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Unilateral isolated sphenoid sinusitis with contralateral abducens nerve palsy - A rare complication treated in a low-resource setting.

Siu J, Sharma S, Sowerby L - J Otolaryngol Head Neck Surg (2015)

Bottom Line: Unilateral isolated sphenoid sinus disease (ISSD) is a rare diagnosis of the paranasal sinuses that can be associated with complications involving vascular, neurologic, and optic structures in close proximity.A 62 year old female presented to a hospital in Georgetown, Guyana with right lateral rectus palsy, diplopia, and a severe progressively worsening headache.The patient's headache resolved immediately after surgery while the diplopia and lateral rectus palsy resolved completely after 6 weeks.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, Queen's University, Kingston, ON, Canada. jsiu@qmed.ca.

ABSTRACT

Background: Unilateral isolated sphenoid sinus disease (ISSD) is a rare diagnosis of the paranasal sinuses that can be associated with complications involving vascular, neurologic, and optic structures in close proximity.

Case presentation: A 62 year old female presented to a hospital in Georgetown, Guyana with right lateral rectus palsy, diplopia, and a severe progressively worsening headache. CT scan revealed an opaque left sphenoid sinus consistent with unilateral ISSD. A transnasal sphenoidotomy was performed without complication under local anesthetic in the absence of endoscopic guidance. The patient's headache resolved immediately after surgery while the diplopia and lateral rectus palsy resolved completely after 6 weeks.

Conclusion: We present a rare complication of ISSD and highlight challenges associated with diagnosis and management of ISSD in a resource-limited setting. This is the second reported case of unilateral ISSD with contralateral lateral rectus palsy in the literature.

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Related in: MedlinePlus

Examination of extraocular movements. Above: Right lateral rectus palsy prior to sphenoidotomy. Below: Full recovery of abduction in right eye 6 weeks following sphenoidotomy.
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Fig2: Examination of extraocular movements. Above: Right lateral rectus palsy prior to sphenoidotomy. Below: Full recovery of abduction in right eye 6 weeks following sphenoidotomy.

Mentions: At the 6 week follow-up appointment, the patient was asymptomatic with complete resolution of the lateral rectus palsy, headache, and diplopia (Figure 2). No disease sequelae were detected at the subsequent 6 month follow up visit.Figure 2


Unilateral isolated sphenoid sinusitis with contralateral abducens nerve palsy - A rare complication treated in a low-resource setting.

Siu J, Sharma S, Sowerby L - J Otolaryngol Head Neck Surg (2015)

Examination of extraocular movements. Above: Right lateral rectus palsy prior to sphenoidotomy. Below: Full recovery of abduction in right eye 6 weeks following sphenoidotomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4359434&req=5

Fig2: Examination of extraocular movements. Above: Right lateral rectus palsy prior to sphenoidotomy. Below: Full recovery of abduction in right eye 6 weeks following sphenoidotomy.
Mentions: At the 6 week follow-up appointment, the patient was asymptomatic with complete resolution of the lateral rectus palsy, headache, and diplopia (Figure 2). No disease sequelae were detected at the subsequent 6 month follow up visit.Figure 2

Bottom Line: Unilateral isolated sphenoid sinus disease (ISSD) is a rare diagnosis of the paranasal sinuses that can be associated with complications involving vascular, neurologic, and optic structures in close proximity.A 62 year old female presented to a hospital in Georgetown, Guyana with right lateral rectus palsy, diplopia, and a severe progressively worsening headache.The patient's headache resolved immediately after surgery while the diplopia and lateral rectus palsy resolved completely after 6 weeks.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, Queen's University, Kingston, ON, Canada. jsiu@qmed.ca.

ABSTRACT

Background: Unilateral isolated sphenoid sinus disease (ISSD) is a rare diagnosis of the paranasal sinuses that can be associated with complications involving vascular, neurologic, and optic structures in close proximity.

Case presentation: A 62 year old female presented to a hospital in Georgetown, Guyana with right lateral rectus palsy, diplopia, and a severe progressively worsening headache. CT scan revealed an opaque left sphenoid sinus consistent with unilateral ISSD. A transnasal sphenoidotomy was performed without complication under local anesthetic in the absence of endoscopic guidance. The patient's headache resolved immediately after surgery while the diplopia and lateral rectus palsy resolved completely after 6 weeks.

Conclusion: We present a rare complication of ISSD and highlight challenges associated with diagnosis and management of ISSD in a resource-limited setting. This is the second reported case of unilateral ISSD with contralateral lateral rectus palsy in the literature.

Show MeSH
Related in: MedlinePlus