Ptosis and Cavernous Sinus Disease

Ptosis is drooping of the eyelid and can be due to nerve (i.e. third cranial nerve, oculosympathetic nerves), muscle (i.e. levator palpebrae superioris, Müller muscle), or neuromuscular junction (e.g., myasthenia gravis) disorders. The cavernous sinus is a paired dural venous sinus composed of multiple trabeculated venous channels which contains the internal carotid artery, both afferent (trigeminal (V1 and V2) sensory) and efferent (the ocular motor (cranial III, IV, and VI)) nerves, as well as the oculosympathetic fibers (loss of which causes Horner syndrome). Intracranial pathology within or adjacent to the cavernous sinus can produce ptosis. Clinicians should be aware of the pathogenesis and etiology for ptosis related to cavernous sinus lesions.