• Journal of Korean Neurosurgical Society
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• v.55 no.1
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• pp.61-63
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• 2014

A differential diagnosis between neurosarcoidosis and neurosyphilis is particularly problematic in patients with a positive serologic result for syphilis. We report here a patient with a solitary cavernous sinus sarcoidosis who had a history of syphilis and showed rapidly progressing cavernous sinus syndrome. A transsphenoidal biopsy was performed and a histopathologic examination revealed a non-caseating granuloma with an asteroid body. His facial pain disappeared after steroid therapy. He received oral prednisolone for one year. A follow-up magnetic resonance imaging of the brain revealed resolution of the mass over the cavernous sinus. Particularly in patients with a history of syphilis, neurosyphilis should be included in a differential diagnosis of neurosarcoidosis.

• Kosin Medical Journal
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• v.33 no.3
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• pp.454-462
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• 2018

A 54-year-old man, suffering from severe headache and ophthalmoplegia after undergoing endoscopic sinus surgery was referred to a tertiary hospital. Computed tomography (CT) revealed soft tissue density lesions in the left sphenoid sinus. The internal carotid artery was shown to be occluded in brain magnetic resonance imaging (MRI) scans without any other cerebral lesion. Endoscopic view of left nasal cavity shows whitish hyphae in the ethmoid and the sphenoid sinuses. We diagnosed him with cavernous sinus syndrome caused by mucormycosis and conducted endoscopic sinus surgery to remove remaining lesions and decompress orbit and optic nerves. After the revision surgery the patient's headache and ophthalmoplegia were improved. However, multifocal cerebral infarctions were newly discovered in a postoperative CT scan. We experienced a case of mucormycosis of sphenoid sinus resulting in occlusion of internal carotid artery and multifocal cerebral infarction, and report it with a brief review of these disease entities.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.198-201
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• 2023

Invasive sphenoid sinus aspergillosis can mimic Tolosa-Hunt syndrome (THS), leading to frequent misdiagnoses and potentially fatal consequences. We report a case of invasive sphenoid sinus aspergillosis initially misdiagnosed as THS. A 79-year-old man presented with right periorbital pain, ophthalmoplegia, and loss of vision. Initial evaluations including magnetic resonance imaging (MRI), were normal. He was first diagnosed with THS based on clinical features. The disease progressed despite high-dose intravenous steroid treatment, and an enhancing mass-like lesion was found in the right orbital apex, cavernous sinus, and sphenoid sinus on follow-up MRI. Aspergillosis was eventually confirmed by sphenoid sinus biopsy. The patient developed cerebral infarction and finally died despite being treated with amphotericin B. Given that invasive sphenoid sinus aspergillosis may initially resemble THS, high suspicion and rapid histological examination are important for diagnosis.

• Journal of Veterinary Clinics
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• v.40 no.5
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• pp.360-364
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• 2023

A 7-year-old castrated male Yorkshire Terrier presented for a palpable mass of the right neck with ophthalmic signs of conjunctival hyperemia and anisocoria with fixed mydriatic pupil of the right eye. Clinical examination findings included the absence of direct and consensual pupillary light reflexes, external and internal ophthalmoplegia, and corneal hypoesthesia with incomplete blinking of the right eye. Magnetic resonance imaging and computed tomography revealed a mass extending from the right cavernous sinus to the orbital fissure with neighboring bone lysis. Cytological examination of fine-needle aspiration samples of the mass revealed a neuroendocrine tumor. The owner declined further diagnosis and did not wish to care for the dog receiving chemotherapy. This study describes the importance of investigating neuro-ophthalmic findings, which might provide clues for the localization of lesions, including tumors, to aid in diagnosis.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.18 no.2
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• pp.86-92
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• 2005

Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus/superior orbital fissure has been termed Tolosa-Hunt syndrome(THS). The syndrome is characterized by pain behind, above or around the eye, involvement of the cranial nerves which pass through the cavernous sinus, spontaneous remissions and exacerbations, and a favourable response to steroid therapy. There was the 56 years old man who suffered from painful ophthalmoplegia and facial palsy. The oriental medical treatment without steroids and analgesics reduced the symptoms of the patient remarkably during 5 weeks. There is few report that treat THS with oriental medical method. If more clinical trials like this are proved to be effective, we can expect that oriental medical treatment will be a good method in THS.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.3
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• pp.356-359
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• 2000

