慢性副鼻腔炎手術法に関する研究--特に赤池式SINOPLASTIKについて
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概要
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The radical operation initiated with Caldwell-Luc is generally adopted for operation of chronic sinusitis. The method, however, leaves the point that it occasionally develops hyperplasia of granulation and changes the operative cavity due to re-infection in the postoperative course. Then the route to the proper nasal cavity is closed to induce occasional onsets of postoperative maxillary cyst. The operation method established in an attempt to improve this point is Akaike's sinoplasty. The author has conducted the sinoplasty for patients with chronic sinusitis. The postoperative course was investigated on subjective symptoms, endoscopy, roentgenography, and histopathological tests for comparison with that in the cases of radical operation. No appreciable difference was seen in the postoperative symptoms between the two groups of sinoplasty and radical operation. Endoscopy of the patency of the intranasal ethmoid sinus and naso-antral openings revealed no specifically appreciable difference between the two groups, but the patency of the inferior nasal meatus was more favorable in sinoplasty than the radical operation. The X-ray contract radiography and laminagraphy of the patency of naso-antral openings and ethmoid sinus revealed almost the same results. Histopathology of the postoperative maxillary sinus revealed that the mucosa was less edema and the cell infiltration and growth of connective tissues were prominent in about half of the treated cases of the 10th postoperative month. On the other hand, the antral tissues from radically treated cases of the end of the first postoperative month consisted of granulation with only hyperplasia of connective tissues. The emergence of squamous cells and regenerated mucosa of the columnar epithelium were noted around the 3rd or 4th postoperative month. The examination of the cases treated separately with sinoplasty and radical operation revealed that naso-antral openings created with sinoplasty were less susceptible to closure than those with radical operation and the resistivity of mucosa to infection in sinoplasty seemed to be stronger than that of the so-called regenerated mucosa following radical operation.
- 社団法人 日本耳鼻咽喉科学会の論文