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면역 저하 환자에서 발생한 접형동 진균성 부비동염에 의한 안와 첨부 증후군 1예

A Case of Orbital Apex Syndrome Secondary to Sphenoid Fungal Sinusitis in an Immune Compromised Patient

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주제분류이비인후과학

초록

Orbital apex syndrome (OAS) is a very rare syndrome caused by damage to the superior orbital fissure and optic canal. This syndrome is characterized by loss of vision, extraocular muscle paralysis, blepharoptosis, and hypoesthesia of the forehead due to damage to the optic nerve, pupillary nerve, trochlear nerve, abducens nerve, and trigeminal nerve branches. Various causes have been reported, including bacterial, viral and fungal infections, inflammation due to immunosuppressed conditions, tumors, and trauma. The authors report a case of OAS, which occurred as a complication of chronic invasive fungal infection with fungal ball of the isolated sphenoid sinus in an immunocompromised patient with multiple myeloma and diabetes, with a literature review.

Abstract

Orbital apex syndrome (OAS) is a very rare syndrome caused by damage to the superior orbital fissure and optic canal. This syndrome is characterized by loss of vision, extraocular muscle paralysis, blepharoptosis, and hypoesthesia of the forehead due to damage to the optic nerve, pupillary nerve, trochlear nerve, abducens nerve, and trigeminal nerve branches. Various causes have been reported, including bacterial, viral and fungal infections, inflammation due to immunosuppressed conditions, tumors, and trauma. The authors report a case of OAS, which occurred as a complication of chronic invasive fungal infection with fungal ball of the isolated sphenoid sinus in an immunocompromised patient with multiple myeloma and diabetes, with a literature review.

참고문헌 (10)

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  3. Badakere A, "Orbital apex syndrome : a review", Eye Brain, 11, pp.63~72 (2019)
  4. Keane JR, "Cavernous sinus syndrome : analysis of 151cases", Arch Neurol, 53(10), pp.967~971 (1996)
  5. Holt GR, "Infectious diseases of the sphenoid sinus", Laryngoscope, 94(3), pp.330~335 (1984)
  6. Jiang N, "A retrospective analysis of eleven cases of invasive rhino-orbito-cerebral mucormycosis presented with orbital apex syndrome initially", BMC Ophthalmol, 16, pp.10~ (2016)
  7. deShazo RD, "Fungal sinusitis", N Engl J Med, 337(4), pp.254~259 (1997)
  8. Foroozan R, "Transsphenoidal diplopia", Surv Ophthalmol, 49(3), pp.349~358 (2004)
  9. Baumann A, "Invasive sphenoidal aspergillosis : successful treatment with sphenoidotomy and voriconazole", ORL J Otorhinolaryngol Relat Spec, 69(2), pp.121~126 (2007)
  10. 이정훈, "시신경 손상을 초래한 국소 침습성 진균성 부비동염 1예", 임상이비인후과, 23(2), pp.270~273 (2012), 대한이비인후과학회 부산,울산,경남 지부회[DOI]

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