Otolaryngology Online Journal

Cavernous thrombosis revealing sinus tuberculosis

Webinar on Otorhinolaryngology: ENT Surgery and Cosmetics
February 09, 2022

Abdelkrim Hanane

Nedir Mohamed Uhc. Algeria

Posters & Accepted Abstracts : Otolaryngology Online

Abstract:

Tuberculosis is still endemic in developing countries. Naso-sinus localization is rare, characterized by clinical polymorphism and non-specific symptomatology. We report in this publication a case of cavernous thrombosis revealing sinus tuberculosis in a 42-year-old patient, garbage collector, diabetic, who consulted in the emergency department for left orbital swelling with insomnia headaches. The ENT clinical examination found ptosis of the left eye and non-reducible axile proptosis, fever at 38°5 and purulent rhinorrhoea from the left middle meatus. The ophthalmological examination found negative light perception, complete ophthalmoplegia, arereflectic mydriasis and inter-maculo-papillary retinal ischemia. Naso-sinus imaging by CT shows almost total filling of the ethmoidal cells and the left maxillary sinus. Cerebro-orbital MRI found left cavernous thrombophlebitis with dilation of the ophthalmic vein, right internal conical intra and extra abscessed collection sheathing the right muscle, the optic nerves in their posterior portions and a small internal temporal empyema. The patient was hospitalized in our department, put on triple antibiotic therapy: cefotaxime, ciprofloxacinand metronidazole with anticoagulation at a curative dose for 3 weeks but without clinical improvement. The patient underwent surgery by combined endoscopic and external approach. The histopathological study of biopsy specimens found a respiratory tissue site of epithelia-giganto-cellular granulomatous inflammatory lesion evoking tuberculosis. The patient was put on anti-tuberculosis treatment: 2RHZ /4RH with a good clinical and biological evolution. The patient kept sequelae: ptosis and permanent left blindness.

Biography:

Abdelkrim Hanane, md is graduated from the faculty of medicine of mouloud mammeri university in tizi ouzou, algeria, where he also completed his university studies and obtained his doctorate in general medicine. dr abdelkrim hanane trained at the department of ent-head and neck surgery of nedir mohamed university medical centre in tizi ouzou during his residency. during his residency, he was able to provide superior care and consultation that resulted in an overall improvement of the department's patient satisfaction quotient. abdelkrim hanane has participated several times by posters publications in ent-head and neck surgery national and international congresses. he is a member of american academy of Otolaryngology- Head and Neck Surgery.

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