Isolated left upper eyelid ptosis with pansinusitis and contralateral otitis media in a 9-year-old boy

Wilbanks, Nathan; Filutowski, Oliver; Maldonado, Michael D.; Karcioglu, Zeynel A.

doi:10.1016/j.ajoc.2018.04.023

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…Most documented cases of ptosis related to sinusitis are due to the infection causing orbital sinusitis. There is one reported case of pansinusitis that resulted in eyelid ptosis in a 9-year-old male, however, it was also associated with contralateral otitis media and was due to orbital cellulitis [8]. As such this remains to be a unique case of unilateral ptosis with no ophthalmoplegia or pupillary involvement as a result of pansinusitis.…”

Section: Discussionmentioning

confidence: 89%

Unilateral Ptosis Secondary to Pansinusitis in a Pediatric Patient: A Case Report

DSa

2023

Arch Clin Pediatr

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Introduction: Ptosis or the dropping of an eyelid can affect both the adult and pediatric populations and can be caused by various factors. Ptosis is not very common and in children, the common causes include orbital cellulitis, congenital ptosis, Cranial Nerve III palsy, and Horner’s syndrome. However, unilateral acute ptosis from an infectious disease process is rare and there are only a few documented cases of such occurrences. Acute ptosis is a medical emergency and prompt diagnosis, and management is critical for the resolution of symptoms and prevention of serious complications. Case: We present an interesting case of a 14-year-old female with pansinusitis who experienced unilateral left-sided ptosis. Initially prescribed oral antibiotics for sinusitis, the patient developed ptosis, requiring inpatient hospital admission and intravenous antibiotics. On admission, the patient had leukocytosis, elevated CRP, and ESR levels. CT facial bones showed pansinusitis and ruled out orbital cellulitis, acute intracranial abnormalities, and venous sinus thrombosis. After aggressive treatment with intravenous antibiotics and systemic steroids, the sinusitis resolved, as did her unilateral ptosis and facial swelling. Discussion: This is a unique presentation of ptosis that was treated successfully allowing for prompt and complete resolution. We want to highlight the establishment of a varying diagnosis and treatment courses which led to the final resolution of the acute ptosis. The patient was treated with meropenem and dexamethasone. The adjunctive use of corticosteroids, in this case, was beneficial.

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Section: Discussionmentioning

confidence: 89%

Unilateral Ptosis Secondary to Pansinusitis in a Pediatric Patient: A Case Report

DSa

2023

Arch Clin Pediatr

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“…Vertical eye movements were not compromised, thereby ruling out entire cranial nerve III (CNIII) involvement. However, Wilbanks et al 10 conveyed this as a contentious mechanism when they were faced with a paediatric case of isolated ptosis due to pansinusitis. Their reasoning was that the inferior ramus is in very close proximity to the superior ramus; the inferior ramus innervates the inferior rectus, medial rectus and inferior oblique muscles, and also innervates the pupillary constrictors parasympathetically.…”

Section: Discussionmentioning

confidence: 99%

“…Other documented rare causes of isolated, unilateral ptosis have included myositis, orbital cellulitis 10 and midbrain infarction. 12 …”

Section: Discussionmentioning

confidence: 99%

Acute unilateral isolated ptosis as a complication of sinusitis in a post-COVID-19 patient

et al. 2023

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A fit and well young man presented to our emergency department in the UK. On examination, he had an isolated left-sided ptosis; he had a 3-day history of frontal headache which was worse on head movement. He lacked any clinical signs of cranial, orbital, or preseptal infection, and his eye movements were normal. Ten days before presentation, he tested positive for SARS-CoV-2. Inflammatory markers were moderately raised, and CT of the head did not reveal any vascular abnormality or intracranial lesion. Imaging revealed opacification, predominantly in the left facial sinuses, keeping with sinusitis. He was discharged the same evening with oral antibiotics and made a full recovery over the next few days. He remained well at 6-month follow-up. The authors convey their findings to raise awareness of a rare complication of sinusitis and to demonstrate the utility of CT imaging for diagnosing sinusitis and ruling out severe pathology.

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“…Childhood ptosis, which is mostly congenital, can also occur due to a variety of causes [6][7][8]. Secondary ptosis observed in infectious ENT diseases is frequently of the mechanical type, occurring due to inflammatory palpebral edema, whereas neurogenic ptosis can also be encountered occasionally as a result of an affected oculomotor nerve [9][10][11]. Determining the function of the levator muscle, which is primarily responsible for the elevation of the upper eyelid, and investigating the presence of other ocular findings coexisting with blepharoptosis are essential for distinguishing the etiology.…”

Section: External Examinations (Palpebrae Orbit Periorbita Lacrimal Apparatus)mentioning

confidence: 99%

Ophthalmological Perspective on Pediatric Ear, Nose, and Throat Infections

Kirik¹,

Özdemir²

2021

Pediatric ENT Infections

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Isolated left upper eyelid ptosis with pansinusitis and contralateral otitis media in a 9-year-old boy

Cited by 3 publications

References 15 publications

Unilateral Ptosis Secondary to Pansinusitis in a Pediatric Patient: A Case Report

Unilateral Ptosis Secondary to Pansinusitis in a Pediatric Patient: A Case Report

Acute unilateral isolated ptosis as a complication of sinusitis in a post-COVID-19 patient

Ophthalmological Perspective on Pediatric Ear, Nose, and Throat Infections

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