Unilateral Abducens Nerve Palsy Secondary to Isolated Fungal Sphenoidal Sinusitis

Abstract

Background: Fungal sinusitis of isolated sphenoid sinus is a rare entity. Most of the sufferers referred with complications since the primary manifestations are non-characteristic. Case presentation: We describe a 40-year old woman presenting with severe headache, diplopia, and limited right-eye movement. Further studies proposed isolated sphenoidal sinusitis, for which she underwent endoscopic sphenoidotomy. Microbiologic studies revealed extramucosal contamination with a saprophytic mucor. She enjoyed healthy life 5 weeks later. Conclusion: Prompt diagnosis and treatment of isolated sphenoidal sinusitis is of utmost importance since it has noncharacteristic manifestations. Noninvasive fungal sphenoidal sinusitis is best treated with sphenoidotomy. It seemed that abducens nerve palsy was associated with total sinus obstruction since patient condition improved promptly following the sphenoidotomy.