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いかなる手術においても副損傷,合併症の危険があり,Vidian neurectomyの場合も例外ではない1)2)。この手術で眼筋麻痺,特に外転神経麻痺が時に報告されている3)。これは一過性のものであるが,患者のみならず術者にとつても大きな驚きであり,もしも初回の手術でこのような麻痺を経験すると,二度とこの手術を行なう気にならないであろう。
私どもも50側のVidian neurectomyにおいて1側に外転神経不全麻痺を経験した。この症例では手術直後よりステロイドを約2週間使用し,2カ月後に麻痺は完全に回復した。
Ophthalmoplegia has been occassionally reported as a complication in vidian neurectomy with use of high frequency electric current in an electric coagulator. The authors report a case of abducens paresis of 2 months duration which they believed the possible cause was due to electrical damage of the abducens nerve.
Anatomic study of the vidian and abducens nerve showed that they are both interconnected with each other on the wall of the internal carotid artery. The high frequency electric current (1.1MHz, 6 watt) passing through the vidian nerve would easily effect the abducens nerve on the wall of the internal carotid artery.
Of late, the authors have discontinued the use of electrocoagulator in the operative procedure of the vidian nerve.
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