501 Lateral Rectus Muscle Palsy Secondary to Sphenoid Sinusitis: A Case Report and Literature Review

Abstract Background Isolated sphenoid sinus disease (ISSD) is a rare, often misdiagnosed condition of the paranasal sinus. If left untreated, it can lead to complications involving pituitary gland, cavernous sinus, neurologic, and vascular structures nearby. Case report We present case 60-year-old female with history severe left-sided headache, facial pain, diplopia, lateral rectus palsy. She was initially referred ophthalmology rheumatology for possible giant cell arteritis. MRI scans revealed opacification in consistent sinusitis. There were no signs thrombosis. then ENT underwent endoscopic transnasal sphenoidotomy procedure. Culture results showed Haemophilus Influenza fungal pseudohyphae. Her palsy headaches recovered completely 3 months later course antibiotics antifungals. Literature review secondary sinusitis without thrombosis not common this should serve as reminder consider when assessing these patients. Conclusions The onset ISSD insidious diagnosis remains challenge. CT imaging remain gold standard recognising managing condition.