蝶形骨洞開放術術後に発生した蝶形骨洞真菌症の1例

Postoperative Aspergillosis of the Sphenoid Sinus: A Case Report

I．はじめに

　鼻副鼻腔真菌症は比較的稀な疾患とされてきたが，近年鼻副鼻腔を含めて臨床各領域において本症の報告は増加している。今回私どもは蝶形骨洞粘液嚢胞に対して鼻内蝶形骨洞開放術を施行し術後に蝶形骨洞真菌症を起した1症例を経験したので，症例を提示し若干の考察を加えて報告する。

　A 48-year-old male complained of headache, dizziness and purulent rhinorrhea for 4 months prior to admission. He has undergone a sphenoid sinus surgery under the diagnosis of mucocele in April, 1980, and the ostium of the sinus was widened for drainage of accumulating mucus. The widened ostium was thought to enable fungi to invade the sinus mucosa. The skull X-ray film of submentovertical view and CT revealed a calcification in the sphenoid sinus mucosa. Irrigation with Amphotericin B solution and packing gauzes pasted with fungicidal ointment into the sinus were effective. This local treatment was evaluated by histopathological examination.