Al-Radadi Abeer Mohammed, Alnoury Khaled Ibrahim
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
J Pak Med Assoc. 2011 Jul;61(7):704-7.
Optic chiasma compression is a very rare complication of allergic fungal rhino sinusitis. Here we report the rare case of a 35-year-old female suffering from unilateral visual loss presented with allergic fungal sinusitis with sphenoid sinus involvement. Examination showed nasal polyposis and unilateral hemianopia. Computerized tomography and magnetic resonance imaging showed bilateral nasal polyposis with intracranial extension; however, the optic nerve was free. The patient underwent functional endoscopic surgery and medical management in the form of steroids and oral antifungal therapy, resulting in complete recovery of the visual field loss. Patient was started on immunotherapy according to the skin prick test. No clinical nor radiological recurrence of the disease was evident within 2 years. Immediate management both surgically and medically is important. Immunotherapy is an essential part for long term control.
视交叉受压是变应性真菌性鼻鼻窦炎极为罕见的并发症。在此，我们报告一例罕见病例，一名35岁女性因单侧视力丧失就诊，诊断为累及蝶窦的变应性真菌性鼻窦炎。检查发现有鼻息肉和单侧偏盲。计算机断层扫描和磁共振成像显示双侧鼻息肉伴颅内扩展；然而，视神经未受侵犯。患者接受了功能性内镜手术以及类固醇和口服抗真菌治疗形式的药物治疗，视野缺损完全恢复。根据皮肤点刺试验对患者开始进行免疫治疗。两年内未发现疾病的临床及影像学复发。手术和药物的即时治疗很重要。免疫治疗是长期控制的重要组成部分。
