and conservative management. This case underscores the importance of perioperative imaging to identify lamina papyracea abnormalities, smooth extubation to prevent complications, and the innovative use of POCUS in diagnosing perioperative orbital emphysema and managing it conservatively while examining the eye at regular intervals. These findings highlight the significance of vigilance during FESS procedures and the utility of POCUS in diagnosing and managing rare perioperative complications.