침습성 진균성 부비동염에 의한 안와첨부증후군 1예

Invasive fungal sinusitis is a slowly destructive process that most commonly affects the maxillary and sphenoid sinus, but may involve any paranasal sinus. Orbital apex syndrome (OAS) has been described as a syndrome involving damage to the oculomotor nerve, trochlear nerve, abducens nerve and ophthalmic branch of the trigeminal nerve in association with optic nerve dysfunction. The symptoms of OAS are characterized by blindness, ptosis, fixed dilated pupils and ophthalmoplegia. In this case, we experienced one case of orbital apex syndrome due to invasive fungal sinusitis. A 67-year-old woman with pulsatile headache was admitted to the Department of Neurosurgery. Suspicious sphenoid sinus and surrounding lesion on imaging study was removed by endoscopic sinus surgery. Adjuvant antifungal therapy was attemped. The patient recovered from fungal sinusitis but visual acuity was partially recovered. (J Clinical Otolaryngol 2014;25:219-223)