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Radiology Quiz Case 2
S. Alex Kim, MD;
Robert H. Mathog, MD
Wayne State University School of Medicine, Detroit, Mich
Arch Otolaryngol Head Neck Surg. 2002;128:81-83.
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A 40-YEAR-OLD man presented with a 2-month history of sudden-onset diplopia
on upward gaze. The diplopia was worsened by fatigue, use of alcohol, and
eye strain. The patient denied eye pain, visual change, nasal discharge, headache,
weakness, or trauma. He had previously been seen by an ophthalmologist, who
had found no abnormalities other than mildenophthalmos after thorough evaluation.
The head and neck examination revealed 4 mm of enophthalmos of the left eye
(Figure 1 and Figure 2). There was noted diplopia on upward gaze; however, there
were no gaze palsies or visual acuity deficits. The nasal examination revealed
a right septal deflection with minimal nasal obstruction. There was no purulence,
necrosis, or congestion noted. A computed tomographic scan of the sinuses
was subsequently performed (Figure 3
[note left and right sides are opposite those of standard computed tomographic
scans] . . . [Full Text of this Article]
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