추체골염을 동반하지 않는 급성 유양돌기염에 의한 외전신경마비 1예

A 29-month-old boy presented with acute onset of esodeviation and limitation of ocular movement in his right eye. He had a history of right otitis media for 6 weeks, was diagnosed as abducens nerve palsy. Ventilation tube insertion was done after the eye symptom developed. At first day after surgery, esotropia of 30 prism diopters (PD) and abduction limitation (-4) was still obseved in the right eye due to abducens nerve palsy of the right side. A computed tomography of the temporal bone and magnetic resonance imaging of the brain showed severe mastoiditis without involvement of the abducens nerve pathway including petrous bone. At 6 days after onset of esotropia, simple mastoidectomy was done. An esotropia was improved gradually and at 4 months after surgery, orthotropia and normal ocular movement were acquired. We report a rare case of abducens nerve palsy presumed to be complicated by septic thrombosis of inferior petrosal sinus from mastoiditis without petrous apicitis. (J Clinical Otolaryngol 2010;21:74-78)