粘液嚢腫の診断と治療—篩骨蜂窩および蝶形骨洞粘液嚢腫を中心として

THE DIAGNOSIS AND TREATMENT OF NASAL SINUS MUCOCELE

　副鼻腔粘液嚢腫は耳鼻科領域の疾患であるが，諸種の眼症状を呈し脳外科的にもあつかわれる事が多い。われわれはorbital apex syndromeを呈した後部篩骨洞粘液嚢腫および蝶形骨洞粘液嚢腫各1例，眼球突出を呈した両側性前頭洞粘液嚢腫1例，1側性前頭洞粘液嚢腫2例の計5症例を経験したのでここに報告する。

　Five cases of mucoceles, found in the following area, one each in the ethmoidal sinus, sphenoidal sinus, frontal sinus and both frontal sinuses in one case, are reported.

　The mucocele of the posterior nasal sinuses is apt to be accompanied by orbital apex syndrome. Therefore it behooves the necessity of differenciating this affection with that of optic glioma, sphenoidal ridge meningioma, pituitary tumor, etc..

　On the other hand, the mucocele of the frontal sinus may be easily diagnosed because of the fact it is always accompanied by symptoms of exophthalmos.

　Most of the patients who suffer sinus mucocele complain of periorbital pain or headache.

　A routine roentgenogram and tomogram will invariably reveal the evidence of enlargement or destruction of the bony structures of the sinus walls.

　The surgical treatment of the mucocele is performed through transnasal or transcranial approach. In either case, the authors emphasize the necessity of establishing a good nasal drainage.

　For the diagnosis and prognosis of the case the aid of the ophthalmologist may be required. The treatment should be established without delay.