The Abducens nerve (VI) is most commonly affected in cavernous sinus thrombosis because it runs within the lumen of the cavernous sinus, unlike the other cranial nerves that are located in the lateral wall. This anatomical position makes it highly vulnerable to compression or ischemia during thrombosis. Clinically, this results in lateral rectus muscle paralysis, manifesting as horizontal diplopia. Early recognition of abducens nerve palsy is crucial for diagnosis and management of cavernous sinus thrombosis secondary to dental infection.

Reference: Gray’s Anatomy, Standring S, 42nd Edition.