Open AccessFacial nerve palsy as an unusual presentation of orbital apex syndrome
Author(s) -
Rafiqahmed Abdulkarim Vasiwala,
Wong Zhen Yu,
Tee Chen Giap,
Ashiya Rafiq,
Irfan Mohamad
Publication year - 2021
Publication title -
paediatrics and family medicine/pediatria and medycyna rodzinna
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.108
H-Index - 5
eISSN - 2391-5021
pISSN - 1734-1531
DOI - 10.15557/pimr.2021.0028
Subject(s) - medicine , presentation (obstetrics) , abducens nerve , mucormycosis , facial nerve palsy , palsy , surgery , complication , sixth nerve palsy , sinusitis , diplopia , pathology , alternative medicine
Clinical cases of orbital apex syndrome are rare and most commonly manifested as a complication of fungal sinusitis, mainly in immunocompromised and poorly controlled diabetic patients. Rhino-orbital mucormycosis is a rare opportunistic, aggressive and fatal infection caused by mucor. The complex presentation of orbital apex syndrome not only poses a diagnostic challenge but also demands a multidisciplinary approach in patient management. Facial nerve palsy is an unusual presentation in orbital apex syndrome. We report the case of a 64-year-old diabetic patient presenting with ophthalmoplegia and visual loss associated with facial nerve palsy. Prompt ophthalmologic and otolaryngologic intervention with imaging and histologic confirmation, followed by early initiation of antifungal and antimicrobial therapy, were integral to preventing further complications, and reducing morbidity and mortality.