Rongeuring of the Lesser Wing of the Sphenoid Bone as a Possible Cause of Isolated Abducens Nerve Palsy : A Case Report

Abstract

Reported is a case of isolated right abducens nerve palsy, which appeared immediately after an operation to treat an unruptured internal carotid artery aneurysm. Rongeuring the roof of the superior orbital fissure and compression of its contents are thought to be a cause of this palsy. The abducens nerve runs medial to the trigeminal nerve in the cavernous sinus, after which it runs laterally to the annulus of Zinn. It can be very easily injured at this point by any compression from the lateral side. A reasonable extension when removing the lesser wing of the sphenoid bone is also discussed.