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緒言
前頭洞嚢胞は前頭洞の自然孔である鼻前頭管がなんらかの原因により狭窄や閉塞をきたし,前頭洞内に分泌物が貯留した状態(粘液嚢胞)である。これに細菌感染が加わり,膿性になったものが前頭洞膿嚢胞である。鼻前頭管は他の副鼻腔自然孔に比べて距離が長く開口部も狭小なため,容易に通過障害をきたす1)。大野ら2)によれば,前頭洞嚢胞の原因のうち,約50%が術後性(副鼻腔手術後に発生),25%が外傷性,残り25%が原発性で占められ砲,また前頭洞はその解剖学的位置関係より頭蓋内合併症を最もきたしやすく,中枢神経系に重篤な機能障害をもたらすこともある3,4)。
最近,われわれは術後性前頭洞膿嚢胞が頭蓋内に広範に進展した症例および頭部外傷が誘因とされた外傷性前頭洞嚢胞に脳膿瘍を合併した症例を経験したのでここに報告する。
Two cases of frontal sinus muco-pyocele with intracranial complication were presented. A 49-year-old male underwent polysinusectomy 25 years ago and was diagnosed as having a postopera five frontal sinus pyocele which was widely extending to the frontal cranial fossa. A 62-year-old male had a past history of trauma of the frontal bone 10 years ago and was diagnosed as having a post-traumatic frontal sinus mucocele with brain abscess in the frontal lobe. Naso-frontal duct was completely obstructed by gra-nulation, and bone defect of the frontal sinus was observed in both cases. Drainage operation from the frontal sinus to the nose was effective in both cases.
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