Isolated unilateral ptosis as a complication of sinusitis: A case report and literature review.

Publication date: Aug 01, 2024

Ptosis associated with rhinosinusitis may indicate orbital or cavernous sinus involvement, typically accompanied by various other symptoms. However, isolated ptosis is a rare occurrence. This explains the diverse treatment approaches found in this literature review, ranging from conservative management to surgery. Imaging plays a crucial role in diagnosis and treatment planning. Isolated upper lid ptosis is a rare manifestation of acute rhinosinusitis, typically occurring without other neuro-ophthalmological or orbital signs. This report presents a case of unilateral isolated ptosis in an adult male with acute rhinosinusitis. A 30-year-old male with asthma and bipolar disorder, and recent intranasal drug use, presented with nasal congestion, facial pressure, headache, and left eye droopiness. Neurological examination found left ptosis as the only abnormality. Lab results were normal, and COVID-19 PCR was negative. Imaging showed pansinusitis without complications. The patient received IV antibiotics and steroids, followed by oral antibiotics and steroids. Ptosis resolved within 3 days and did not recur at three-month follow-up. Only seven cases of isolated ptosis with rhinosinusitis have been reported, all in males, most recovering with medical therapy alone. This is the first case treated with high-dose steroids in addition to antibiotics. Isolated ptosis may be due to inflammation of the oculomotor nerve’s distal branch or related muscular structures. Isolated ptosis in rhinosinusitis has a favorable prognosis. Imaging is crucial to exclude severe complications. The role of steroids needs further evaluation, and the timing for considering surgery remains to be defined.

Concepts Keywords
Conservative neurologic complications
Drug orbital complications
Month ptosis
Ophthalmological rhinosinusites
Rhinosinusitis

Semantics

Type Source Name
disease MESH sinusitis
disease VO report
disease MESH asthma
pathway KEGG Asthma
disease MESH bipolar disorder
disease MESH COVID-19
disease MESH complications
disease VO dose
disease MESH inflammation

Original Article

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