鼻涙管形成不全の3症例

Three cases of atresia of nasolacrimal duct

要約　出生直後から流涙と眼脂が続き，頻回のブジーを行っても治癒しなかった3症例を鼻涙管形成不全と診断した。全例に眼以外の奇形があった。第1例には，指欠損症，外胚葉形成不全症，口唇口蓋裂の合併（ectrodactyly,ectodermal dysplasia,cleft lip-palate syndrome：EEC症候群）があり，鼻涙管閉塞は両側にあった。第2例にはRubinstein-Taybi症候群があり，鼻涙管閉塞は両側にあった。第3例には心室中隔欠損，口蓋裂，披裂部喉頭軟化症があり，鼻涙管閉塞は片則性であった。3症例とも，CT涙道造影で鼻涙管骨異常があり，骨影が不明瞭で下鼻道と連続せず，管腔にも異常陰影があった。全例に涙囊鼻腔吻合術を行い，良好な結果を得た。

Abstract.　We diagnosed three cases with atresia of nasolacrimal duct. All the cases had lacrimation and eye discharge since birth. Repeated attempts with bougie were futile. All the cases had extraocular anomalies. One had bilateral atresia and EEC syndrome with bilateral ectodactyly,ectodermal dysplasia and cleft palate. Another had bilateral atresia and Rubinstein-Taybi syndrome. The other had unilateral atresia,ventricular septal defect,cleft palate,and arytenolaryngeal malacia. All the cases showed anomalies at the lower portion of nasolacrimal duct by dacryocystography using computerized tomography. The bone shadow of nasolacrimal duct was unclear and lacked connections with the lower nasal meatus. Abnormal shadow was present in the lumen of the nasolacrimal duct. Symptomatic cure was obtained by dacryocystorhinostomy in all the cases.