Pupil size and reaction during functional endoscopic sinus surgery (FESS)

This aim of this study was to evaluate the size and light reflex of the pupils during endoscopic sinus surgery (FESS). Pupil size and light reflexes were recorded prospectively in 20 patients undergoing FESS under general anaesthesia. Nasal mucosal vasoconstriction was induced by Moffett's solution. A control group of 20 patients underwent other standard ENT operations under general anaesthesia. Myosis occurred in all 40 patients after induction of general anaesthesia. During surgery, the light reflex was negative for all 40 patients. However, the light reflex became positive in 22 patients within 5 min of surgery, and in all patients after 20 min. Monitoring pupillary size and reflexes during FESS as a means of assessing trauma to the orbital structures is difficult because of the presence of myosis induced by anaesthetic agents. Moffett's solution did not have a mydriatic effect from the systemic absorption of cocaine during the operative period.