Endoscopic decompression of superior orbital fissure syndrome
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Transsphenoidal endonasal Endoscopic decompression of superior orbital fissure syndrome
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Endoscopic decompression of superior orbital fissure syndrome
- 1. Pansinusitis, cavernous sinus thrombosis Endonasal Endoscopic Decompression
- 2. PATIENT PARTICULARS • Name : Abdul Jalil • Age : 70 • Address : • Diabetic • Non- Hypertensive.
- 3. PRESENTING COMPLAINTS • Blurring of vision for 3 weeks • Drooping of left upper eyelid. • Proptosis of left eyeball. • H/O Fever for past 2 months but afebrile for last15 days. • Persistent headache.
- 4. EXAMINATION FINDINGS • GCS- 15/15 • Left sided total ophthalmoplegia. • Left sided Complete Ptosis. • Visual acuity: • Right- Reduced (finger counting possible) • Left – Absent ( No PL/PR) • Fundoscopy – Left eye- Early Optic atrophy • Temperature - Normal
- 5. RADIOLOGICAL FINDINGS • MRI of orbit ē PNS :Chronic Inflammatory Lesion in left parapharyngeal space extended upto Left Cavernous Sinus ē Abscess formation. Pansinusitis.
- 8. • Debriding the sinuses • Evacuation of “fungal ball” like structure • Drilling of the Sphenoid sinus • Decompressing Superior orbital fissure and Optic canal • Opening the cavernous sinus and decompression.
- 11. HISTOPATHOLOGY • Chronic Non-specific Sinusitis. No Malignancy. • Fungal culture yielded no growth. • Bacteriological Studies revealed following organisms: • MRSA • Pseudomonas spp. • Enterococcus spp.
- 12. POST OPERATIVE TREATMENT • Patient was on Intravenous Antibiotics and antifungal drugs for 2 weeks. • Ophthalmoplegia Improved. • Ptosis improved. • Visual acuity is improving.
- 13. 18TH POD
- 14. Thank you