局所ステロイド処置による好酸球性副鼻腔炎(ECRS)術後の再燃抑制効果  [in Japanese] Inhibition of Postoperative Recurrence of Eosinophilic Chronic Rhinosinusitis (ECRS) Using Local Steroid Treatment  [in Japanese]

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Author(s)

    • 今野 渉 Konno Wataru
    • 獨協医科大学耳鼻咽喉・頭頸部外科 Dokkyo Medical University, Department of Otorhinolaryngology, Head & Neck Surgery
    • 宇野 匡祐 Uno Keisuke
    • 獨協医科大学耳鼻咽喉・頭頸部外科 Dokkyo Medical University, Department of Otorhinolaryngology, Head & Neck Surgery
    • 後藤 一貴 Goto Kazutaka
    • 獨協医科大学耳鼻咽喉・頭頸部外科 Dokkyo Medical University, Department of Otorhinolaryngology, Head & Neck Surgery
    • 春名 眞一 Haruna Shinichi
    • 獨協医科大学耳鼻咽喉・頭頸部外科 Dokkyo Medical University, Department of Otorhinolaryngology, Head & Neck Surgery

Abstract

<p>好酸球性副鼻腔炎(eosinophilic chronic rhinosinusitis,以下ECRS)は難治性で内視鏡下副鼻腔手術(endoscopic sinus surgery,以下ESS)の後に再燃することが少なくない。今回我々は,ECRS術後の再燃をコントロールするために,ECRS再燃例24例に対してトリアムシノロンアセトニド注射液(ケナコルト<sup>®</sup>)添加サージセル<sup>®</sup>を篩骨洞,嗅裂に留置する処置を行い,その効果を検討した。1度処置を行ったA群と2週間の間隔で2度処置を行ったB群を比較すると,2週間後では自他覚所見ともに有意に改善効果が得られた。しかし,1度目の処置後4週間ではB群では改善効果は維持されたが,A群では減弱する傾向が得られた。1度目の処置後4週間に測定した血中ACTHとコルチゾール値は正常範囲であり,ステロイド薬による副作用の危険性は少ないと考えられた。ECRS術後の再燃時に経口ステロイド薬を使用しないで,局所ステロイド処置でコントロールできる可能性が示唆された。</p>

<p>We investigated whether recurrence of eosinophilic chronic rhinosinusitis (ECRS) after endoscopic sinus surgery (ESS) could be improved by local steroid treatment applied directly to the opened sinuses. Surgicel<sup>®</sup> and Triamcinolone Acetonide were inserted into the ethmoid sinus and olfactory cleft in 24 cases with recurrence after ESS. The 24 subjects were divided into two groups of 12 cases each: patients in group A received treatment once a month and those in group B were treated every two weeks. Significant subjective and objective improvements were obtained in both groups at two weeks after the initial treatment. However, at four weeks, the improvement in group A had decreased whereas the effect in group B was maintained. Both groups had normal blood ACTH and cortisol levels after four weeks, and to date the steroid treatment has had few side effects. These results suggest that local steroid treatment may be used to control and improve postoperative ECRS without the need for oral steroids.</p>

Journal

  • Nihon Bika Gakkai Kaishi (Japanese Journal of Rhinology)

    Nihon Bika Gakkai Kaishi (Japanese Journal of Rhinology) 56(2), 97-102, 2017

    Japan Rhinologic Society

Codes

  • NII Article ID (NAID)
    130005865215
  • Text Lang
    JPN
  • ISSN
    0910-9153
  • Data Source
    J-STAGE 
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