著明な囊胞状涙囊炎に対し経鼻的涙囊鼻腔吻合術を施行した10例

Endonasal dacryocystorhinostomy in ten cases of severe ballooning dacryocystitis

要約　背景：顕著な囊胞状涙囊炎がある鼻涙管閉塞症には経皮的涙囊鼻腔吻合術が一般的な手術法であった。しかし膿が貯溜し炎症が強い涙囊部に切開を行うことは，侵襲が強く，癒着や炎症が遷延化しやすい。目的：重篤な囊胞状涙囊炎に対する経鼻的涙囊鼻腔吻合術の報告。症例：過去4年間に経鼻的涙囊鼻腔吻合術を行った10例で，すべて片側に発症していた。男性1例，女性9例で，年齢は54～92歳（平均65歳）である。結果：6か月以上の経過観察で，涙囊炎は全例で改善し，再発はなかった。涙囊圧亢進が原因と推測される涙小管閉塞が5例に残った。結論：症例によっては顕著な囊胞状涙囊炎があっても，涙囊圧を管理して手術操作を行えば，経鼻的涙囊鼻腔吻合術は施行可能かつ有効である。

Abstract.　Background：Percutaneous dacryocystorhinostomy has often been performed for ballooning dacryocystitis. In severe cases, however, this approch may result in inflammation or scarring. Purpose：To report the outcome of endonasal dacryocystorhinostomy for such cases. Cases：This retrospective study was made on 10 cases of ballooning dacryocystitis treated by endonasal approach. All cases were unilaterally affected. The series comprised 1 male and 9 females. Their age ranged from 54 to 92 years, average 65 years. Results：Dacryocystitis was cured in all cases after follow-up for 6 months or longer. Stenosis of canaliculus remained presumably due to elevated pressure of lacrimal sac. Conclusion：Endonasal dacryocystorhinostomy is possible and effective for severe balooning dacryocystitis when due attention is paid to the lacrimal sac pressure.