最近の小児慢性副鼻腔炎に対する上顎洞穿刺洗滌療法について

Treatment of Sinusitis in Children: Puncture and Irrigation Therapy for Maxillary Sinus

I．はじめに

　最近では副鼻腔炎の軽症化とともにアレルギー性鼻炎などの増加傾向がいわれている。　しかし実際の日常診療においては治療に苦慮するような症例も少なからず認められる，成人であれば根治手術の適応となる症例でも，小児では年齢的に問題が多い。

　今回私どもはこのような症例に対して上顎洞穿刺洗條療法と薬物療法との併用を行い，その治療効果と限界について検討したので報告する。

Maxillary sinus puncture/lavage therapy using physiological saline was performed in 34 cases of chronic sinusitis in children. As the results, regard-ing the changes of the symptoms, the therapy was effective ("excellent" plus "good") in 71% of the patients and "unchanged" or "worsened" in 29%. Regarding x-ray findings, it was effective in 45.1 % and "unchanged" or "worsened" in 54.9%. The overall efficacy of the therapy on both the changes of the symptoms and x-ray findings was rated as effective in 50% and "unchanged" or "worsened" in 50% of the patients. With regard to the relationship between the number of punc-ture/lavage and the therapeutic efficacy, the result was much better when the number was larger and the treatment was applied in the initial stage of disease, while the efficacy gradually decreased when the therapy was applied in the later stage.