内視鏡下鼻内手術を施行した巨大な鼻口蓋管囊胞例

A case of giant nasopalatine duct cyst treated by endoscopic endonasal marsupialization

はじめに

　鼻口蓋管囊胞は上顎正中部に生じる非歯原性囊胞で，鼻口蓋管（切歯管）の遺残上皮に由来するとされる^1）。根治的治療法として囊胞全摘出が行われるが，巨大な囊胞の場合，摘出後の死腔の処理が問題となる。今回われわれは，内視鏡下鼻内手術で鼻口蓋管囊胞を両側鼻腔に開窓した症例を経験したため，若干の文献的考察とともに報告する。

　Nasopalatine duct cyst is one of the most common cysts among the nonodontogenic cysts in the maxillofacial area. The cyst originates from epithelial remnants from the nasopalatine duct. We presented a 38-year-old male with extensive nasopalatine duct cyst in the middle portion of the hard palate. He complained of a palatal swelling and nasal obstruction and underwent marsupialization with transnasal endoscopic surgery. The opening was enlarged as far as possible by mucosal resection in the floor of the nasal cavity over the cyst roof. The palatal swelling and nasal obstruction disappeared postoperatively, and the clinical course was uneventful.