Neuro-ophthalmic manifestations in sinusitis patients who underwent endoscopic sinus surgery
Kitthaweesin, K.; Theerakul, T.
Journal of the Medical Association of Thailand 95(12): 1543-1547
2012
ISSN/ISBN: 0125-2208 PMID: 23390785 Document Number: 13696
To describe neuro-ophthalmic manifestations in sinusitis patients who underwent functional endoscopic sinus surgery The medical records of 341 patients who underwent functional endoscopic sinus surgery (FESS) between October and January 2001 were reviewed in this retrospective study. Patient mean age was 37.09 years (range, 3-77) and 171 (50.15%) patients had no underlying disease. Visual loss and limited ocular motility were revealed in 43 (12.72%) and 40 (11.83%) patients, respectively Sphenoid sinus was the most commonly affected sinus in patients presenting with either visual loss (odds ratio 5.88; 95% CI 2.79-12.38) or ophthalmoplegia (OR 7.09; 95% CI 3.28-15.32). Twenty-three percent of patients with visual loss had abnormal funduscopy, while 30.23% had abnormal radiologic imaging study. After FESS, 12 (27.91%) patients had better visual acuity, but 11 (25.58%) had permanent visual loss. Isolated oculomotor and combined oculomotor with abducens nerve involvement were revealed in nine (22.50%), and 31 (77.5%) patients, respectively. Diabetes was a significant risk factor associated with ocular complications in patients with either visual loss (OR 2.98; 95% CI 1.37-6.44) or ophthalmoplegia (OR 2.56; 95% CI 1.17-5.61). Sphenoid sinusitis significantly increased the risk of neuro-ophthalmic manifestations, particularly among diabetic patients.
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