Lateral Rectus Palsy Associated with Isolated Sphenoid Sinus Fungal Lesion

Lateral Rectus Palsy Associated with Isolated Sphenoid Sinus Fungal Lesion

Fungal sinusitis of isolated sphenoid sinus is a rare entity. Most of the sufferers referred with complications since the primary manifestations are non-characteristic. Occasionally the patients present with ophthalmic signs and symptoms most commonly proptosis and diplopia. We describe a sixty year old woman presenting with headache and diplopia. On examination there was right lateral rectus palsy and further studies revealed isolated right sphenoidal sinusitis, for which she underwent endoscopic sphenoidotomy. Histopathology revealed Aspergillus species. All the symptoms completely resolved one month post-surgery and the patient has been symptom free till date. Hence a prompt diagnosis and treatment of isolated sphenoidal sinusitis is of utmost importance since it has non characteristic manifestations. Non-invasive fungal sinusitis is best treated with sphenoidotomy. Abducens nerve palsy could be implicated to sphenoid fungal sinusitis since the patient condition improved promptly following sphenoidotomy.