Correlation between dental infections and the development of cavernous sinus syndrome
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Date
2020-03-11
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faculty of Basic Medical Science - Libyan International Medical University
Abstract
Cavernous sinus and it's direct communication to dental structures can predispose
individuals to "Cavernous sinus Thrombosis" , which can be developed due to the
spread of :
Paranasal Sinus infections in the (of dental origin) , Or due to the spread of infections
from (Gingivitis)/(Parapharyngeal abscess) "in the Pharyngomaxillary space".
Or an abscess in the buccal spaces via "Buccal mucosal laceration", which may be
caused by an ill-fitted denture and dental extractions .
Misdiagnosis and inappropriate treatment of Dental infections for example , The
neglectance of Dental Hygiene , leads to the Development of CST.
Description
"Cavernous sinus Thrombosis " It is a rare medical emergency and a life threatening
condition in which blood clots are formed within the Cavernous sinus, through sepsis
and disseminated Intravascular coagulation(1) .
Because the Cavernous sinus contains vital neuronal structures, and the elevated risk
of hemorrhage . Before the development of Antibiotics the mortality rate was almost
100%.(1)
CST can be aseptic which may result from surgery or trauma . The spread of infection
from infected teeth can proceed mainly by "Venous Pathways". CST has different
symptoms depending on the affected anatomical structures(4):
Lesions involving the entire sinus :
Opthalmoplegia " the paralysis of the external extraocular muscles secondary to the
dysfunction of CN III / CN IV ", Diplopia , Periorbital ecchymosis . Fixed dilated
pupils " due to damage of the parasympathetic fibers ", Or even the Loss of vision (4).
Impaired vascular drainage for the face and eyes : Meningitis, Subdural empyema
"collection of pus between the dura and arachnoid matter"(2).
Damage to the sympathetic plexus : Leads to Horner's syndrome
"Miosis/ptosis/anhidrosis"(4)
Damage to CN V (V1/V2): Sensory loss in face/scalp/maxilla/nasal cavity/palate (4) .
Damage to CN VI Lateral gaze palsey "The inability to move the eye in a single
direction" , which is an isolated early sign of CST (3).
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