海綿静脈洞病変87症例の検討

Analyses on 87 cases with cavernous sinus lesions

　海綿静脈洞病変87例の臨床症状を検討し，局所診断上次の4点が重要であると考えた．①動眼・滑車および外転神経の単独または複合麻痺を示す．②動眼神経麻痺では上板と下板の障害程度に差があり，上板障害優位例が多い．③三叉神経とくに眼神経や上顎神経障害が認められる．④瞳孔は左右等大のことが多い．また，これらの臨床症状の特徴は海綿静脈洞の形態学的所見とよく相関していることがヒト海綿静脈洞連続切片標本の観察から確認された．

We evaluated a consecutive series of 87 cases with cavernous sinus lesions seen during the past 5 years. The lesions were inflammatory in 28 cases, tumor-induced in 27, associated with inflammation in 28 cases, tumor in 27, paranasal sinusitis in 13, trauma in 10, carotid cavemus sinus fistula in 6 and carotid aneurysm in 3.

Oculomotor, trochlear and abducens nerves were often involved, either isolated or combined events.In oculomotor palsy, the superior branch palsy was more frequent than inferior one. Trigeminal nerve palsy was often associated by optic nerve and/or maxillary nerve lesions. Even in cases with oculomotor palsy, the pupil was normal or minimal-ly involved. These clinical signs are of importance in diagnosing cavernous sinus lesions. As an overall finding, these clinical signs were well in accord with the morphological characteristics of the cavernous sinus and the orbid seen as serial sections.

Rinsho Ganka (Jon J Clin Ophthalmol) 41(8) : 973-976, 1987