ArticleJournal of surgical case reports2025
Orbital apex syndrome in noninvasive fungal rhinosinusitis: a case report.
Article in Journal of surgical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Noninvasive fungal rhinosinusitis is the most common type of fungal sinusitis, but it rarely leads to orbital apex syndrome. In this case study, we present a 44-year-old female who developed headache and sudden loss of vision in the left eye. Examination revealed ptosis, complete visual loss, and total ophthalmoplegia in the left eye. Imaging showed a fully opacified mass in the left orbital apex and spheno-ethmoidal recess, involving the adjacent ophthalmic artery, optic nerve, and extraocular muscles. The patient was diagnosed with orbital apex syndrome secondary to noninvasive fungal rhinosinusitis. She received a 3-day course of methylprednisolone without improvement, followed by functional endoscopic sinus surgery. Histopathology confirmed a fungal ball (aspergilloma) without tissue invasion. The patient was hospitalized for 2 weeks, treated with perioperative antibiotics, but did not receive systemic antifungal therapy. At 3 months follow-up, headache, proptosis, and pain had resolved, but vision loss and ptosis did not improve significantly. Early recognition and timely surgical intervention are crucial in preventing irreversible complications of noninvasive fungal rhinosinusitis.
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