PRACTICA OTO-RHINO-LARYNGOLOGICA

Vol. 100  No. March  2007


Mycosis of the Sphenoid Sinus with Oculomotor Paralysis: 
A case report

Miwa Kitamura, Hideyuki Murata and Koichi Tomoda
(Kanazawa Medical University)

      

  An 80-year-old male consulted the Department of Ophthalmology for headache, left blepharoptosis, and diplopia, and was diagnosed with left oculomotor paralysis. Neurological examinations revealed no abnormalities. A shadow was detected in the sphenoid sinus, and the patient was referred to the Department of Otorhinolaryngology. CT revealed a shadow in which the inner area was not uniform, without bone destruction, in the left sphenoid sinus. Under a tentative diagnosis of sphenoiditis-related oculomotor paralysis, endoscopic sphenoidectomy was performed. The sphenoid sinus was occupied by a fungal mass, suggesting fungal sphenoiditis. In the sinus, there was no bone defect. After surgery, conservative therapy such as steroid therapy and follow-up were continued. After 2 months, oculomotor paralysis subsided. Aspergillus was detected in the fungal mass. We reviewed the literature regarding the pathogenesis of peripheral cranial paralysis related to noninvasive mycosis of the sphenoid sinus.


Key words : sphenoid sinus, oculomotor paralysis, noninvasive mycosis


第100巻3号 目次   Vol.100 No.3 contents