Vol.100 No.11 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 11 November 2007
Acute Sphenoid Sinusitis Associated with
Abducens Nerve Palsy
Akiko Katoh, Narihisa Ueda, Teruo Shiomori,
Toyoaki Ohbuchi, Takeyuki Fujimura and Hideaki Suzuki
(University of Occupational and Environmental Health, School of Medicine)
Because the sphenoid sinus is adjacent to important structures including optic, oculomotor, trochlear, trigeminal, and abducens nerves, diseases of this sinus may cause related neurological disorders. We herein report a case of sphenoid sinusitis associated with abducens nerve palsy. A 66-year-old man with a 7-day history of diplopia was referred to our hospital. On physical examinations, he manifested left-sided abducens nerve palsy and nasal polyposis. Computed tomography and magnetic resonance imaging (MRI) demonstrated ethmoid-sphenoid sinusitis on the affected side. The patient underwent endoscopic sinus surgery on the day of examination followed by intravenous administration of hydrocortisone (200 mg/day for 3 days). Postoperative MRI showed a contrast-enhanced area in the left cavernous sinus, suggesting the presence of an inflammatory change. His postoperative clinical course was uneventful, and complete neurological recovery was obtained two and a half months after surgery. It is stressed that physicians should be aware of potential diseases of the sphenoid sinus during the diagnosis and management of such patients.
Key words : sphenoid sinusitis, abducens nerve palsy, cavernous sinus