眼症状を呈した好酸球性副鼻腔炎の1例

A case of eosinophilic sinusitis with ophthalmic manifestations

Ⅰ　はじめに

　好酸球性副鼻腔炎は副鼻腔粘膜に好酸球浸潤がみられる難治性の副鼻腔炎で，気管支喘息を高頻度で合併することが報告されている。その臨床像は，両側性の粘膜浮腫や鼻茸による鼻閉，好酸球性ムチンと呼ばれる粘稠性の鼻汁を特徴とする。今回われわれは，篩骨洞内に充満したムチンが眼窩紙様板を圧排し，眼球運動障害をきたした好酸球性副鼻腔炎の1症例を経験したので，若干の文献的考察を加えて報告する。

　A 75-year-old male was treated as chronic sinusitis without improvement,but he developed bilateral proptosis and diplopia. A computed tomographic scan showed bilateral thickening of all paranasal sinus mucosa and erosion of the lamina papyrarcea. An endoscopic sinus surgery was performed,and histopathologic examination showed infiltration of eosinophils.

　After surgery,he was treated with beclomethasone nasal spray and all of his symptoms were improved. The ophthalmic manifestation was presumably caused by the pressure from expansive growth of polyps and mucin which produced a mass effect in the orbit.