蝶形骨洞嚢胞の臨床的研究
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概要
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Twenty six sphenoidal mucoceles are classified into two types according to the location and extent of the mucoceles. Two types are Ala parva type (mucoceles extending to the Ala parva) and common type (other than Ala parva type). Ala parva type comrises 8 cases and common type 18 cases. Ala parva type showed a more limited area of distribution at the superior posterior aspect of the sinuses and were provided with more frequent destruction of the bony optic canals. The average age at onset was 42.2 years old, male preponderance (81%) and left preponderance (69%) were seen. Postoperative cases were 77% with the average years after the initial sinus surgery (Caldwell-Luc surgery) of 19.8 years. Visual disturbance was seen in 58% and more than half showed an advanced degree (blind, sense of light only, or discrimination of finger movement only). Average duration from the onset of visual disturbance to surgery was 2.0 months. Improvement in visual disturbance was seen in the half of the cases, and the prognosis was poor when the disturbance was of advanced degree and the duration of the disturbance exceeded 1 to 2 months. Destruction of the bony optic canal was seen in 73% and medial portion (37%) and superior portion (32%) were commonly affected. Among cases with optic canal destruction, 79% were complicated with visual disturbance. Postoperative cases differ from non-operative cases in no aspects. A bibliographical study for the pneumatization of the lesser wing was also included in discussion.
- 一般社団法人 日本耳鼻咽喉科学会の論文