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緒言
鼻疾患の中最も多く取扱れる急性乃至慢性副鼻腔炎の診断に際して,鼻鏡検査にて鼻腔内所見を確実に診る事は極めて重要で,其所見のみにても副鼻腔炎の存否が略決定される.併しそれのみにては副鼻腔炎の存在を確定する事が出来ない樣な疑しい場合には上顎洞内穿刺洗滌に依り洞内内容物を検するのが常識である.更に「レ」線撮影を行うが,此は副鼻腔の形状を確認するにはよいが,此の陰影の有無により副鼻腔炎の有無を判定し,殊に手術適応の判定を下す事は危険率も多い.更に洞内陰影剤注入に依る「レ」線検査は古来幾多の先人に依つて為されたが確実な診断法と謂い得るには至らなかつた.
余は洞内に注入せられた造影剤の陰影像並に其の排泄状況を観察する時は,洞粘膜の機能状態が確実に把握され,副鼻腔炎の極めて正確な診断が為し得る事を昭和25年の耳鼻科総会で恩師大藤教授と共に発表した.
ISHIKAWA says the diagnosis of sinusitis which may be accompanied by vague symptoms yet suffici-ently present to arouse suspicion of the involvement is determinable with use of radio-opaque moliodol and susequent rroentgenography. Both maxillary sinuses in such cases are first punctured with a trocar and irrigated with normal saline solutions; noting especi-ally the character of the return fluid. Among 11 cases examined in this way sinusitis was found as unilateral affection in 8 cases and the affe-ctions were generally found on the side upon which the nasal septum was deviated to which caused tnar-rowing of the nasal cavity on that side. Deflection of nasal septum in these cases was a type resembli-ng the letter C or C type deviation.
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