嗅裂部形態異常に関する病理組織学的観察-嗅裂炎に対する私見
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概要
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Sulcus olfactorius nasi has a great significance as osmatic locus, but great deal of its specific anatomy, structural state and also of morphological abnormalities remain still unknown.From autopsied 47 cases, ranging from the new born to the age of 74 years old, the nasal septum, the upper and the middle meatus on both sides and the ethmoid together with the ethmoidal canopy and the lamina orbitalis were taken out as a whole entity, preserving the structural relation of each other; and the specimens of the 47 cases, that is, 94 materials for both sides (9 cases for 0-4 years old, and 38 cases for over 17 years old) were prepared for continuous serial section of the frontal occiput for histopathological examination. The obtained result is as follows:1) Morphology of sulcus olfactorius is very complicated, and there are some observed with stricture, closure and adhesion. The absolute number of adhesion is relatively of low rate.2) When delicate differential diagnosis between the closure and the stricture is required, artifact in the process of preparation of the specimens should be taken into consideration.3) Any findings transgoing from closure to adhesion are hardly found. In such area as sulcus olfactorius with narrow space and exposed to the chance of infection, the possibility of the closure proceding to the adhesion due to inflammatory change is recognized. In other words, both clinically and histologically inflammation of sulcus olfactorius is to be regarded to exist.4) Among the specimens of the new born, the mucous membrances of the middle meatus and the nasal septum are sometimes observed to become adhesive and the sulcus closed. This is considered as congenital anomaly of sulcus formation.5) Therefore, the adhesion of sulcus olfactorius among the adult cases are not always of inflamatory change, and it is now revealed that the etiology of the change exists in.i. congenital malformation of sulcus olfactorius originated from the embryonic stageii. acquired morphological anomaly of sulcus olfactorius plus inflammation due to the overgrowth of ethmoidal cells.It is, however, very difficult to presume its etiology from the finding of organizing adhesion.6) Clinical significance of the abnormality whether it is of congenital malformation of acquired inflammation or acquired inflammatory adhesion of sulcus olfactorius is great and should not be neglected.
- 一般社団法人 日本耳鼻咽喉科学会の論文