清水式Oral-Paranasal Method

SHIMIZU'S METHOD OF ORAL-PARANASAL APPROACH IN OPERATION ON CHRONIC SINUSITIS

　Ⅰ．緒言

　本法は慢性副鼻腔炎に普遍的に行なわれているoral methodに時として表われる歯牙の異常感を避け，かつ手術侵襲を少なくすることを主目的に開発した方法で，それについては第7回日本鼻副鼻腔学会（1968），第70回日本耳鼻咽喉科学会総会（1969），第8回日本鼻副鼻腔学会（1969），第71回日本耳鼻咽喉科学会総会（1970），第9回日本鼻副鼻腔学会（1970）において報告し，なお論文として耳鼻咽喉科41巻2号^1），および同12号^2）に発表してきたが，完成された本法について総括して報告する次第である。

　The present method of approach in performing operation of chronic sinusitis has been developed by the author in order to avoid the often complained the postoperative symptom of abnormal sensitivity of the dental roots.

　The initial incision is placed vertically besides the line of ligamentum labialis superioris; a lateral incision is followed on the line of the gingivolablial junction.

　The periosteal separation is carried out superiorly to expose the piriform apperture the lateral nasal wall is carefully separated avoiding any injury to it until the christa chonchalis is exposed. This process is bitten away which affords a free passage into the anterior ethmoids.

　The spina nasalis interna is removed in order to establish a passage way into the frontal sinus.

　Avoiding injury to the piriform apperture the maxillary sinus is opened. At this stage the nasal lacrymal duct will be exposed. This duct is pushed aside along with the inferior turbinate and the drainage passage into the maxillary sinus is established in the inferior meatus.