難治性前頭洞嚢胞の3症例

Recurrent Frontal Sinus Mucoceles:Report of Three Cases

　はじめに

　再発性前頭洞嚢胞は，前回手術より局所の解剖が複雑になること，および治癒機転において鼻前頭管は閉塞傾向があることから，再手術時には問題点が多い。このような意味で再発性前頭洞嚢胞は難治性前頭洞嚢胞である。

　今回，難治性前頭洞嚢胞の3症例を報告し，本疾患の治療に対する問題点について文献的考察をする。

Three cases of recurrent muco-pyoceles in the fronto-ethmoidal region were reported. The difficult problems on clinical aspects and treat-ment were discussed.

Case 1: Postoperative frontal sinus was oblite-rated. Two cysts in the fronto-ethmoidal region with a small area of exposed dura were found. Extranasal approach was abandoned and cn-donasal one was chosen.

Case 2 : Medial wall of the orbit with partial loss was medially displaced. As the naso-frontal communication was uncertain in keeping pa-tency for a long period, intersinus septum per-foration was performed to the left frontal sinus.

Case 3: Close contact with the extraocular mus-cle sand loss of the medial orbital wall were found.

Because of hign risk due to myocardial infarc-tion, any surgery was refused by anesthesiologists. Simple puncture and aspiration were chosen as a palliative procedure.