{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T21:10:52Z","timestamp":1770153052560,"version":"3.49.0"},"reference-count":19,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,8,14]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>Sphenoid sinusitis is a rare disease associated with life-threatening complications that can be avoided with early recognition and timely treatment. Here, we present a case of a woman in her 80s admitted for symptomatic anaemia likely secondary to a gastrointestinal bleed with left cranial nerve (CN) VI palsy incidentally discovered on physical examination. CT and MRI were suggestive of chronic left sphenoid sinusitis with possible involvement of the left cavernous sinus. Surgical treatment was deferred due to high cardiac risk for perioperative mortality and recent ischaemic stroke. Despite antibiotic treatment, the patient\u2019s CN VI palsy remained unchanged. This report contributes to the current understanding of sphenoid sinusitis by presenting a complex case of chronic sphenoid sinusitis in which urgent surgical intervention was deferred due to the patient\u2019s multiple comorbidities. Furthermore, it highlighted the importance of the CN examination and imaging modalities in diagnosing sphenoid sinusitis.<\/jats:p>","DOI":"10.1136\/bcr-2022-253773","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T11:36:12Z","timestamp":1692876972000},"page":"e253773","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Cranial nerve VI palsy in chronic sphenoid sinusitis"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7992-4756","authenticated-orcid":false,"given":"Ruoyu Luie","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertilia","family":"Tav\u00e1rez","sequence":"additional","affiliation":[{"name":"Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Amaro-Barron","sequence":"additional","affiliation":[{"name":"Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arooj","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rovie","family":"Mesola","sequence":"additional","affiliation":[{"name":"Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"key":"2025082803571622000_16.8.e253773.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(03)00160-9"},{"key":"2025082803571622000_16.8.e253773.2","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s13760-014-0292-0","article-title":"Sixth cranial nerve palsy in isolated sphenoid sinusitis: a case report","volume":"114","author":"Fockaert","year":"2014","journal-title":"Acta Neurol Belg"},{"key":"2025082803571622000_16.8.e253773.3","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1177\/000348940211100407","article-title":"Isolated sphenoid sinus disease: an analysis of 122 cases","volume":"111","author":"Wang","year":"2002","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"2025082803571622000_16.8.e253773.4","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199712000-00003"},{"key":"2025082803571622000_16.8.e253773.5","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.wjorl.2017.02.001","article-title":"Ocular cranial nerve palsies secondary to sphenoid sinusitis","volume":"3","author":"El Mograbi","year":"2017","journal-title":"World J Otorhinolaryngol Head Neck Surg"},{"key":"2025082803571622000_16.8.e253773.6","first-page":"104","article-title":"Diagnostic imaging of fungal sinusitis: eleven new cases and literature review","volume":"33","author":"Roithmann","year":"1995","journal-title":"Rhinology"},{"key":"2025082803571622000_16.8.e253773.7","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-69446-5","article-title":"A model for classification of invasive fungal rhinosinusitis by computed tomography","volume":"10","author":"Slonimsky","year":"2020","journal-title":"Sci Rep"},{"key":"2025082803571622000_16.8.e253773.8","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.129.2.236"},{"key":"2025082803571622000_16.8.e253773.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2003.11.011"},{"key":"2025082803571622000_16.8.e253773.10","doi-asserted-by":"publisher","DOI":"10.1053\/hn.1999.v120.a89436"},{"key":"2025082803571622000_16.8.e253773.11","doi-asserted-by":"crossref","first-page":"432","DOI":"10.2500\/ajra.2013.27.3943","article-title":"Prognosis for sixth nerve palsy arising from paranasal sinus disease","volume":"27","author":"Miller","year":"2013","journal-title":"Am J Rhinol Allergy"},{"key":"2025082803571622000_16.8.e253773.12","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2015-209408","article-title":"Isolated acute sphenoid sinusitis presenting with hemicranial headache and ipsilateral abducens nerve palsy","volume":"2015","author":"Gupta","year":"2015","journal-title":"BMJ Case Rep"},{"key":"2025082803571622000_16.8.e253773.13","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.126.6.777"},{"key":"2025082803571622000_16.8.e253773.14","doi-asserted-by":"crossref","first-page":"V","DOI":"10.1590\/0100-3984.2021.54.3e1","article-title":"The cranial nerves: extensions of the central nervous system or components of the peripheral nervous system - 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