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A case of Pourfour du Petit syndrome following tumour surgery of the mandible
  1. D Mattes1,
  2. M Mayer1,
  3. M Feichtinger2,
  4. S Lindner1
  1. 1
    Department of Ophthalmology, Medical University Graz, Graz, Austria
  2. 2
    Department of Oral and Maxillofacial Surgery, Medical University Graz, Graz, Austria
  1. Dr D Mattes, Department of Ophthalmology, Medical University Graz, Auenbruggerplatz 4, 8036 Graz, Austria; di.mattes{at}

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A 15-year-old male patient was referred to our eye clinic due to a sudden postoperative anisocoria after removal of a myxofibroma on the right side of the mandible on the preceding day (fig 1B). This semimalignant aggressive odontogenic tumour is rarely life-threatening, but can cause local destruction. The operation had been performed without complications.

Figure 1 Pupillary widths during follow-up. (A) The differences in pupillary widths between right and left eye 10 days postoperatively were 2.5 mm in light and 1 mm in darkness. After a follow-up of 5 months, the difference was 2 mm in light and 0.5 mm in darkness. Right upper lid retraction decreased from 2 mm to 1 mm. (B) Preparation of the superior thyroid artery (arrow) during the operation: rest of the mandible (1), microvascular transplant from the iliac crest bone replacing the mandible (2), carotid artery (3) and neck (4). The upper cervical ganglion (not visible) is considered to be under the carotid artery.

On first ophthalmic examination, the patient exhibited a difference in pupillary widths, 2.5 mm in light and 1 mm in darkness (fig 1A). The position of the right upper lid was 2 mm higher than that of the left upper lid. Direct, consensual light reaction and the pupillary …

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  • Competing interests: None.

  • Patient consent: Obtained from the parents.