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北村教授のA:鼻炎の手術療法について(耳鼻咽喉科臨床54巻10号昭和36年10月1日),B:肥厚性鼻炎(耳鼻咽喉科専門講座1,日本耳鼻咽喉科学会67巻3号附録昭39)。名越教授のはC:副鼻腔炎手術後の治癒機転をめぐりて(日本耳鼻咽喉科学会65回総会シンポジウム昭和39年5月4日)を基として感想を述べたい。
1)北村氏は(B. 2頁)両側下甲介附着点距離21-34mmの鼻腔を正常として,機能的にもよいとしているようだが,下甲介表面(正中面)と中隔との距離や,中鼻道,下鼻道,嗅裂などを重く見ていないらしいが,私には狙う的が別物のような感じがして困つた。これでは議論が喰い違いそうに思えてならない。小倉氏(アメリカ)のこの鼻腔構造の研究は,解剖的には科学的であるのかも知れないが,私には,屍体それも骨標本で議論されているようで,ピンと来ない。高橋氏の呼吸気流の通過と分泌物の排泄に何等の障害のないものを正常鼻腔とする定義の方が,数字で表現しては居ないが生きていると感じる。
The author comments on Professor Kitamura's stand in which the latter takes a strong opposition against Doctor Takahashi's method of intranasal plastic operation.
Kitamura strongly maintains that the nasal mucosa should be preserved, which in itself is readily agreeable, yet, practically when it comes to the disposal of the highly involved pathological mucous membrane the operativeresults in the amount in which the mucous membranes are removed differ very little in the two opponents.
Kitamura says that favorable immediate postoperative results in no measure by which the general condition of the patient can be judged, because when severe mucous membrane injury is incurred undesirable results may be manifested at a later date, months or years after. However, this author is diametrically opposed to this view, the good results shown immediately after the operation is highly beneficial to the patient.
In Kitamura's opinion the nasal sinuses aredevoid of any physiological function. Takahashi maintains that the sinuses are endowed with definite physiological functions. According to Prof. Ogata, pathologist, the sinuses have important function of ridding CO2 from the body.
Prof. Nagoshi denies that there is any circulation of the respiratory air within the sinus cavity but, the author's view is directly opposite.
The author gives a warning although that science is observation of analytica facts care must be taken in drawing a fair conclusion.
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