The paralysis of the pair Vi is the most common paralysis of extra ocular muscles. Due to the close proximity to other cranial nerves in their rout, the lesions may produce neurological signs and symptoms more than one additional isolated paralysis of the lateral rectus muscle. Rarely causes rhinosinusitis are taken into account. PURPOSE: To consider the vulnerability of the pair Vi in the rhinosinusal pathology. Correlate anatomical location of the lesion with nerve industry committed. If present five clinical cases of patients with paralysis of pair Vi, as clinical manifestation of pathology rhinosinusal period in March 2010 and March 2011. METHOD: Given the patient's clinical presentation, complementary studies, diagnosis, procedure performed and follow-up. RESULTS: We evaluated five patients with paralysis pair VI as clinical manifestations of mucoceles, cementome, inverted papillome, squamous cell carcinoma and chronic inflammatory process of unknown etiology. In three of them were reversible by treating the root cause and is not reversible in the case of cementome and in advanced squamous cell carcinoma. CONCLUSIONS: Sinus causes of the commitment of the sixth pair are not always taken into account. In pathology rhinosinusal the place most frequent commitment is sinuscavernous and paralysis is initially isolated by the location within the same lower. Obtaining a careful history, proper patient evaluation and implementation of complementary examinations are appreciated, along with appropriate treatment.