Brenet Esteban, Boulagnon-Rombi Camille, N'guyen Yohan, Litré Claude-Fabien
Department of Oto-rhino-laryngology, Head & Neck Surgery, Robert Debré University Hospital, Reims, France.
Department of Anatomopathology, Robert Debré University Hospital, Reims, France.
Auris Nasus Larynx. 2016 Oct;43(5):566-9. doi: 10.1016/j.anl.2016.01.007. Epub 2016 Feb 6.
Cavernous sinus thrombosis is a rare but serious complication of sphenoid aspergillosis. The rarity of this pathology makes its diagnostic very difficult on a clinical, biological and radiological sense. The authors present a case of cavernous sinus thrombosis with ipsilateral internal carotid artery thrombosis secondary to a non-invasive sphenoid aspergillosis in an immunocompetent host, responsible of a cavernous syndrome associated to a Claude Bernard Horner syndrome. One year after surgery, the patient is still asymptomatic without recurrence. Diagnostic modalities are detailed and several management of this pathology are compared. Surgery is essential in a diagnostic and therapeutic sense. There is no evidence of the interest of adjuvant therapies such as antibiotic and anticoagulation. Concerning the antifungal treatment, the attitude towards a non-invasive sphenoid aspergillosis in an immunocompetent host is unclear.
海绵窦血栓形成是蝶窦曲霉菌病一种罕见但严重的并发症。这种病理情况的罕见性使得在临床、生物学和放射学意义上对其诊断非常困难。作者报告了一例免疫功能正常宿主因非侵袭性蝶窦曲霉菌病继发海绵窦血栓形成并同侧颈内动脉血栓形成的病例,该病例导致了与Claude Bernard Horner综合征相关的海绵窦综合征。术后一年,患者仍无症状且未复发。详细介绍了诊断方法,并比较了这种病理情况的几种治疗方法。手术在诊断和治疗方面至关重要。没有证据表明抗生素和抗凝等辅助治疗有意义。关于抗真菌治疗,对于免疫功能正常宿主的非侵袭性蝶窦曲霉菌病的治疗态度尚不清楚。