開口障害を伴った小児蝶形骨洞炎例

Sphenoid sinusitis with trismus in a child

はじめに

　急性副鼻腔炎は重症化すると周囲に炎症が波及し，眼窩・頭蓋内合併症を生じることがあるが，開口障害を伴うことはきわめて稀である^1）。今回われわれは，蝶形骨洞の炎症が側頭下窩に波及し，開口障害を伴った小児蝶形骨洞炎の1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 12-year-old boy complained of headache and trismus. CT showed right sphenoid sinusitis with an expanding inflammation from parapharyngeal space to infratemporal fossa. We suspected an abscess formation at the infratemporal fossa. Endoscopic sinus surgery was performed immediately. Subsequently, carbapenem and clindamycin were administered. The patient recovered uneventfully. We considered that drainage and appropriate administration of antibacterial agents would be very useful for severe sphenoid sinusitis.