Rollet syndrome (orbital apex-sphenoidal syndrome) 1

General: Lesion in the apex of the orbit (neoplastic, hemorrhagic, or inflammatory) invo 121h77b lving the third, fourth, and sixth cranial nerves, the ophthalmic branch of the fifth sympathetic fibers when they pass through the sphenoidal fissure, and the optic nerve; manifestations vary greatly with extent of lesion; pain is frequent early sign; orbital fissure syndrome and sphenocavernous syndrome are similar; sudden onset.

Ocular: Exophthalmos; ptosis; hyperesthesia or anesthesia of the upper lid; ophthalmoplegia (partial or complete); wide pupil with loss of reaction on accommodation; neuralgic pain in the region of the ophthalmic branch of cranial nerve V; anesthesia of the cornea; papilledema; optic neuritis; optic atrophy; diplopia; herpes zoster ophthalmicus.

Clinical: Hyperesthesia or anesthesia of the forehead; inflammation of cavernous sinuses; meningoencephalitis.

Bourke RD, Pyle J. Herpes zoster ophthalmicus and the orbital apex syndrome. Aust N Z J Ophthalmol 1994; 22:77-80.

Goldberg RA, et al. Microanatomy of the orbital apex. Computed tomography and microcryoing of soft and hard tissue. Ophthalmology 1992; 99:1447-l452.

Kander PL, Leaver PK. Orbital apex syndrome complicating frontal pyocele. J Laryngol Otol 1974; 88:551.

Kattaah JC, Kennerdell JS. Orbital apex syndrome secondary to herpes zoster ophthalmicus. Am J Ophthalmol 1978; 85:378-382.

Rollet J. Dict Traite des Maladies Veneriennes, Vol. 15. Paris: Masson, 1865:993.