動眼神経単独麻痺で発症した蝶形洞疾患の2例

Sphenoid sinus disease presenting as isolated oculomotor nerve paralysis: a report of two cases

はじめに

　蝶形洞は，解剖学的に視神経管や海綿静脈洞，上眼窩裂と近接しているため，同部の病変により脳神経障害をきたし，眼症状を呈することがある。しかし，動眼神経麻痺単独で発症する症例は稀である。今回われわれは，初発症状として動眼神経麻痺を呈した蝶形洞疾患の2症例を経験したため報告する。

　We report two cases of sphenoid sinus disease with oculomotor nerve paralysis. Both patients presented with diplopia and ptosis. Neurological examination revealed left-side oculomotor nerve paralysis in two cases. Computed tomography showed soft tissue density in the sphenoid sinus in both cases. Magnetic resonance imaging demonstrated soft tissue lesion extending from the left cavernous sinus in the first case. Endoscopic biopsy was performed, and the two cases were histopathologically diagnosed as diffuse large B-cell lymphoma and sphenoid sinus mucocele, respectively. Both patients underwent endonasal endoscopic sphenoidotomy. Oculomotor nerve paralysis improved within a month after treatment in both cases.