内視鏡下鼻内涙囊鼻腔吻合術を要したサルコイドーシス例

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タイトル別名
  • A Case of Endoscopic Dacryocystorhinostomy for Nasolacrimal Duct Obstruction Secondary to Sarcoidosis
  • 臨床 内視鏡下鼻内涙囊鼻腔吻合術を要したサルコイドーシス例
  • リンショウ ナイシキョウ カ ビ ナイ ルイノウ ビコウ フンゴウジュツ オ ヨウシタ サルコイドーシスレイ

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抄録

Sarcoidosis is a multisystem granulomatous disorder of unknown origin. Sarcoidosis can affect the nasal mucosa and result in acquired nasolacrimal duct obstruction that induces epiphora and dacryocystitis. We report herein on a 41-year-old man with nasolacrimal duct obstruction secondary to sarcoidosis. He had pulmonary sarcoidosis when he was 22-year-old. He underwent septoplasty and turbinectomy for nasal obstruction at the age of 29. Histopathological examination showed non-caseating epithelioid granuloma resulting in nasal sarcoidosis. Epiphora in both eyes developed and an endoscopic-dacryocystorhinostomy was performed bilaterally at the age of 41. His nasal cavity was deformed and the mucous membrane was hypertrophic. We used a navigation system and a 25G light guide to establish orientation. A 2.5 mm diamond bur was used for the dacryocystorhinostomy. A Nunchaku-type silicon tube was inserted successfully in the left side, but was inserted only half way in the right side. The left and right tubes were removed a month and 3 months after surgery. The symptoms of the left eye disappeared after one year but the symptoms of the right eye remained.

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