Optic nerve disorder due to diseases of paranasal sinuses has an incidence of 2-5% in diseases of the paranasal sinuses. with the incidence highest in posterior paranasal sinus cyst. Posterior paranasal sinuses are anatomically close to the optic nerve, oculomotor nerve, trochlear nerve, abducent nerve, internal carotid artery and cavernous sinus, with symptoms caused by cyst inflammation and pressure. These symptoms belong to the domains of ophthalmology, neurosurgery, and internal medicine, not of otorhinolaryngology, so many patients visit ophthalmology, neurosurgery and internal medicine departments for their first medical examination.
In nasal optic nerve diseases, early discovery and treatment are thought to greatly influence prognosis. Eye doctors, neurosurgeons, and internists find it difficult to judge that paranasal diseases are accountable for nasal optic nerve diseases, which leads to delays in starting treatment. A 51-year-old woman seen at internal medicine first for headache and, later, vision disturbance, blerharoptosis, and ocular motor apraxia, was sent to ophthalmology and neurosurgery, whereupon a sphenoidal sinus cyst was found in imaging and she was referred to otorhinolaryngology. Intranasal surgery for the paranasal sinus and steroid preparations improved blepharoptosis and ocular motor apraxia, but the vision disturbance remained.
View full abstract