Posters

Bilateral orbital apex syndrome resulting from pansinusitis: a case report

Poster Details

First Author: I.Messafi MOROCCO

Co Author(s): H. Boutahar   A. El Mekkaoui   M. Salhi   S. Chariba   R. Sekhsoukh        

Abstract Details

Purpose:

Orbital apex syndrome (OAS) is a complex anatomo-clinical entity, resulting from the involvement of several cranial nerves (oculomotor, ophthalmic and optic nerve). This is an unusual presentation, a consequence of a infiltration of the orbital apex by a process (inflammatory, infectious ... etc) Early diagnosis and treatment are essential for preservation visual function.

Setting:

Mohammed VI University Hospital , Oujda , Morocco

Methods:

We report the particular case of a patient admitted for complicated pansinusitis with bilateral Orbital Apex Syndrome and superior sagittal sinus Thrombophlebitis.

Results:

62-year-old patient, having a history of a recent self-medication by NSAIDs, admitted for chronic resistant headache, painless and rapidly progressive visual acuity decreasing. In right eye: a visual acuity limited to fingers counting, slight chemosis, limited ocular motility in lateral, spuerior and inferior. In the left eye : exophthalmia,ptosis,important chemosis and no light perception, complete ophthalmoplegia and Relative Afferent Pupillary Defect .Radiology exams had revealed bilateral pansinusitis with infiltration of  of orbits and extra-conical fat and mass effect on the optic nerves, a thrombophlebitis of the superior sagittal sinus. The treatment: antibiotic therapy,anticoagulation, and drainage.The death occured after two days.

Conclusions:

The orbital apex syndrome remains an uncommon and blinding entity. The case of our patient has the specifity of associating a pansinusitis with a bilateral orbital apex syndrome with complete ophthalmoplegia without signs of intra-conical infection and atypical localisation of thrombosis concerning the superior sagittal sinus. The use of NSAIDs is principal factor that explains the speed of the of vision decreasing and the occurrence of death.

Financial Disclosure:

None