Cavernous Sinus Syndrome : A clinical comparison between mucormycosis and Non-mucormycosis
Abstract
Abstract
Introduction
Cavernous sinus syndrome is a disorder characterized by paralysis of cranial nerve 3, 4 6, and 5. Causes of this syndrome are infectious and non – infectious source, such as mucormycosis, bacteria and malignancy. Delay in diagnosis and improper management contributed to high mortality rate. We report cavernous sinus syndrome patients at Srinagarind hospital for recognition and clinical comparison between mucormycosis and non – mucormycosis.
Patient and Method
Review of patient charts from 1985 to 1994 at Srinagarind Hospital, Department of medicine, Faculty of Medicine, Khon Kaen university with sinus thrombosis.
Result
There were 25 patients, 9 male, 16 female, male to female ratio was 1:1.7, age range form 30-79 years, mean was 55.08 years. Common presenting symptoms were headache 96%, eye pain 76%, visual impairment 56% ptosis 52% . Physical examination showed paralysis of CN 3,4,6 100%, visual impairment 90%, chemosis 72%, proptosis 64%, black crust 28% weakness 20% and associated with sinusiis 80% . Underlying diseases were diabetes mellitus 48% and chronic renal failure 20%. Mortality rate was 54% . The common causes of cavernous sinus syndrome were mucormycosis 60% , bacteria 36% and lymphoma 4%. Clinical comparison between mucormycosis and non-mucormycosis, visual impairment, weakness, black crust were more common in mucormycosis group, high level of BS, BUN and CSF sugar to BS ratio were more common in mucormycosis group too, but fever was more common in non-mucormycosis group (P <0.05), ther finding no difference.
Conclusion
The most common cause of cavernous sinus syndrome is infectious diseases, associated with sinusitis 80%, with a 54% mortality rate and different features between mucormycosis and non-mucormycosis.
