慢性副鼻腔炎の手術適応と実際--保存手術の効果と限界

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In a study of post-operative conditions of chronic sinusitis surgery in which progress after surgery was observed for over one year, 88 cases of conservative surgery were compared with 44 cases of radical sinusotomy.The percentages of patients showing marked improvement and those without noticeable change after radical sinusotomy were 40.9% and 15.9%, respectively. If cases where marked and moderate improvement were considered together, the results of conservative surgery (64.8%) were slightly better than those of radical sinusotomy (61.4%).With conservative surgery, diseases of the nasal sinus mucous membrane could be reversed with highest success in cases of catarrh, diminished results with local infection and least beneficial response with polyp edema. Good results were also obtained in cases where the pathological pictures showed bilateral differences.The following points are important for effective treatment of chronic sinusitis:1) Establish a relation of trust and explain the need of treatment at an unstable stage and at the time of post-operative reinfection. Prescribe medical treatment and chemotherapy in conjunction with surgical repair.2) Accelerate recovery and secure an excretory path early by applying local medication.3) Thoroughly investigate the structural condition of the nasal cavity and attempt to restore a normal shape.
耳鼻咽喉科臨床学会の論文