Bilateral Mydriasis in a Post-parotidectomy Patient: A Case Report

Abstract

Anticholinergic agents, such as atropine and glycopyrrolate, are commonly utilized during anesthesia for their effects on secretion reduction and vagal activity. However, substantial dosages can induce mydriasis, which poses diagnostic challenges, particularly in head and neck surgeries. Despite their clinical relevance, limited studies explore these effects. A 35-year-old female presented with a left parotid mass and scheduled for a left superficial parotidectomy. Preoperatively, the patient exhibited normal ocular and neurological function. Postoperatively, fine bilateral ptosis, predominantly on the left side, and bilateral unresponsive mydriasis were noted. Anticholinergic-induced pupillary changes may mimic neurological pathology, underscoring the necessity for meticulous postoperative evaluation and awareness among clinicians.

Keywords: Case report, General anesthesia, Myasthenia gravis, Mydriasis