Superior orbital fissure syndrome is characterized by ophthalmoplegia, ptosis of the eye, reflex dilation of the pupil, and anesthesia of the upper eyelid and forehead. This syndrome may be the result of craniofacial fractures as well as neoplasms of the retrobulbar space, hematomas in the orbital muscle cone and retrobulbar space, and hematoma and infection of the cavernous sinus. A case of superior orbital fissure syndrome is described.

• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.65-69
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• 2023

We report a unique case of hemangioma of the nasal cavity in von Hippel-Lindau (VHL) syndrome. A 26-year-old female with VHL syndrome who had previously undergone surgery for pancreatic and adrenal mass presented with a 4-month history of left-sided nasal obstruction. The patient had an expansile mass lesion in the left nasal cavity and an imaging test demonstrated the mass in the left maxillary sinus extending to the nasal cavity. The tumor was removed with an endoscopic prelacrimal recess approach considering the possibility of not only a benign tumor such as hemangioma but also a malignant tumor of the maxillary sinus and histopathologic examination confirmed cavernous hemangioma. This case is the rarely reported manifestation of the paranasal sinus in VHL disease.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.16 no.1
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• pp.220-225
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• 2003

The Tolosa-Hunt syndrome is a symptom complex with unilateral painful ophthalmoplegia associated with retro-orbital pain, proptosis and Ⅲ, Ⅳ, Ⅴ-1, Ⅵ cranial nerves palsy due to nonspecific granulomatous inflammation in the superior orbital fissure or cavernous sinus. We experienced a 50 years old female patient with Tolosa-Hunt syndrome who had several clinical signs and symptoms such as ocular pain, headache, sensory loss of face, diplopia, and visual disturbance. In the point of Differentiation of Syndrome(辨證). this subject was diagnosed as Deficiency of yin in liver and kidney(肝腎陰虛), and was administrated with Yangyeummyungmoktang-Gamibang. After treatment of acupuncture and herbal medicine above symptoms were improved.

• Journal of Acupuncture Research
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• v.18 no.5
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• pp.179-184
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• 2001

The Tolosa-Hunt syndrome(THS) consists of a painful ophthalmoplegia related to a granulomatous inflammatory process in the cavernous sinus, which may be documented by cerebral magnetic resonance imaging with gadolinium enhancement. Generally, it has been reported that 2 weeks steroid therapy relieves the symptoms(periorbital pain, ophthalmoplegia) of THS. In this case, there had been no improvement of symptoms by western medical treatments(steroid & analgesics). but, the symptoms were resolved clearly by acupuncture therapy during 6 weeks(5 times/week). If more clinical trials like this are proved to be effective in THS, we can expect that acupuncture will be another therapeutical modality in THS.

• Journal of Oral Medicine and Pain
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• v.1 no.1
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• pp.14-23
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• 1973

眼球의 紅彩, 毛樣體 및 脈絡膜은 相異한 機能을 하나 이의 發生, 構造,血管 및 神經系등의 共通點이 많으므로 炎症發生時 어느 한 部分에 局限되지 않으므로 選括하여 葡萄膜炎이라하며, 隣接器官의 炎症및 波及은 內因性感染 卽 肺炎 등 흔한 原因이며 口腔과는 葡萄官 및 Cavernous Sinus 등을 通한 Uveoparotid fever, Mikulicz's Disease 또는 Sjogrene Syndrome등과 깊은 關係가 있으며, 一般 및 特殊治療에도 大部分 完治되나 例外가 있는 바 저자는 六個月餘에 걸친 眼科的 治療의 結果 아무런 好展이 없는 葡萄膜炎 患者에 病巢感染說을 뒷받침하여 口腔內病巢를 完全除去한 結果 좋은 豫後를 觀察, 이에 報告하는 바이다.