Cavernous sinus is located adjacent to sphenoidal sinus and presents close relationship with internal carotid artery and some important nerves (abducent, troclear, oculomotor and ophthalmic branch of the trigemic nerve). Since the sphenoid lateral wall is too thin, adjacent structure involvement is more frequent and dangerous when this sinus is disease. The purpose of this study is to report a case of an acute rhinosinusitis complicated with the involvement of the third cranial nerve. A 53-year-old woman was complaining about frontal headache one month before hospital admission. An acute sphenoiditis associated with exclusive involvement of oculomotor nerve was diagnosed. She received intravenous antibiotics and underwent Functional Endoscopic Sinus Surgery (FESS) with total recovering of the signs and symptoms. Sphenoiditis misdiagnosis or delay in the treatment of this condition may increase the risk of neurological complications. The initial clinical suspicion is important to start a specific treatment improving the outcome of these patients. In our experience FESS is a safe and efficient surgical approach for the treatment of acute rhinosinusitis complications.
acute rhinossinusitis; sphenoid sinus; complications; oculomotor nerve; functional endoscopic sinus surgery
