内視鏡下に開放した斜台粘液嚢胞の1例

A Case of a Clival Mucocele Drained Through an Endoscopic Transnasal Transsphenoidal Approach

　はじめに

　斜台はトルコ鞍背から後方へ続くなだらかな傾斜部にあり，通常は骨髄で満たされ含気化することは少なく，同部に粘液嚢胞が生ずることは極めて稀で，今回検索した限りでは過去に2例しか報告がなかった^1,2）。

　診断にはCT，MRIが欠かせないが，骨欠損を伴う場合，脊索腫など腫瘍との鑑別が困難で生検を必要とする。

A 73-year-old male presented with otitis media of the right ear and nasal polyps. CT scan revealed a cir-cumscribed lesion in the clivus. Because the findings ofCT and MRI suggested the possibilities of mucocele, chordoma and metastatic tumor, the lesion was inspected through an endoscopic transnasal taranssphe-noidal approach. The lesion was confirmed as a muco-cele and drained widely to the posterior nasal cavity. Only two cases of clival mucocele have been reported previously in Japanese and English literatures since 1960. This endoscopic approach is thought useful for inspecting a lesion and drainig a mucocele in the clivus.