眼窩内神経鞘腫に伴う高度の外斜視に上下直筋全幅移動術が奏効した1例

Total transpositioning of vertical muscles was effective for large-angle exotropia in a case of intraorbital schwannoma

要約　目的：眼窩内神経鞘腫で生じた外斜視に上下直筋全幅移動術と外直筋後転術が奏効した症例の報告。症例：49歳男性が右眼の外斜視と複視で受診した。10年前に右眼の眼窩内腫瘍を指摘されたが放置していた。眼球突出が悪化し，6か月前に脳神経外科で眼窩腫瘍摘出術を受けた。診断は神経鞘腫であった。所見：矯正視力は右0.5，左1.5で，眼球突出はなく，右眼に高度の内転障害と110Δの外斜視があった。牽引試験では抵抗はなかった。右眼の上下直筋全幅移動術と外直筋後転術を行い，斜視角は10Δになり，第1眼位での複視は消失した。結論：眼窩内神経鞘腫への術後に生じた外斜視に，上下直筋全幅移動術と外直筋後転術が奏効した。

Abstract.　Purpose：To report a case of exotropia following surgery for orbital schwannoma treated by total transpositioning of vertical muscles. Case：A 49-year-old male presented with diplopia and exotropia in the right eye. He had been diagnosed with orbital tumor 10 years before. He had received excision of orbital tumor 6 months before and been diagnosed with schwannoma. Findings：Corrected visual acuity was 0.5 right and 1.5 left. No exophthalmos was present. The right eye showed impaired adduction with eye position of 110Δ in the primary position. No resistance was present for forced duction test. The right eye was treated by total transpositioning of vertical muscles and recession of lateral rectus. Diplopia disappeared with 10Δ in the primary position. Conclusion：Total transpositioning of vertical muscles with recession of lateral rectus was effective for exotropia following surgery for orbital schwannoma.