視力障害を伴う術後性副鼻腔嚢胞患者の視力予後

Abstract

We analyzed 19 consecutive cases of paranasal sinus mucoceles manifesting visual disturbance requiring surgery. Subjects were 12 men and 7 women aged 37 to 82 years (average; 57.4 years). Six negative prognostic factors examined were: (i) patients' age 70 years, (ii) time from onset to surgery 8 days, (iii) sphenoid sinus involvement, (iv) abnormal ocular fundus findings, (v) optic canal bone defect, and (vi) preoperative visual acuity ≤0.1. A prediction equation obtained by multivariate analysis provided highly accurate in predicting visual prognosis. We also found that factors ii), v), and vi) were mainly responsible for visual prognosis, whereas the impact of factors iii) and iv) was minor. We explored predicting more simply and feasibly visual prognosis with sufficient accuracy using the number of positive items from among the above 6 factors, using the number of those of i), ii), iv), v), and vi), or using the number of those of i), ii), v), and vi). Sensitivity/specificity was 80/93%, 80/100%, and 100/93%. We would like to stress that accurate prediction by these methods is helpful in managing paranasal sinus mucocele associated with visual disturbance.