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Case Reports in Otolaryngology
Volume 2014, Article ID 601671, 5 pages
http://dx.doi.org/10.1155/2014/601671
Case Report

Intracranial Complication of Rhinosinusitis from Actinomycosis of the Paranasal Sinuses: A Rare Case of Abducens Nerve Palsy

1ENT Department, San Luigi Gonzaga University Hospital, Regione Gonzole 10, Orbassano, 10043 Turin, Italy
2ENT Department, Martini Hospital, Via Tofane 1, 10141 Turin, Italy

Received 9 May 2014; Revised 25 July 2014; Accepted 11 August 2014; Published 21 August 2014

Academic Editor: Marco Berlucchi

Copyright © 2014 G. L. Fadda et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sinonasal actinomycosis should be suspected when a patient with chronic sinusitis does not respond to medical therapy or has a history of facial trauma, dental disease, cancer, immunodeficiency, long-term steroid therapy, diabetes, or malnutrition. Radiological evaluation with computed tomography and magnetic resonance imaging are important in differential diagnosis, evaluating the extent of disease, and understanding clinical symptoms. Endoscopic sinus surgery associated with long-term intravenous antibiotic therapy is the gold standard for treatment of sinonasal actinomycosis. We report an unusual case of abducens nerve palsy resulting from invasive sinonasal actinomycosis in a patient with an abnormally enlarged sphenoid sinus. A review of the current literature highlighting clinical presentation, radiological findings, and treatment of this uncommon complication is also presented.