経前頭開頭による下垂体腺腫手術後に見られた髄液鼻漏の1治験例

A Case of Nontraumatic Cerebrospinal Rhinorrhea Following Subtotal Removal of the Pituitary Adenoma by Means of Transfrontal Approach

I．緒言

　髄液鼻漏（Cerebrospinal rhinorrhea）は，1676年Willisによつて初めて記載され，1899年Thomsonにより臨床疾患単位として確立されて以来，数多くの報告がなされている。

　われわれは最近，経前頭開頭による下垂体腺腫手術後照射中にみられた，いわゆる非外傷性髄液鼻漏の1治験例を経験したので，ここに報告し，若干の考察を加える。

Nontraumatic cerebrospinal rhinorrhea is rare. Ac-cording to Ommaya's paper, only eighty-two cases were reported up to 1964. One of such case is re-ported here.

A 44-year-old man admitted to our Department with complaint of wartery discharge from, right nostril in June, 1967. The subcapsular subtotal removal of the pituitary adenoma was carried out at a certain hospital four months ago. At that time, a part of capsule, which existed in anterior part of pituitary groove, was removed with the tumor. Postopratively he received Co⁶⁰ irradiation (6,000r). When he received 5, 500r as total irradiation dose during one and half months after operation, he noted the development of intermittent profuse war-tery discharge from the right nostril.

At the time of admission, radiological examinations revealed destruction of the anterior wall of the pituitary groove. The wartery liquid discharge was observed at posterior inner side of the superior turbinate by using intranasal fiberscope.

In July, 1967, the patient underwent surgery. It was seen that air bubles discharged from high portion of the anterior wall of the pituitary groove. A muscle piece immersed in E. D. H.-adhesive was placed on that portion.

The post-operative course was uneventful and the patient came back his occupation without any com-plaints.