Abstract
An 80-year-old male consulted the Department of Ophthalmology for headache, left blepharoptosis, and diplopia, and was diagnosed with left oculomotor paralysis. Neurological examinations revealed no abnormalities. A shadow was detected in the sphenoid sinus, and the patient was referred to the Department of Otorhinolaryngology. CT revealed a shadow in which the inner area was not uniform, without bone destruction, in the left sphenoid sinus. Under a tentative diagnosis of sphenoiditis-related oculomotor paralysis, endoscopic sphenoidectomy was performed. The sphenoid sinus was occupied by a fungal mass, suggesting fungal sphenoiditis. In the sinus, there was no bone defect. After surgery, conservative therapy such as steroid therapy and follow-up were continued. After 2 months, oculomotor paralysis subsided. Aspergillus was detected in the fungal mass. We reviewed the literature regarding the pathogenesis of peripheral cranial paralysis related to noninvasive mycosis of the sphenoid sinus.
