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Ⅰ.緒言
慢性副鼻腔炎の保存的治療に対して,サルファ剤,抗性物質,ステロイド,非ステロイド消炎剤,酵素剤など各種の薬剤が次々と登場してきたが,現在なお手術的療法がその治療の主軸をなしている。
術法には経上顎洞法,鼻内法,鼻外法,傍鼻法があるが,一般には経上顎洞法と鼻内法の併用によるKonservative PansinektomieまたはKonservative Polysinektomie1)が行なわれている。
The author describes a new method of approach in the operation of chronic sinusitis involving the ethmoid cells and frontal sinus. The maxillary sinus, the posterior ethmoid cells and the sphenoid sinus are operated by usual method of transantral approach. This is followed by removal of the posterior wall of the prelacrimal recess which is bound by the nasolacrimal duct and the orbital medial wall to clearly expose the lateroposterior wall of the nasolacrimal duct and the posterior wall of the lacrimal sac. A relatively wide opening would be established between the anterior ethmoid cells and the maxillary sinus. This postlacrimal approach enables one to operate the anterior ethmoid cells along with the posterior cells and provide a good drainage for the frontal sinus.
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