慢性副鼻腔炎の病理組織学的研究—特に骨病変に就いて

　緒言

　慢性副鼻腔炎は耳鼻咽喉科領域に於て最も屡々遭遇する疾患であり，之に関する研究も種々の方面からなされ，既に多くの業績は発表されている．しかるに今日尚根治手術によつても全治しがたい症例もあり，今後研究しなければならぬ分野も相当に残されているように思われる．

　慢性副鼻腔炎の病理に就ても，もう一度新しい観点に立つて研究し，考え直さなければならない時期でないかと思う．我が国に於ても上顎洞粘膜に関しでは詳細な研究が発表されているが骨壁の病変に関してはあまり関心が払われず，昭和18年に天野氏が上顎洞骨壁病変に関する研究を発表し骨破壊は全症例の87.8％にみられたと報告している．又仁保（三）氏は慢性副鼻腔炎の骨病変と臨床的意義に就て発表し，手術適応の症例の殆ど全部に骨病変があると述べ，此問題はようやく注目されて来たようである．

INABA examines microscopically mucous mem-branes and bones obtained from operations on pa-ranasal sinuses consisting of 49 specimens from the maxillary and 50 from ths. ethmoidals. Among these 14 specimens were a part of a more thorough search which included that of such areas as the anterior wall of maxillary sinus, the lateral wall of the inferior and middle meati, peripheral ethm-oidal cells, and anterior and posterior ethmoidal cells. Almost every bone examined in this way showed pathological involvement of the bony tissue but, the extent to which an individual bone was involved was the most pronounced in that of the ethmoidal cells. In the septal wall between the maxillary sinus and the ethmoids was seen prolife-ration of granulation tissues which penetrated thro-ugh the two bones. For the spread of inflammato-ry processes within the osseous tissue the haversian canal seemed to play an important role. The author concludes that chronic sinusitis is an involvement which is brought about not only by inflammatory processes of the mucous membranes but also by concommitant chronic osteitis and/or periosteitis re-gardless of the degree in which the latter may be involved.