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<p>Isolated Sphenoid Sinusitis (ISS) has a very low incidence rate of 1–2% among rhinosinusitis patients. This report describes a case of ISS with intracranial complications in the form of cavernous sinus thrombosis and bilateral 6th cranial nerve palsy. The patient presented with headache and blurring of vision along with bilateral retro-orbital pain. Clinical examination revealed bilateral exophthalmos, marked reduction in visual acuity, esotropia and lateral rectus palsy. The patient was evaluated with diagnostic nasal endoscopy (no specific findings) and radiological imaging (bilateral sphenoid sinusitis, erosion of left sinus roof, cavernous sinus thrombosis). Bilateral endoscopic sphenoidotomy was performed, histopathological examination of sinus content suggested mucormycosis, hence the patient was started on intravenous Amphotericin B. Following treatment, there was resolution of headache and esotropia with modest improvement in visual acuity. ISS is a rare condition with potentially life-threatening complications. A high degree of clinical suspicion, prompt diagnostic workup and aggressive surgical and medical management is required for optimal outcomes in such cases.</p>

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“A Rare Double Threat” Isolated Sphenoid Sinusitis Leading to Cavernous Sinus Thrombosis and Bilateral Lateral Rectus Palsy : A Case Report

  • 期刊论文

  • 发表日期：

    2026年2月2日

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  • R. Santhana Lakshmi,
  • Deeptabha Misra,
  • Nishitha Vaddi,
  • Dantuluri Chihnita Madhuri

摘要

Isolated Sphenoid Sinusitis (ISS) has a very low incidence rate of 1–2% among rhinosinusitis patients. This report describes a case of ISS with intracranial complications in the form of cavernous sinus thrombosis and bilateral 6th cranial nerve palsy. The patient presented with headache and blurring of vision along with bilateral retro-orbital pain. Clinical examination revealed bilateral exophthalmos, marked reduction in visual acuity, esotropia and lateral rectus palsy. The patient was evaluated with diagnostic nasal endoscopy (no specific findings) and radiological imaging (bilateral sphenoid sinusitis, erosion of left sinus roof, cavernous sinus thrombosis). Bilateral endoscopic sphenoidotomy was performed, histopathological examination of sinus content suggested mucormycosis, hence the patient was started on intravenous Amphotericin B. Following treatment, there was resolution of headache and esotropia with modest improvement in visual acuity. ISS is a rare condition with potentially life-threatening complications. A high degree of clinical suspicion, prompt diagnostic workup and aggressive surgical and medical management is required for optimal outcomes in such cases.