動眼神経麻痺を主症状とした後部副鼻腔嚢胞の1症例

A Case Report of Posterior Paranasal Sinus Cyst with Paralysis of the Oculomotor Nerve

　はじめに

　後部副鼻腔嚢胞は比較的稀な疾患であり，その主要な症状は眼症状と頭痛である^1）。これらのうち最も頻度が高く著明な症状は眼症状であるが，その多くは視力障害で^2），動眼大神経麻痺のみを呈する例の報告は極めて稀である。

　今回われわれは視力障害を伴わずに動眼神経麻痺で発症した後部副鼻腔嚢胞の1症例を経験したので，その概要を報告するとともに動眼神経麻痺の成因について考察を行った。

A 56-year-old male, who suddenly complained of double vision and ptosis of the right eye, had a medical history of an operation of bilateral chronic sinusitis 36 years ago. The symptoms were only due to the disturbance of the right oculomotor nerve. In x-ray tomography and CT, a shadow was observed in the right poster-ior paranasal sinus and diagnosed as a cyst of the right posterior paranasal sinus. Right eth-moidectomy was performed via an endonasal approach under local anesthesia. About 2 ml of pus was observed in this cyst. About 6 weeks later, the symptoms had completely disappeared.