Case Of Orbital Apex Syndrome Research Articles

Mucocoele of the Anterior Clinoid Process: An Unusual Cause of Orbital Apex Syndrome

A case of orbital apex syndrome presenting with prominent periorbital pain and diplopia caused by a mucocoele in the anterior clinoid process is presented with particular reference to the interpretation of the appropriate neuro-imaging.

A rare case of orbital apex syndrome with herpes zoster ophthalmicus in a human immunodeficiency virus-positive patient

We report a rare instance of favorable outcome in orbital apex syndrome secondary to herpes zoster ophthalmicus (HZO) in a human immunodeficiency virus (HIV)-positive patient. The patient complained of pain and decrease in vision in one eye (20/640) for 2 weeks accompanied with swelling, inability to open eye, and rashes around the periocular area and forehead. The presence of complete ophthalmoplegia, ptosis, relative afferent pupillary defect, and anterior uveitis with decreased corneal sensation prompted a diagnosis of HZO with orbital apex syndrome. The enzyme-linked immunosorbent assay test and a low CD4 count confirmed HIV. Highly active antiretroviral therapy (HAART), systemic acyclovir, and systemic steroids were started. Visual acuity and uveitis improved within 10 days. By the end of the fourth week, ocular motility also recovered and the final visual acuity was 20/25. We highlight the role of HAART, used in conjunction with systemic steroid and acyclovir therapy, in improving the outcome.

A Case of Invasive Paranasal Aspergillosis with Opthalmopathy

Invasive paranasal aspergillosis has been considered to have a poor prognosis. We report a case of orbital apex syndrome due to left ethmoid-sphenoid aspergillosis. A 76-year-old woman with untreated diabetes mellitus, presented with left visual disturbance, oculomotor nerve palsy, ptosis and orbital pain. CT and MRI showed cloudy images with defects of the bone wall in the left posterior ethmoidal sinus. The serological examination revealed aspergillus antigen (+) and high levels of β-D glucan. Therefore, we diagnosed paranasal aspergillosis, and administrated voriconazol preoperatively as an antifungal agent. The patient underwent left ethmoid-sphenoidectomy and biopsy via the endonasal approach. In the histopathologic examination, aspergillus was found around the optic nerve canal. At the present, continucus administration of voriconazol has improved the patient's ptosis and orbital pain, but not her visual disturbance. This case suggests that invasive paranasal aspergillosis has the possibility of visual loss and high mortality rate so that he needs early diagnosis and treatment.

A Case of Orbital Apex Syndrome Related to Sphenoid Fungal Sinusitis

Orbital apex syndrome (OAS) has been described previously as a syndrome involving damage to the oculomotor nerve, trochlear nerve, abducens nerve, and ophthalmic branch of the trigeminal nerve in association with optic nerve dysfunction. The conditions and symptoms of OAS are characterized by blindness, fixed dilated pupils, proptosis, ptosis of the eye and ophthalmoplegia. Infectious diseases involving the central nervous system, paranasal sinuses, and periorbital structures may lead to an OAS. We recently experienced a rare case of sphenoidal aspergillosis, which damaged the adjacent cavernous sinus structures and led to the definite symptom of OAS in a 75 year-old female. We present this rare case with a brief review of these disease’s entities. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:644-7

Magnetic Resonance Imaging in Case of Cortical Apex Syndrome Caused by Varicella Zoster Virus

We present a case of orbital apex syndrome that developed after a re-activation of varicella zoster virus. The magnetic resonance imaging showed signs of a diffuse inflammation of the ipsilateral orbital cavity, external ocular muscles and optic nerve. Pattern visually evoked cortical potentials were non-recordable by stimulating the affected eye.

A case of orbital apex syndrome caused by an injury

A case of orbital apex syndrome caused by an injury

Orbital Apex Syndrome due to mucormycosis caused by Rhizopus microsporum.

The incidence of fungal rhino sinusitis has increased in recent years in a tropical country like India. A case of Orbital Apex Syndrome due to mucormycosis caused by Rhizopus microsporum fungus is reported in a 65 year old male diabetic patient. The disease though invasive with early diagnosis and treatment, has a good prognosis with a favorable outcome.

Síndrome do ápice orbital associado com herpes zoster oftálmico em paciente HIV positivo: relato de caso

O presente relato tem como objetivo apresentar um caso raro de síndrome do ápice orbital associado com herpes zoster oftálmico de prognóstico reservado em paciente HIV positivo que procurou o pronto-socorro com quadro clínico de lesões crostosas em hemiface esquerda, dolorosa, acompanhado de baixa acuidade visual, diminuição da sensibilidade corneal e oftalmoplegia completa do olho esquerdo. A síndrome do ápice orbital é entidade rara que se caracteriza por ptose, proptose, oftalmoplegia interna e externa (acometimento do II, III, IV e VI nervos cranianos), prejuízo funcional da primeira divisão do nervo trigêmeo (nervo oftálmico) e graus variados de diminuição da acuidade visual. O tratamento do herpes zoster oftálmico baseia-se no uso de antivirais sistêmicos, sendo que o prognóstico irá variar conforme o acometimento ocular.

Perineural spread of cutaneous squamous cell carcinoma manifesting as ptosis and ophthalmoplegia (Orbital Apex Syndrome)

This paper reports two cases of orbital apex syndrome. The most salient clinical signs, ophthalmoplegia and eyelid ptosis, arose from perineural spread of facial squamous cell carcinomas that were previously excised with tumour-free surgical margins and exhibited no signs of local or other regional recurrence. The interest of these two cases lies in the fairly rare occurrence of this type of tumour spread and the highly aggressive nature of the tumour, unequivocal diagnosis of which usually arrives too late for a surgical solution. Awareness of the possibility of such perineural spread may allow the clinician to establish an early diagnosis and thus undertake radical surgery, thereby increasing the likelihood of success in combination with postoperative radiotherapy.