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上顎洞手術(漫性副鼻洞炎,洞腫瘍等)に際して,洞内粘膜の剥離時に感ずる疼痛は極めて顕著なものであり,従つてその疼痛緩和の為には従来も種々なる方法が試みられている。最も一般に行われている方法として,
(A)局所粘膜えの浸潤麻酔,及びこれを補助する目的で洞内えのCocaine溶液の注入攪伴等がある。Novocaine溶液を洞粘膜内或は粘膜下え注射する局所麻酔法は,多くの場合比較的有効で,患者の苦痛も割合少く施術し得るが,慢性副鼻洞炎でも炎性変化が特に著るしく,洞粘膜の浮腫状腫脹が著明であつたり,或いは洞腫瘍の手術に際しては,是等の麻酔法は必ずしも充分な鎮痛効果を示し得ない事は衆知の通りである。加之此注射法は仲々繁雑でもあり,尚又多量のCocaine液の使用は,時として幼老年者に対してCocaineの急性中毒の危険も一応は考慮せねばならず,従つて本法は常に優秀なる方法とは云えない。
Saito describes a new approach to establish a complete anethesia of the maxillary nerve in order to alleviate the source of pain altogether in the operation of the maxillary sinus. Heretofore the procedure by which induction anethesia may be established within the pterygopalatine fossa required much practice and experience on the part of the surgeon and yet, resulted with a margin of uncertainty. The present method eliminates all of these troubles. With infiltration anesthesia the tissues on the anterior surface of the maxilla are anethesized even towards the maxillary tuberosity posteriorly and beneath the zygomatic arch superiorly. The usual incision in the canine fossa is carried further posteriorly towards the tuberosity. The infratratemporal surface of the maxilla is exposed: at the region where this surface and the anterior wall of the sinus cavity conjoin to form a raised area the periosteum is incised and separated to expose the pterygopalatine fossa. By use of a curved or an angled needle maxillary nerve may be reached with ease for a complete anesthesia.
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