JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 55 No. 5       2009

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

We report a rare case of rhinogenous optic neuritis (RON) that was induced by odontogenic maxillary sinusitis in a 34-year-old woman. The patient was referred to our hospital because of visual disturbance of the left eye, gradually developing over the course of 1 month. On presentation to the Department of Ophthalmology, the corrected visual acuity and central critical flicker frequency of the affected left eye was 1.0 and 24Hz, respectively (1.2 and 45 Hz for the right eye). The left eye also showed paracentral scotoma. Computed tomography and magnetic resonance imaging revealed left sphenoid and maxillary sinus opacification, which indicated thickening of these sinus membranes. For a clinical diagnosis of RON in the left eye, a otolaryngologist performed endonasal sphenoid and maxillary sinusotomy under general anesthesia. After sinusotomy the patient came to our department for further evaluation. A panoramic radiograph showed projection of root canal filling material to the left maxillary sinus from the apex of the left maxillary second premolar. We extracted this tooth and the projecting material. Visual symptoms completely resolved 3 months after diagnosis by collaboration among the patient's ophthalmologist, otolaryngologist, and oral and maxillofacial surgeon. Keywords: rhinogenous optic neuritis, odontogenic maxillary sinusitis, sphenoid sinus, root canal filling, team treatment.

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