Orbital Apex Syndrome: An Uncommon Complication caused by a Common Nasal Commensal

Main Article Content

Dr. Chandrakiran
Dr. Trupthi

Abstract

Introduction


Orbital apex syndrome, an uncommon condition seen in ENT practice, is characterised by multiple cranial neuropathies, presenting as visual loss, ophthalmoplegia, ptosis and hypoesthesia of forehead due to involvement of Cranial nerves III, IV, VI and V1.


Case Report


This is a case of an 80-year-old female patient, with poorly controlled Type 2 Diabetes mellitus and Hypertension, who presented with right sided headache of 10 days duration, drooping of right eyelid and decreased vision in right eye for 3 days. Clinically, there were features suggestive of right orbital apex syndrome. MRI Brain showed abnormal enhancement in right orbital apex with subtle enhancement of optic nerve in optic canal and intense enhancement of mucosal thickening in sphenoid sinus. Aerobic culture report of the purulent nasal discharge revealed Staphylococcus epidermidis.


Discussion


Aetiology of this condition is varied. Rarely known to occur following bacterial sinusitis, it is most commonly seen secondary to fungal sinusitis or orbital cellulitis involving orbital apex. Here we report an unusual case occurring secondary to Staphylococcus epidermidis sinusitis. In conclusion, although acute orbital apex syndrome is usually associated with invasive fungal sinusitis, clinicians must be aware that bacterial sinusitis may also present with a similar aggressive pattern.

Article Details

How to Cite
1.
C C, Uthappa T. Orbital Apex Syndrome: An Uncommon Complication caused by a Common Nasal Commensal. BJOHNS [Internet]. 2022Mar.18 [cited 2024Nov.5];29(3):306-9. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/556
Section
Case report
Author Biographies

Dr. Chandrakiran, M.S.Ramaiah Medical College

Professor and Head of the Department, Department of ENT, M.S.Ramaiah Medical College, Mathikere, Bangalore, Karnataka

Dr. Trupthi , M.S.Ramaiah Medical College

Junior Resident, Department of ENT, M.S.Ramaiah Medical College , Mathikere, Bangalore, Karnataka

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