病巣性扁桃炎について--扁桃の二次疾患に及ぼす予後と扁桃誘発試験の診断的価値について (三吉康郎教授開講20周年記念論文集)

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With the increasing attention given to the immunological role of the tonsil, a conservative attitude has developed toward tonsillectomy. We know, however, that there are some diseases which respond to tonsillectomy. This idea has introduced the concept of tonsillar focal infection. Unnecessary onsillectomy must be avoided. Hence, it is critical to determine whether the tonsil is the primary focus of infection or not.Seventy-one patients were suspected of tonsillar focal infection by the tonsillar provocation test and tonsillectomy was indicated. Thirty-eight patients underwent tonsillectomy and 68.4% of them showed improvement in their secondary diseases. Thirty-three patients for whom tonsillectomy was indicated did not undergo the operation and 39% of them showed improvement in their secondary diseases. The difference in the rate of improvement between the two groups was statistically significant. Those who underwent tonsillectomy within one year from the onset of the secondary disease improved more than those who underwent the operation after three years from the onset. The improved secondary diseases included kidney, skin and rheumatic diseases.We have been employing a massage provocation test when tonsillar focal infection is suspected. The patients whose secondary disease was alleviated had an increased number of WBC by the provocation test compared to those whose secondary disease was not alleviated. Among the non-tonsillectomized patients, those whose with secondary disease was not alleviated increased the number of WBC by the provocation test compared with the patients who improved. Other variables, such as ESR, body temperature and urinalysis were not significantly changed by the provocation test. It has thus been indicated that the increase in the number of WBC by the provocation test is a useful indicator of tonsillectomy for tonsillar focal infection.
耳鼻咽喉科臨床学会の論文

病巣性扁桃炎について--扁桃の二次疾患に及ぼす予後と扁桃誘発試験の診断的価値について (三吉康郎教授開講20周年記念論文集)

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