上顎洞気のう腫(Pneumocele)--その成因について

概要

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Pneumocele of the maxillary sinus is a rare condition in which the sinus cavity expands in any direction. Several authors attribute this disease to valve-like action of obstructed ostium of the maxillary sinus, resulting in air trapping.A 25 year old man had suffered from epiphora and dull pain on his left cheek since December 1975 and first visited our clinic on May 10, 1976.X-ray film showed hyperlucence of maxillary sinus areas of the left side, expanding of the left maxillary sinus cavity and thinning of the sinus wall. Dehiscence of bone was seen at the lateral wall of the left maxillary sinus. Ethmoid cells were also dilated significantly.Operation (Caldwell-Luc) was performed on June 2, 1976. The large maxillary sinus cavity contained nothing except air, and no communication with ethmoid cells was demonstrated. In the sinus cavity there were many balks or septums covered with thin mucous membrane. The postoperative course was uneventful.In this case pathogenesis was considered to be a transient hyperactivity of the pneumatization process of the maxilla. If obstruction of the ostium was the main genesis of this disease, there should have been mucous accummulation in the sinus cavity, and balks or septums are not likely to form under such circumstances.
耳鼻咽喉科臨床学会の論文