著者

原 稔 高崎 賢治 江夏 薫 海江田 哲 隈上 秀高 小室 哲 高橋 晴雄

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.99, no.7, pp.555-559, 2006-07-01 (Released:2011-10-07)

参考文献数

10

被引用文献数

1

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We report three cases of isolated oculomotor nerve palsy caused by paranasal disease. All patients complained of double vision but showed no sign of brain aneurysm or diabetes mellitus. These patients had unilateral disturbance of ocular movement and ptosis, but there was no visual impairment on opthalmologic examination. In two cases, computed tomography (CT) demonstrated soft tissue density (STD) in the posterior ethmoid and sphenoid sinuses and also inside the ipsilateral anterior clinoid process (ACP) of the sphenoid bone. In the other case, CT and magnetic resonance imaging showed STD in the ethmoid sinus and pneumatization in the ACP. In all cases, a bony defect was identified at the inferior wall in ACP, adjacent to the superior orbital fissure. We performed endoscopic sphenoidectomy in two cases and conservatively treated the other case with steroid and antibiotics. In all three cases, ocular movement became normal approximately one month later. Since the oculomotor nerve coursed just under the pneumatized ACP in these cases, we speculated that compression and/or inflammation through the ACP might have induced oculomotor nerve palsy.

著者

高橋 晴雄 高野 篤 畑地 憲輔 吉田 晴郎 海江田 哲 安達 朝幸 塚崎 尚紀

出版者

THE JAPAN OTOLOGICAL SOCIETY

雑誌

Otology Japan (ISSN:09172025)

巻号頁・発行日

vol.14, no.2, pp.171-175, 2004

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Pharyngeal orifice of the eustachian tube was ligated in 6 patients, 8 ears withintractable patulous eustachian tube. While the eustachian tube orifice was observed by an endoscope inserted through the contralateral nostril, the orifice was ligated transnasally and/or transorally using instruments usually used in the endoscopic nasal surgery. Now 1 to 6 months after the surgery, the outcome was excellent (both symptoms and sonotubometry were normalized) in 3 ears, good (either symptoms or sonotubometry was improved) in 3 ears, and unchanged in the remaining 2 ears. In one of the ears with an outcome of unchanged, the ligation was found to be spontaneously released soon after surgery, but the symptom was improved after the second operation 2.5months after the first operation. Temporary otitis media with effusion was seen in one ear, and mild inflammation around the ligated site also in one ear, but no other serious complication has been observed. Although further improvement in the surgical procedure and further discussion about its longterm outcome should be required, this procedure appeared to be one of the therapeutic options for intractable patulous eustachian tube.