涙囊鼻腔吻合術下鼻道法術後にみられた発熱例2例

Two cases of fever following dacryocystorhinostomy through inferior meatal approach

要約　目的：下鼻道経由による涙囊鼻腔吻合術の直後に発熱した2症例の報告。症例：1例は81歳男性，他の1例は81歳女性である。2例とも鼻涙管閉塞症が右眼にあり，1例には同側の涙囊炎があった。いずれも患側に下鼻道経由の涙囊鼻腔吻合術が行われた。1例では術直後の36.7℃の体温が帰宅後に38℃以上，他の1例では36.6℃の体温が夜になり38.7℃になった。両症例とも抗菌薬の全身投与で術2日後までに平熱になり，1週間後には白血球数が正常化した。結論：下鼻道経由による涙囊鼻腔吻合術では，特に高年者では術後の体温に留意し，術後3日間は抗菌薬の全身投与が望ましい。

Abstract.　Purpose：To report 2 cases who developed fever after dacryocystorhinostomy through the inferior meatus. Cases and Findings：One was an 81-year-old male and the other an 81-year-old female. Both had obstruction of nasolacrimal duct on the right side. One had ipsilateral dacryocystitis. Both patients received dacryocystorhinostomy through the inferior meatus. Body temperature in one case was 36.7℃ immediately after surgery and rose to 38℃ after returning home. It was 36.6℃ after surgery and rose to 38.7℃ the same evening in the other case. Body temperature normalized in both cases after treatment with antibiotics for 2 days. Leukocyte count returned to normal value after one week. Conclusion：These cases illustrate that dacryocystorhinostomy through the inferior meatus may be followed by fever,particularly in patients of advanced age. Prophylaxis with systemic antibiotic is recommended for 3 days after surgery.