視力障害を呈した副鼻腔疾患手術10例の検討

概要

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Orbital complications in sinus infections occur due to the anatomical proximity of the paranasal sinuses and orbit. Delayed diagnosis and treatment may involve unfavorable morbidity and mortality. We report 10 cases—7 men and 3 women—of acute rhinosinusitis and acute exacerbation of chronic sinusitis complicating orbital symptoms in the last 5 years. Mean age at consultation was 64.6 years (54-75). Seven had undergone previous sinus surgery. The posterior ethmoid and sphenoid sinus were mainly affected. Mean preoperative visual acuity of 0.07 became 0.53 postoperatively. Restricted eye movement occurred in 1 case of good recovery. Of antibiotics, second- or third-generation cephem was used in 8 cases and carbapenem in 2. Corticosteroids were administered by pulse therapy in 5 and by tapering schedule in 4. Visual recovery occurred in 7. Unrecovered cases were likely to receive delayed surgery. We recommend initial 3-day steroid pulse therapy in subject with decreased vision, discontinued on vision recoveries. Pulse therapy should be continued in case of incomplete or poor recovery.
2011-06-01