Muhammad Sohail Ajmal Ghoauri, Nauman Ismat Butt, Abdul Samad, Muhammad Bilal Rasheed, Mutahra Khaliq.
Maxillary Sinus Carcinoma Presenting as Trochlear Nerve Palsy.
Pak J Ophthalmol Jan ;39(4):357-60.

We present a case of 21-year old gentleman presented with diplopia for last 4 months. There was history of protrusion of left eye ball, abnormal head posture causing head tilt and turning face towards right side and a painless lump in mouth over hard palate on left side. On examination, there was torticollis of the head with proptosis and partial ptosis of the left eye. There was impairment of intorsion, depression and adduction of the left eye with binocular diplopia which worsened when the left eye was directed downwards and medially. There was sensory loss in ophthalmic and maxillary divisions of the left Trigeminal nerve. CT scan of the paranasal sinuses revealed a locally aggressive mass in the left maxillary sinus with erosion and extension to left temporal bone. Biopsy confirmed it as Maxillary Sinus Carcinoma and a multidisciplinary management with ENT, neurosurgery and oncology was planned.

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