A Case of Postpartum Chronic Sinusitis with Abducens Nerve Palsy

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Abducens nerve palsy during pregnancy is an extremely rare condition. The case described herein involved a 26-year-old woman presenting with postpartum chronic sinusitis accompanied by abducens nerve palsy. The patient had complained of sinusitis, but did not receive treatment because of her pregnancy. She complained of headache and fever before delivery, and exhibited diplopia just after delivery. On admission, meningitis and chronic sinusitis were diagnosed. She was treated with antibiotics and sinus surgery, which improved her diplopia. Thereafter, meningitis resolved gradually.Involvement of the abducens nerve in isolation might be attributable to progressive thrombophlebitis affecting the sphenoid sinus, or direct compression by the thickened dura due to meningitis.There are several reports in the literature concerning otolaryngological conditions during pregnancy. In our case, it appeared that chronic sinusitis worsened because of hormonal changes during pregnancy in addition to the lack of treatment. This case suggests that careful diagnosis and proper treatment of chronic sinusitis are needed even during pregnancy to avoid serious complications such as meningitis.
耳鼻咽喉科臨床学会の論文