小児および成人の慢性副鼻腔炎の手術的治療

• 斎藤 等

  福井医科大学耳鼻咽喉科学教室

• 本多 徳行

  福井医科大学耳鼻咽喉科学教室

書誌事項

タイトル別名

• Surgical treatment of paranasal sinusitis in children and adults

抄録

The results of surgical treatment of paranasal sinusitis in children and adults were analyzed.<br>Long-term intra-maxillary intubation was performed to treat 24 children (43 sides) with severe sinusitis, which in almost all cases was accompanied by antrochoanal polyps, since 1985. The sinusitis was bilateral in 19 cases and unilateral in 5. Polyps were present on 26 sides and absent on 17. Intubation was often combined with intranasal ethmoidectomy and turbinectomy under general anesthesia after hospitalization.<br>The results were evaluated on the basis of the x-ray or CT findings alone. “Excellent” means almost complete resolution of the sinus findings, and “good” means more than a 50% decrease in sinus shadow. Two sides were excluded from the analysis because of unknown results at 4 months after intubation. Efficacy was excellent in 59% of the 16 sides without polyps, but only excellent in 12% of the 25 sides with polyps. The total “good” or better efficacy rate on all 41 sides was 51%. In summary, severe sinusitis in children is difficult to be cured by ventilation of the sinus and drainage of the discharge alone.<br>Although functional endoscopic endonasal sinus surgery has been becoming more common, severe chronic sinusitis with irreversibly diseased mucosa and recurrence after endoscopic surgery are still indications for radical sinus surgery.<br>The modified Caldwell-Luc procedure without creating a counter opening has been performed to severe chronic sinusitis (436 sides) in adults since 1986. The efficacy and adverse effects of treatment in these cases were surveyed by a mailed questionnaire survey. “Good” results or better were reported in more than 98.6% of the patients in terms of nasal obstruction, hyperrhinorrhea and headache, but only 88% in terms of hyposmia. However, 20% of the patients still complained of facial dysesthesia after 5 years. In summary, radical antrostomy is still necessary in severely diseased sinusitis in adults and yields fairly good results.

収録刊行物

• 日本鼻科学会会誌

  日本鼻科学会会誌 34 (2), 399-404, 1995

  日本鼻科学会

キーワード

• chronic sinusitis
• intra-maxillary intubation
• modified Caldwell-Luc procedure
• antrochoanal polyp
• children

詳細情報

• CRID: 1390001204737398144
• NII論文ID: 130003720578
• DOI: 10.7248/jjrhi1982.34.2_399
• ISSN: 18837077
• ISSN: 09109153
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可