Routes of Spread to Eye from the Notorious Neighbour i.e. Nose, Sinuses and Nasopharynx
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ORIGINAL ARTICLE
Routes of Spread to Eye from the Notorious Neighbour i.e. Nose, Sinuses and Nasopharynx Novshaba Novshaba Nazeer1 • L. Sudarshan Reddy2 • Phani Bhushan Ivaturi3 Divya Jaina2
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Received: 24 August 2019 / Accepted: 22 January 2020 Ó Association of Otolaryngologists of India 2020
Abstract Due to close anatomical relationship of eye with nose and sinuses it is liable to get involved secondary to sinonasal and nasopharyngeal pathology. Sinonasal and nasopharyngeal pathology may present with varied ophthalmic manifestations. Ocular involvement from sinonasal diseases occur due to direct spread to orbit, venous spread due to valveless nature of veins, cranial nerve involvement, nasolacrimal apparatus involvement and intracranial spread. The present study is to determine the sociodemographics, ocular manifestations due to sinonasal and nasopharyngeal pathology, etiological factors and routes of spread. The most common etiology in present study was sinonasal squamous cell carcinoma followed by nasal vestibulitis. The most common ocular pathology was proptosis followed by preseptal cellulitis. The most common route was erosion followed by compression and vascular. To conclude sinonasal and nasopharyngeal pathology can spread to orbit and increase the mortality and morbidity. Keywords Sinonasal Nasopharyngeal Ocular manifestations Proptosis Preseptal cellulitis
Introduction Due to close anatomical relationship of eye with nose and sinuses it is liable to get involved secondary to Sinonasal and nasopharyngeal pathology [1]. About 3/5th–4/5th of & L. Sudarshan Reddy [email protected] 1
Shadan Institute of Medical Sciences, Hyderabad, India
2
Osmania Medical College/Government ENT Hospital, Koti, Hyderabad, India
3
Government Medical College, Nalgonda, India
orbital wall is related to sinuses, superiorly being floor of frontal sinus, medially being lateral wall of the ethmoid labyrinth, inferiorly being the roof of the maxillary sinus and posteromedially being the anterolateral wall of the sphenoid sinus [2]. Sinonasal and nasopharyngeal pathology may present with varied ophthalmic manifestations [3]. Ocular involvement from sinonasal diseases occur due to direct spread to orbit, venous spread due to valveless nature of veins, cranial nerve involvement, nasolacrimal apparatus involvement and intracranial spread [4]. Hence anatomical knowledge is essential in understanding the spread of sinonasal and nasopharyngeal pathology, to prevent complications during surgery and to chose different management strategies [5]. Aims and Objectives 1. To describe the demographic characteristics of ocular manifestations due to sinonasal and nasopharyngeal pathology. 2. To evaluate the etiology and clinical profile of ocular involvement due to sinonasal and nasopharyngeal pathology. 3. To identify the routes of spread to eye from nose, sinuses and nasopharynx. Inclusion Criteria 1. All age group of patients presenting with ocular symptoms due to sinonasal and nasopharyngeal pathology. 2. Patients who
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