Death related to the septorhinoplasty procedure

Abstract.

A 23-year-old lady was referred to a plastic surgeon with complaints of asymmetrical nostrils and a nasal hump. Septorhinoplasty surgery was performed under local anesthesia. After osteotomy and at the end of the operation, she developed unusual bleeding from the site of the operation and her neurologic condition appeared to have worsened, as indicated by deep coma, bilateral pupillary mydriasis, and lack of reflexes. Computed tomography (CT) scan revealed the presence of air within the anterior cranial fossa, an irregular defect in the floor of the anterior cranial fossa, third and fourth ventricular hemorrhage, and subarachnoid hemorrhage in the posterior cranial fossa. Unfortunately, she died on the 7th day of intensive care unit (ICU) admission. Medicolegal autopsy revealed a 2×2 cm crushed region associated with hemorrhage around it in the orbital portion of the left frontal lobe. A fracture of the left cribriform plate of the ethmoid bone was also seen. The patient's death was therefore determined to have been caused by traumatic brain injury and its complications.