小児涙囊鼻腔吻合術鼻内法（pediatric endonasal dacryocystorhinostomy）の2例

Two cases of congenital nasolacrimal duct obstruction treated by pediatric endonasal dacryocystorhinostomy

要約　目的：先天鼻涙管閉塞症（CNLDO）に，涙囊鼻腔吻合術鼻内法（E-DCR）を施行した2症例の報告。

症例：症例1：3歳男児。生直後から両眼に眼脂と流涙があった。右E-DCR目的にて紹介受診。前医で左E-DCRを施行し治癒。経過：右E-DCR施行，術後経過良好で現在，眼脂，流涙症状は消失している。症例2：6歳男児。生直後に両眼眼脂，流涙および左涙囊炎に伴う涙囊部腫脹があった。右は3か月で自然治癒した。左涙囊炎は圧迫で排膿し，症状軽快するため経過観察されていた。4歳時，腫脹が持続的となり紹介受診した。経過：左E-DCR下鼻道法を施行，術直後は症状消失した。4か月後再発，E-DCRを施行し症状は消失している。

結論：CNLDOにE-DCRが根治的治療として有効な症例を報告した。

Abstract　Purpose: To report two cases who received pediatric endonasal dacryocystorhinostomy for congenital nasolacrimal duct obstruction.

Cases: A 3-year-old boy had had discharge and epiphora since birth in both eyes. He had received endonasal dacryocystorhinostomy in the left eye followed by resolution of symptoms. Endonasal dacryocystorhinostomy in the right eye relieved subjective symptoms. Another 6-year-old boy had had discharge and epiphora since birth in both eyes with swelling of left lacrimal sac. Signs of dacryocystitis in the right eye resolved at the age of 3 months. Swelling of left lacrimal sac persisted until the age of 4 years. Endonasal dacryocystorhinostomy via the inferior meatus, performed twice, induced lasting cure.

Conclusion: Endonasal dacryocystorhinostomy was effective in two cases of congenital nasolacrimal duct obstruction.