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慢性副鼻腔炎は臨床的にカタル性副鼻腔炎と化膿性副鼻腔炎,及びその混合型とに大別し,カタル性副鼻腔炎は更にアレルギー性と非アレルギー性とに分けるのが便利だと思われる。
カタル性副鼻腔炎は,その成因にアレルギー,又は體質的因子が多く含まれると考えられているので,保存的にも手術的にも化膿性のものに比して治癒困難とされ,抗生物質によつても治癒困難なことはCardwell,大澤氏等の報告にても明かである。特にこの型の副鼻腔炎に伴う鼻茸は,最近Hansel,Wiethe,Schnek等の報告以來,アレルギー性のものとして一般の注意を惹いて來た。教室の阿部の研究では,副鼻腔含氣蜂窠形成に密接に關係し,カタル性副鼻腔炎,及び鼻茸を形成するものは,含氣蜂窠形成の良好な副鼻腔に認められることを報告しているから,體質的因子が強いことになる。
TSUTSUMI investigates the effects of procaine penicillin used as instillation in treatment of catarrhal infections of paranasal sinus in 14 pateints. Similar treatment was originally reported by Simon Ruskin. The results of the present series are as follows: There were 3 cases who were effectively cured; 8 cases, improved; and 3 cases, without any effect whatsoever. In cases with whom the treatment proved to be effective, there were observed marked reduction of the turbinal edema, a definite decrease in the size of the nasal polyps and remarkable lessening of nasal discharge. Particularly in cases which showed prominence of eosinophilia as a sign the treatment proved to be effective in 5 cases out of the 7. The author believes that the effectiveness of this treatment on sinusitis is relegated to the combined use of penicillin and procaine the latter of which is possessed with properties that are slightly vasoconstricting and antihistaminic in action.
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