重度の緊張性眼窩により失明を引き起こした歯原性眼窩蜂巣炎の一例

A case of odontogenic orbital cellulitis causing blindness by severe tension orbit.

• Chang Hyun Park
• Dong Hyun Jee
• Tae Yoon La

抄録

重度の緊張眼窩により失明を来した非常に稀な歯原性眼窩蜂巣炎の1例を報告する。41歳の男性患者は歯周膿瘍の治療中に眼窩周囲の腫脹と鼻づまりがひどく、来院した。歯原性副鼻腔炎、眼窩蜂窩織炎と診断され、抗生物質の投与を受けた。症状が悪化し、緊急副鼻腔ドレナージを行った。翌日に虚血性視神経症と網膜中心動脈閉塞症の所見を伴う急激な視力低下がみられた。眼窩CTから眼球後極の円錐状への変形を認めた。直ちに高用量ステロイドを投与して眼窩周囲腫脹は改善したが，視力は回復しなかった．歯原性眼窩蜂窩織炎は比較的まれであるが、急速に進行する緊張性眼窩を介して失明の原因となることがある。そのため、簡単な歯のトラブルでも注意が必要です。

We report a very rare case of odontogenic orbital cellulitis causing blindness by severe tension orbit. A 41-yr old male patient had visited the hospital due to severe periorbital swelling and nasal stuffiness while he was treated for a periodontal abscess. He was diagnosed with odontogenic sinusitis and orbital cellulitis, and treated with antibiotics. The symptoms were aggravated and emergency sinus drainage was performed. On the next day, a sudden decrease in vision occurred with findings of ischemic optic neuropathy and central retinal artery occlusion. Deformation of the eyeball posterior pole into a cone shape was found from the orbital CT. A high-dose steroid was administered immediately resulting in improvements of periorbital swelling, but the patient's vision had not recovered. Odontogenic orbital cellulitis is relatively rare, but can cause blindness via rapidly progressing tension orbit. Therefore even the simplest of dental problems requires careful attention.