下鼻甲介shoulder osteotomyを行った狭鼻の1例

Inferior turbinate shoulder osteotomy in a patient with a narrow nasal cavity

はじめに

　鼻閉を訴える症例のうち，鼻腔の形態異常を伴い保存的治療で十分な治療効果が得られない場合は手術治療が選択される。一般に下鼻甲介肥大や鼻中隔彎曲による鼻閉は，粘膜下下鼻甲介骨切除術や鼻中隔矯正術にて改善できることが多い。しかし鼻腔の横幅が狭い，いわゆる“狭鼻”症例では，内鼻弁の横幅が狭いため，粘膜下下鼻甲介骨切除術や鼻中隔矯正術だけでは同部位を十分に拡大できず，鼻閉の改善が得られないことがある。

　近年報告された下鼻甲介shoulder osteotomyは，下鼻甲介の基板（下鼻甲介肩）を切除して前端を外側化させる術式で，内鼻弁を外側に拡大することが可能となる^1）。今回われわれは下鼻甲介shoulder osteotomyを行った狭鼻の1例を報告する。

　The inner nasal valve is formed by a combination of anatomical structures that include the leading edge of the upper lateral nasal cartilage, the nasal septum, and the head of the inferior turbinate. The nasal valve is the most significant area limiting airflow in the nose and is largely responsible for nasal obstruction. Conventional surgical techniques such as septoplasty and inferior turbinectomy may not result in sufficient widening of this area and may occasionally fail to improve patients' symptoms, particularly in those with a narrow nasal cavity. Inferior turbinate shoulder osteotomy is a new surgical technique that lateralizes the head of the inferior turbinate and widens the inner nasal valve. Here, we describe a patient treated with inferior turbinate shoulder osteotomy.