副鼻腔炎から海綿静脈洞血栓症，髄膜炎を併発し急激に失明に至った1症例

Loss of vision in a case of sinusitis with secondary cavernous sinus thrombosis and meningitis

　慢性副鼻腔炎の治療中の39歳の男子に，海綿静脈洞血栓症と髄膜炎が併発し，両眼の視神経炎と眼球突出が生じた。副鼻腔炎に対する手術後全身状態が改善し，右眼は回復したが，左眼は視神経萎縮の結果失明した。副鼻腔疾患に続発する鼻性視神経炎は，耳鼻咽喉科的手術が奏効し，予後良好とされてきたが，頭蓋内合併症のため視力喪失に至る事例のあることを本例は示している。

A 39-year-old male presented with acute bilat-eral visual impairment, chemosis and proptosis. He had been under treatment for sinusitis. Acute fever developed 2 days before and was diagnosed as meningitis and cavernous sinus thrombosis. Computed tomography showed accumulation of putrid mass in the frontal, ethmoid and sphenoid sinus. Laboratory examinations showed signs of septicemia. His general condition improved follow-ing surgery for infected paranasal sinus performed 3 days later.

Full visual recovery set in in the right eye. The left vision was lost due to postneuritic optic atro-phy. The case illustrates that optic neuritis secon-dary to paranasal sinus infection may result in poor outcome contrary to the currently accepted view