Abducens nerve palsy on a patient with sphenoid fungal rhinosinusitis and cavernous sinus meningioma – Case report

Abstract

We report a case of a 47-year-old patient recently diagnosed with left abducens nerve palsy, who was admitted in our clinic with diplopia. The cranio-facial CT scan revealed left sphenoid fungal rhinosinusitis and the patient underwent endoscopic surgery with complete removal of the fungal material. The immediate postoperative evolution of the patient was favourable, with partial improvement of diplopia. The first month follow-up visit revealed the recurrence of the diplopia, so the patient performed an MRI scan of the brain that showed a cavernous sinus meningioma. The patient was referred to a neurosurgeon who choose a "wait-and-see" strategy instead of surgery. The paper presents the limits of computed tomography versus magnetic resonance imaging in the radiologic diagnosis of intracranial tumors.

Sinonasal non-intestinal-type adenocarcinoma with isolate lagophthalmos and abducens nerve palsy: Case report

“…The sixth nerve palsy is commonly caused by tumors located close to the nerve, such as tumors in the cavernous sinus. The nerve compression can be caused directly by the tumor or indirectly by the peritumoral edema 13 . Although in our case we did not find definite imaging evidence for the invasion of the cavernous sinus, the peritumoral edema in the left lateral wall of the sphenoid could be responsible for the abducens nerve palsy.…”