gms | German Medical Science

Introduction: In most cases of abducent nerve paralysis patients are primarily seen by ophtalomologists, neurologists, pediatricians or physicians. The palsy is often benign and transient. More rarely inflammatory complications, trauma or tumor of the skull base cause abducent nerve palsy. These cases require an intervention by an otorhinolaryngologist.

Methods: 15 Patients (9 male, 6 female) have been treated in the Department of Ear-, Nose-, Throat- Surgery of Charité (Campus CVK) between 2003 and 2011. Fourteen patients have been operated, one patient with an temporal bone fracture has been treated conservatively. Seven patients had an inflammatory complication (2x chronic sinusitis, 3x acute otitis media, 1x osteomyelitis of the skull base, 1x Wegeners disease). Seven patients had a skull base tumor (5x nasopharyngeal carcinoma, 1x lymphoma, 1x metastasis of a bronchial carcinoma).

Results: In 67% of patients with inflammatory complications a recovery of abducent nerve function was achieved after operation and iv-antibiotic treatment. Patients with tumors gained full recovery in only one case and partial recovery in two cases. The patient with the temporal bone fracture achieved partial remission after three months.

Conclusion: The cardinal symptom of an abducent paralysis requires in complicated extra- and intracranial inflammations, tumors or trauma the expertise of a skull base surgeon. Prognosis of complicated inflammation is improved by efficient surgery considerably.