眼窩骨膜下膿瘍に対して内視鏡下鼻副鼻腔手術を施行した2症例

Endoscopic surgery of subperiosteal orbital abscess

Ⅰ　はじめに

　眼窩骨膜下膿瘍は鼻性眼窩内合併症の1つであり，眼痛，眼球突出，眼球運動障害などが出現し，病変の進行から視力障害をきたすこともある。そのために，視機能の保存のため，速やかに診断し，適切な治療を行うことが必要である^1,2）。

　今回，眼窩蜂窩織炎に対して，他科で保存的治療が行われたが改善しないため，当科にて内視鏡下鼻副鼻腔手術を施行した眼窩骨膜下膿瘍の2症例を経験したので治療経過とともに診断や治療方法などについて考察を行い，文献的考察を加えて報告する。

　Subperiosteal orbital abscess is one of the orbital complications usually caused by acute sinusitis. We reported 2 cases of subperiosteal orbital abscess treated by an endoscopic drainage. Both patient 1 and 2 had a persistent swelling in the eyelid and exophthalmos. They were treated with intravenous antibiotics,however their symptoms were not improved. CT scan suggested medial subperiosteal orbital abscess. The patients underwent endonasal endoscopic drainage for abscess,and the patients were treated successfully. In general,the orbital complications can be treated successfully with intravenous antibiotics. However,we have to decide early surgery at the time of no improvement of symptoms.