眼窩拡大を伴う眼窩内静脈瘤の1症例

A case of orbital varix with expansion of the bony orbit

　症例は52歳男性で，右眼の15年来の眼球陥凹があり，20年前に副鼻腔の手術を受けていた。Valsalva法で右眼球突出を呈した。CT検査にて眼窩内静脈瘤と診断した。また，右篩骨洞は縮小し，眼窩側壁は篩骨洞側に突出しており，眼窩容積が拡大していた。一般に眼窩内静脈瘤における眼球陥凹は眼窩内の軟部組織の萎縮が原因とされているが，今回の症例では，副鼻腔炎手術後の眼窩拡大が眼球陥凹の一因であると考えられた。

A 52-year-old man presented with ocular pain of recent onset and enophthalmos in the right eye of 15 years'duration. He had undergone surgery for the right maxillary and ethmoidal parasinusitis 20 years before. His right eye responded by proptosis after Valsalva maneuver. Computed tomography led to the diagnosis of varix in the right orbit. The ipsilateral ethmoidal sinuses were reduced in size. The medical wall of the right orbit was markedly convexed. While atrophy of intraorbital soft tissue is claimed to be the cause of enophthalmos secondary to orbital varix, the enophthalmos in the present case was apparently induced by enlargement of the bony orbit following paranasal surgery.