Unilateral hemiplegia: a unique complication of septoplasty

Background: Septoplasty is one of the most common otolaryngological operations. It is often dismissed as a simple procedure, despite the wide range of potential complications. We describe the first reported case of unilateral hemiplegia as a complication of septoplasty. Methods and results: A 51-year-old man presented with right hemiplegia following a septoplasty and turbinoplasty procedure carried out elsewhere. Cranial imaging showed a breakthrough fracture of the left sphenoid sinus anterior wall and clivus, with a haemorrhagic area in the left paramedian pons, which was responsible for the patient's right hemiplegia. Despite neurological and physiotherapeutic rehabilitation, the patient gained only partial recovery from his right hemiplegia. Conclusion: Good intra-operative visualisation and appropriate surgical technique are essential to prevent complications and achieve a functional nasal airway. The importance of the presented case to the pre-operative informed consent process is underlined.