A STUDY ON A MODIFIED DISPLACEMENT THERAPY OF THE PARANASAL SINUSES
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概要
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Purpose of the Study: Proetz's method for the displacement of the entire paranasal sinuses is highly appraised for its practical value in the diagnosis and treatment of paranasal sinusitis.It requires, however, a special instrument. lt also requires practice in synchronizing the aspiration and the up-lifting of the soft palate. Moreover, it is mainly the posterior group of paranasal sinuses which can be displaced by Proetz's original method and the anterior group is rather difficult to be displaced.In order to mitigate the above inconveniences we devised a modification of Proetz's method.In our method, by means of forced inhalation, the problems of the instrument and the synchronization were solved, and by adopting two step positional change of the head, the displacement of the anterior group was facilitated.Method: From the head position in which the connecting line between the chin and the external meatus is vertical the head is rotated more than 90° towards the side to be displaced (the first position). Then the head is returned to the original position. Next the head is over extended so that the connecting line between the Adam's apgle and the enternal meatus becomes vertical (the second position). In each position the patient is requested to repeat forced inhalation (rapid and strong inhalational action with the mouth and nose closed) to create a negative pressure(-40--50 mmHg) in the nasal cavity so that a previously instilled drug is displaced.Conclusion: By our method, when compared with Proetz's original method. the displacement of the anterior group becomes easie. It a1so enables simultaneous displacement of the entire sinurses. The practical value of our modified method was confirmed not only as a diagnostic method but also as a treatment of paranasal sinusitis in chidren.
- 一般社団法人 日本耳鼻咽喉科学会の論文