S276 – Nasal Sinus Diseases Demonstrating Ophthalmologic Symptoms

Abstract

Objectives This study reviewed the clinical features of paranasal sinus diseases demonstrating ophthalmologic manifestations. Methods Between April 1995 and December 2007, we performed endoscopic sinus surgery (ESS) in 106 patients with paranasal sinus diseases presenting with ophthalmologic symptoms. There were 57 men and 49 women, aged 56.4 years (10 − 86 years). Diagnosis was based on the pre- and intraoperative findings. Patients with symptoms due to tumors were excluded from this study. Results Of 106 patients, loss of visual acuity was most frequently observed in 40 patients (37.7%). Other symptoms were eyelid swelling (28.3%), diplopia (18.9%), constriction of the visual field (13.2%), exophthalmos (13.2%), ocular pain (12.3%), external ophthalmoplegia (3.8%), and epiphora (1.9%). The symptoms involved in paranasal sinus cysts were found in 67 patients (63.2%), those in bacterial sinusitis in 36 patients (34.0%), those in fungal sinusitis in 2 patients, and those in Wegener's granulomatosis in 1 patient. The 38 patients (35.8%) were diagnosed as rhinogenic optic neuropathy, and most of them (32/38 patients, 78.9%) initially referred to ophthalmologists. Major lesions were observed in anterior and posterior ethmoid sinus (40 patients, 37.7%). For the treatment, external approaches were required in 11 patients (10.4%). During the postoperative course, reoperation (ESS) was required in 3 patients (2.8%) because of recurrence in the sphenoid sinus, whereas the other 103 patients had an uneventful course. Conclusions Pre- and postoperative observation by not only otolaryngologists, but also ophthalmologists, is recommended in order to perform minimally invasive surgery and to avoid recurrence.