内視鏡的篩骨洞微細手術

Endoscopic Endonasal Microsurgery of the Ethmoid Sinus

はじめに

　最近の内視鏡，小型CCDカメラ，ビデオ機器の進歩により副鼻腔の内視鏡的手術が可能になり世界的に注目されている。この方法は鼻内篩骨洞手術を安全かつ確実に施行することを可能にし，手術効果を著しく向上するもので，現在，私どもの行っている手術法を内視鏡的篩骨洞微細手術（Endoscopic microsurgery of the ethmoid sinus）として記述したい。

The authors describe a method of radical eth-moidectomy by means of endoscopic microsurgery. In conventional surgical treatment of chronic sin-usitis with diffuse nasal polyposis one of the major causes of failure has been uncertain surgical rese-ction of local diseases, where hidden diseases have often been left unremoved at the critical areas such as the naso-frontal duct and fontanel areas. The authors describe a stepby-step surgical tech-nique of microscopic ethmoidectomy under endo-scopic control. Meticulous removal of sinus dise-ases and restoration of fuctional anatomy of the sinuses under endoscopic magnification enabled an ethmoidectomy of microscopic level. The re-sults of this surgical technique in 30 patients revealed an improvement rate of 80 to 90% of the cases in both subjective and objective findings.