涙囊鼻腔吻合術後に悪臭症が生じた1例

Cacosmia in a case after dacryocystorhinostomy

要約　目的：涙囊鼻腔吻合術後に悪臭症が生じた症例の報告。症例：74歳女性の右涙囊炎に対し，鼻外法による涙囊鼻腔吻合術を行った。ヌンチャク型シリコーン管を留置し，軟膏ガーゼを3日間留置した。通水は良好であった。3か月後に鼻閉感と悪臭が生じた。内視鏡でシリコーン管に付着した痂皮と，総鼻道底部に黒色で悪臭のある堆積物があった。これを除去することで，鼻閉と悪臭症は消失した。結論：涙囊鼻腔吻合術後では，鼻内観察と清掃が望ましい。

Abstract.　Purpose：To report a case who developed cacosmia following dacryocystorhinostomy. Case：74-year-old female received surgery for dacryocystitis in her right eye. External dacryocystorhinostomy was performed with insertion of nunchaku-type silicone tube. Small sheets of gauze with ointment was retained for 3 days. Surgery resulted in patent nasolacrimal duct. She noticed congested nose with malodor. Endoscopy showed crust sticking to the silicone tube and black malodorous deposit on the nasal meatus. Removal of the deposit resulted in clinical cure. Conclusion：This case illustrates that careful endoscopic follow-up may prevent complications following dacryocystorhinostomy.