Abducens Nerve Neuropraxia due to Acute Bacterial Rhinosinusitis: Case Report and Literature Review

Background. Acute bacterial rhinosinusitis (ABRS) is a common infection of the paranasal sinuses that can lead to complications such as orbital and intracranial extension. The abducens nerve course is adjacent to the sphenoid sinus. Diplopia is rarely the initial presentation of sphenoid sinus patho...

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Main Authors: Abdulrahman Alghulikah, Sarah Alseneidi, Hedayah Alsaady, Ahmed Alhussien, Surayie Al-Dousary, Saud Alromaih, Abdulrahman AlHumaizi
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Case Reports in Otolaryngology
Online Access:http://dx.doi.org/10.1155/2023/5175871
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author Abdulrahman Alghulikah
Sarah Alseneidi
Hedayah Alsaady
Ahmed Alhussien
Surayie Al-Dousary
Saud Alromaih
Abdulrahman AlHumaizi
author_facet Abdulrahman Alghulikah
Sarah Alseneidi
Hedayah Alsaady
Ahmed Alhussien
Surayie Al-Dousary
Saud Alromaih
Abdulrahman AlHumaizi
author_sort Abdulrahman Alghulikah
collection DOAJ
description Background. Acute bacterial rhinosinusitis (ABRS) is a common infection of the paranasal sinuses that can lead to complications such as orbital and intracranial extension. The abducens nerve course is adjacent to the sphenoid sinus. Diplopia is rarely the initial presentation of sphenoid sinus pathology. In this article, we present the case of a middle-aged male who presented with diplopia and abducens nerve palsy secondary to ABRS, and we conducted a literature review in search of similar cases. Case Presentation. A 52-year-old male presented with diplopia secondary to ABRS. Imaging revealed the complete opacification of the bilateral sphenoid and frontal sinuses, with the extension of the inflammatory process to the optic nerve and cavernous sinus. The patient underwent a surgical intervention, which revealed a pyocele collection in the opticocarotid recess inside the sphenoid sinuses. After the surgery, the patient received antibiotics and reported a complete recovery. Conclusions. Acute bacterial rhinosinusitis can present with atypical symptoms and lead to serious complications, such as abducens nerve palsy. Early diagnosis, appropriate management, and timely referral to a multidisciplinary team are crucial to preventing residual nerve damage and ensuring favorable outcomes.
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spelling doaj-art-1ebd289aaea2407f84ed8a06cd79a6d12025-08-20T02:03:47ZengWileyCase Reports in Otolaryngology2090-67732023-01-01202310.1155/2023/5175871Abducens Nerve Neuropraxia due to Acute Bacterial Rhinosinusitis: Case Report and Literature ReviewAbdulrahman Alghulikah0Sarah Alseneidi1Hedayah Alsaady2Ahmed Alhussien3Surayie Al-Dousary4Saud Alromaih5Abdulrahman AlHumaizi6Otolaryngology–Head and Neck Surgery UnitChildren’s HospitalDepartment of SurgeryOtolaryngology–Head and Neck Surgery DepartmentOtolaryngology–Head and Neck Surgery DepartmentOtolaryngology–Head and Neck Surgery DepartmentDepartment of Otolaryngology–Head and Neck SurgeryBackground. Acute bacterial rhinosinusitis (ABRS) is a common infection of the paranasal sinuses that can lead to complications such as orbital and intracranial extension. The abducens nerve course is adjacent to the sphenoid sinus. Diplopia is rarely the initial presentation of sphenoid sinus pathology. In this article, we present the case of a middle-aged male who presented with diplopia and abducens nerve palsy secondary to ABRS, and we conducted a literature review in search of similar cases. Case Presentation. A 52-year-old male presented with diplopia secondary to ABRS. Imaging revealed the complete opacification of the bilateral sphenoid and frontal sinuses, with the extension of the inflammatory process to the optic nerve and cavernous sinus. The patient underwent a surgical intervention, which revealed a pyocele collection in the opticocarotid recess inside the sphenoid sinuses. After the surgery, the patient received antibiotics and reported a complete recovery. Conclusions. Acute bacterial rhinosinusitis can present with atypical symptoms and lead to serious complications, such as abducens nerve palsy. Early diagnosis, appropriate management, and timely referral to a multidisciplinary team are crucial to preventing residual nerve damage and ensuring favorable outcomes.http://dx.doi.org/10.1155/2023/5175871
spellingShingle Abdulrahman Alghulikah
Sarah Alseneidi
Hedayah Alsaady
Ahmed Alhussien
Surayie Al-Dousary
Saud Alromaih
Abdulrahman AlHumaizi
Abducens Nerve Neuropraxia due to Acute Bacterial Rhinosinusitis: Case Report and Literature Review
Case Reports in Otolaryngology
title Abducens Nerve Neuropraxia due to Acute Bacterial Rhinosinusitis: Case Report and Literature Review
title_full Abducens Nerve Neuropraxia due to Acute Bacterial Rhinosinusitis: Case Report and Literature Review
title_fullStr Abducens Nerve Neuropraxia due to Acute Bacterial Rhinosinusitis: Case Report and Literature Review
title_full_unstemmed Abducens Nerve Neuropraxia due to Acute Bacterial Rhinosinusitis: Case Report and Literature Review
title_short Abducens Nerve Neuropraxia due to Acute Bacterial Rhinosinusitis: Case Report and Literature Review
title_sort abducens nerve neuropraxia due to acute bacterial rhinosinusitis case report and literature review
url http://dx.doi.org/10.1155/2023/5175871
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