一側性眼球突出に対する診断的アプローチ

副鼻腔嚢胞症例を中心に

抄録

In the field of otolaryngology, diseases of the paranasal sinuses, especially cystic lesions are the most frequent causes of exophthalmos. In order to diagnose the cause of unilateral exophthalmos, it is important to differentiate cystic lesions of the paranasal sinuses from other diseases such as neoplasms (orbital tumors, tumors of the paranasal sinuses, pituitary tumors) which produce unilateral exophthalmos. In these patients, past history, inspective, palpative and ophthalmological examinations are very useful for topographical diagnosis, but further examination such as x-ray examination, CT scanning, or echogram should be performed for the differential diagnosis. The mucocele of the anterior sinuses can be easily diagnosed, while those of the posterior sinuses (especially sphenoidal sinuses) cannot be done easily. Some of those patients with sphenoidal mucocele may not be diagnosed definitely even after these examinations. However the route of approach to the lesion must be decided with this limited information. In this paper, some essential points in the diagnosis of cystic lesions of the paranasal sinuses are described.