Bilateral Otorrhagia Discovered at the Completion of a Robotic Bilateral Salpingo-Oophorectomy

Abstract

Background: Otorrhagia is an unusual occurrence in the operating room. This occurrence is usually associated with trauma to the ear or head, infection, foreign bodies, cancer, or (as reported in the literature) as a complication of a ruptured aneurysm. Only 5 cases have been reported in the literature to date in association with non-otolaryngology surgery. Case: A 64-year-old postmenopausal female developed bilateral otorrhagia, which was discovered at the completion of a robotically assisted bilateral salpingo-oophorectomy for bilateral complex ovarian cysts. This was discovered when this patient was taken out of the Trendelenburg position and dried blood coming from her ear canals was seen. Otolaryngology follow-up found the bleeding to be benign. Results: The patient recovered fully without any hearing deficits or other neurologic issues noted at her follow-up. Her incisions healed well, and she was happy to not have pelvic pain any longer. Conclusions: This is the sixth case reported in the literature of intraoperative otorrhagia and is the fourth reported case associated with deep Trendelenburg positioning. The current report highlights the possibility of this complication even in a short, straightforward, robotically assisted, bilateral salpingo-oophorectomy on a 64-year-old woman. It is important for laparoscopic and robotic surgeons to be aware of this rare but alarming complication so that they can treat the complication appropriately and counsel patients about it. (J GYNECOL SURG 32:70)