ОПТОХИАЗМАЛЬНЫЙ АРАХНОИДИТ СИНУСОГЕННОГО ГЕНЕЗА: КЛИНИЧЕСКИЙ СЛУЧАЙ И МЕЖДИСЦИПЛИНАРНЫЙ ПОДХОД К ДИАГНОСТИКЕ И ЛЕЧЕНИЮ

Abstract

Introduction. Optochiasmatic arachnoiditis is a severe form of chronic inflammatory involvement of the arachnoid membrane of the brain, predominantly affecting the optic nerves and the optic chiasm and often resulting in irreversible visual loss. Inflammatory diseases of the paranasal sinuses, particularly sphenoid sinusitis, play a significant role in its pathogenesis due to the close anatomical relationship with the optic pathways.

Objective. To analyze the clinical features, diagnostic findings, and treatment outcomes of sinusogenic optochiasmatic arachnoiditis based on a clinical case.

Materials and Methods. A retrospective analysis of a clinical case of a patient with bilateral ethmoiditis, sphenoiditis, and optochiasmatic arachnoiditis was performed. Clinical presentation, ophthalmological and otorhinolaryngological findings, CT and MRI data, as well as the outcomes of surgical and conservative treatment were evaluated.

Results. The disease was characterized by progressive bilateral visual impairment, persistent headache, and MRI signs of inflammatory involvement of the chiasmatic region. Despite successful endoscopic surgical sanitation of the paranasal sinuses and comprehensive anti-inflammatory therapy, visual function could not be restored due to advanced optic nerve atrophy.

Conclusion. Sinusogenic optochiasmatic arachnoiditis represents a severe complication of paranasal sinus inflammation. Early diagnosis and timely multidisciplinary management are crucial to prevent irreversible visual loss.