内視鏡下経鼻Partsch I法鼻内開窓法による切歯管嚢胞の治療

Endoscopic Endonasal Partsch's Operation for Nasopalatine Duct (Incisive Canal) Cyst

　はじめに

　切歯管嚢胞は鼻口蓋嚢胞の1型で，胎生期鼻口蓋管の遺残上皮に由来する非歯系外胚葉性上皮性嚢胞（裂隙性嚢胞）であり，上顎骨内に発生する疾患である^1）。最近われわれは本症を経験し，顎嚢胞手術法として古くより知られるPartsch I法開窓法^1）を応用し内視鏡下に鼻腔底部に副腔として開窓したところ良好な結果が得られた。症例を報告し若干の考察を加えた。

Nasopalatine duct cyst is a comparatively rare disease.

A 46-year-old male presented with a cyst of 3×3×3 cm in size defect in the middle portion of the hard palate. A large swelling in the oral vestibuleand the floor of the nasal cavity was observed. X-ray examinations suggested a nasopalatine duct cyst. The Partsch's type 1 open method was applied by endonasal endoscopy. Wide opening was made by mucosal resection in the floor of the nasal cavity over the cyst roof.

Although the cyst was remained as a new cavity in the nose for a long time, no depression nor distur-bance were complained by the patient. The opera-tion was very simple and easy for ENT surgeon, and it was effective to cure the cyst. The benefit for the patient was of its minimal invasion.