上顎洞留置チューブを用いた上顎洞炎の治療 Treatment of Maxillary Sinusitis with an Indwelling Tube
Objective: Treatment of maxillary sinusitis with an indwelling tube is not a common method at present. The study examined the efficacy of treatment by puncture and repetitive irrigation of the maxillary sinus using an indwelling tube.<br>Subjects: The subjects consisted of 52 cases (sinuses) of maxillary sinusitis in 51 patients (10 to 80 years old, averaged 52.7 years old) that had not responded at all to pharmacotherapy (including clarithromycin) and nebulized aerosol therapy (cefmenoxime hydrochloride) for more than 1 month after the acute stage. Patients of odontogenic sinusitis or nasal polyp were excluded from this study.<br>Method: The patients were treated by sinus irrigation with normal saline solution (100 to 200ml) and instillation followed by 1% cefmenoxime hydrochloride solution (1ml) in the sinus once daily, using an indwelling tube with SinoJect<sup>®</sup> (a special device for puncture and irrigation of the maxillary sinus) inserted in the maxillary sinus via the inferior meatus. And the tube was removed when macroscopic observation confirmed recovery of clear washout products. The effects of treatment were also evaluated on X-ray findings obtained 1 to 2 weeks later.<br>Results: 1) Complete response (opacity disappeared) was noted in 21 (40.4%) cases, partial response (opacity was reduced) in 17 (32.7%) cases, and no response in 14 (26.9%) cases. Finally, more than half the patients showing no response underwent endoscopic sinus surgery. 2) The frequencies of the irrigation ranged 2 from 19 times and averaged 3.9 times. 3) Puncture and irrigation was performed very easily and safely. There was no significant complication in any patient.<br>Conclusion: The results suggested that repetitive irrigation with an indwelling tube is a useful treatment method for intractable maxillary sinusitis.
耳鼻咽喉科臨床 101(5), 355-360, 2008-05-01
The Society of Practical Otolaryngology