蝶形骨洞内骨髄腫の開頭手術例

SUCCESSFUL REMOVAL OF THE SPHENOID SINUS TUMOR (MYELOMA):Our Frontal Intra- and Extradural Combined Approach

I．はじめに

　われわれは最近，蝶形骨洞より篩骨洞および眼窩後方に拡がる頭蓋底硬膜外の腫瘍に対しわれわれの考えた開頭接近法によつて手術を行ない，それを亜全摘し，症状はいちじるしく改善したが術後その腫瘍組織は骨髄腫であり，しかも種々検索の結果diffuse typeのものであることがわかった，稀な症例を経験したので紹介する。

A large tumor of the sphenoid sinus was success-fully removed through the frontal intra- and ex-tradural combined approach, and the tumor was revealed to be myeloma histologically. This approach is superior to the nasal or paranasal approach, in broader operative exposure, direct visualization of the tumor and its extension to the important neighbour-ing structures such as the dura, the optic nerve and the internal carotid artery.

Diagnosis of the sphenoid sinus tumor is difficult, for the sinus is located in the depth of the cranium and has no its own function and symptoms.

Circustomogram made diagnosis decisive in our case, and was thought to be very useful in diagnosing the cranial base tumors.

Multiple myeloma is better treated medically or/ and by radiation. But surgical removal of the cranial base tumor in multiple myeloma is consider-ed reasonable, when the tumor produces severe symptoms and the operation seems to save his complaints.