Middle third facial fracture（Le Fort-Ⅰ型）後の前鼻孔閉鎖症の2例

ATRESIA OF ANTERIOR NARE DUE TO THE MIDDLE THIRD FACIAL FRACTURE, A REPORT OF TWO CASES

　Ⅰ．緒言

　前鼻孔閉鎖症は先天性と後天性，さらに炎症性，外傷性などに分類される。外傷性のものは文献的には高山の戦傷によるものの報告がある^1）。最近では馬場らの報告^2），これに類似した広戸らの報告^3）があるが，われわれは軽度のmiddle third facial fractureの中のLe Fort-Ⅰ型による外傷で前鼻孔閉鎖をきたした症例を経験したので報告する。

　Case 1. A man, aged 41, suffered a middle third facial fracture with complaint of bilateral nasal blockage. The line of bony fracture and consequent osteogenisis were found at the apertura piriformis. The skin deficit was treated by island nasolabial flap graft.

　Case 2. A boy, aged 15, complained of nasal blockage of the left side due to the middle third facial fracture. The patient at the age 6 suffered the facial fracture by traffic accident. Seven months later he was operated for the relief of nasal blockage but the effect of relief was temporary. Three month after the operation the blockage retuned.

　X-ray examination revealed an elevation of the floor of the nasal cavity and abnormal development of the left maxillary sinus to such an extent that the sinus floor fell below the level of the nasal floor.

　The treatment consisted of the removal of superfluous bony tissue, that accumulated through the process of healing and the skin deficit created was mended by means of Z-plastic operation.