先天性後鼻孔閉鎖症の1例

A BILATERAL CONGENITAL ATRESIA OF THE NASAL CHOANAE

　I．はじめに

　後鼻孔閉鎖症は比較的稀な疾患で1829年Ottoが剖検時に見出したのが最初とされている。本邦においては1918年，柳沢^1）が外傷が原因となつた後天性後鼻孔閉鎖症を報告したのが最初であり，先天性のものとしては，1924年の木村^2）の報告が最初である。一方，柴田^3）らは1918年から1965年までに本邦において報告された本疾患45例（先天性33例，後天性12例）について統計的観察を行なつた。その後著者らが文献を渉猟し得た範囲ではさらに5例が報告されている^17）-21）。最近われわれも本疾患の1例を経験し，手術的に治癒せしめ得たので報告する。

　A woman, aged 41, complained of nasal obstruction, nasal discharge and an anosmia since her childhood. The first attempt at correction an operation performed through intranasal route was unsuccessful. The second attempt was performed through transpalatal method which was successful. Six months after the operation the nasal choanae are relatively well open; the patency was tested by means of passing frontal sinus dilators. The authors state that the transpalatal method offers the best means by which such conditions may be corrected as advocated by Owens.

　The authors emphasize the importance of keeping the nasal passage open by leaving the polyethylene tube in place for more than 3 weeks, while the posterior portion of the nasal septum should be resected at the time of the operation.