鼻副鼻腔のアスペルギルス症

ASPERGILLOSIS OF THE MAXILLARY SINUS, A CASE REPORT

　Ⅰ．緒言

　鼻副鼻腔に発生したアスペルギルス症に関する報告は増加してきており，その認識も深まりつつあることが判る。

　しかしながら，その治療成績については一概に良しとはいえず，多数症例で難治の経験が発表されている。

　今回われわれは難治な上顎洞アスペルギルス症の1例を経験したので，その経過を詳述するとともに文献をまとめ，本症の診断治療について考察する。

　A case of aspergillosis of the right maxillary sinus is reported. The patient a man, farmer, aged 73, complained of a dull paint in the right cheek and hemicrania of the same side.

　X-ray examination revealed a massive blurring of the right maxillary sinus with bone destruction. The maxillary sinus was opened by Caldwell-Luc approach. Microscopic examination and culture showed the growth of aspergillus fumigatus. Fovellowing this operation the patient showed improment but two months later he again began to complain of the same hemicrania. Thereupon, the patient was treated with a partial maxillectomy and resection of the maxillary nerve in the pterygopalatine fossa. The hemicrania disappeared after this operation. Because of the side-effects caused by antimyotic drug the authors were unable to administer a prolonged treatment with this drug.