ナビゲーションシステムを用いて摘出した眼窩内散弾異物の1症例

Removal of a pellet from the right orbital cavity by image-guided endoscopic navigation

Ⅰ．はじめに

　わが国での耳鼻咽喉・頭頸部領域における銃弾異物の発生数は，銃砲刀剣類所持等取締法により銃砲刀剣類の所持や使用が厳しく制限されているためきわめて少なく，われわれの渉猟し得た限り頭蓋内を除いた報告例は，1983年以降17例にすぎない^1～9）。今回われわれは，散弾銃の流れ弾による眼窩内異物をナビゲーションシステムを使用し，鼻内視鏡下に摘出した症例を経験したので報告する。

　A 60-year-old male patient was referred after receiving a hunting accident with a pellet in the right orbit. X-ray films and CT scans of the orbit and the paranasal sinuses showed a pellet adjacent to the lamina papyracea. Emergency surgery was performed by ophthalmologist,but a pellet could not be removed by external orbital approach. Thirty days after the emergency surgery,the pellet was removed using the transnasal endoscopic approach with intraoperative image guidance without major complications. Image-guided removal of foreign bodies in head and neck is safe and valuable.