両側後天性後鼻孔閉鎖症の1例

A Case of Bilateral Idiopathic acquired Choanal Atresia

I．はじめに

　後鼻孔閉鎖症は比較的まれな疾患で，先天性のものと後天性のものがある。その大部分は先天性で，生後まもなく呼吸困難，哺乳障害などで発見されることが多い。後天性の場合は外傷，梅毒，アデノイド手術後などに起こってくることがあるが，なかには原因のはっきりしないものもある。

　今回特発性と考えられる両側後天性後鼻孔閉鎖症の1症例を経験したので報告する。

A case of bilateral idiopathic acquired choanal atresia was found in a 63-year-old female who had suffered nasal obstruction, hyposmia and nasal discharge without any known cause for 8 years. Nasopharyngography and computed tomo-graphy revealed bilateral complete choanal atresia. Surgical correction was performed by transmaxil-lary approach with carbon dioxide LASER. The choanal region was completely occluded with granulation tissue. After vaporization, the choanae assumed a round shape with a diameter of about 2.5cm. Free skin was grafted at the opened choanae.

After the operation, hyposmia improved and the patient breathed satisfactorily through her nose. At present, 8 months after the operation, the choanae are patent without problems.