慢性の経過をたどった海綿静脈洞炎の1例

Chronic Cavernous Sinusitis

　I．はじめに

　蝶形洞のmucoceleまたはpyoceleにより，周囲の骨が破壊され頭蓋内や眼窩内を圧迫し，眼球突出や視力低下，眼球運動障害などを呈した報告は数多く見受けられる。

　しかし，骨破壊を伴わず骨壁や静脈路を介し炎症が副鼻腔外に波及した報告は比較的稀である。

A 30-year-old man with a complaint of head-ache and diplopia was found to have sphenoiditis. Enhanced CT and MRI with Gd-DTPA revealed a mass lesion in the cavernous sinus. Orbital venography showed a filling defect of the caver-nous sinus.

After the sphenoidectomy and chemotherapy with antibiotics and steroid, his symptoms were relieved. However, the symptoms reappeared and fluctuated with nasal infections. Because the boney wall of the sphenoid sinus was intact, infection was considered to be transmitted through the venules of the sphenoid bone. Differential diagnosis and optimum treatment were discussed.