鼻アレルギーに対する下鼻甲介粘膜広汎切除手術

GLOBAL TURBINECTOMY OF THE INFERIOR TURBINATE MUCOSA FOR TREATMENT OF NASAL ALLERGY

　I．はじめに

　鼻アレルギーの治療は第1表のごとく，a）保存的療法，b）手術的療法に大別される。保存的療法，とりわけ特異的減感作療法は今日，治療の主体をなしている。奥田^1）によれば特異的減感作療法の成績はよく，1年以上減感作を施行することにより，くしゃみで86.2％，鼻閉で79.3％が日常生活に差しつかえない程度まで改善できる。しかしながら，くしゃみが消失しても鼻閉が消失しない例が19.5％あり，この様な例では下甲介粘膜は結合織の増生，膨化が強く，もはや保存的療法の限界をこえているとし，手術療法を勧めている。

　今回，われわれは鼻アレルギー患者に一定期間，特異的減感作療法を行ない，なお鼻閉を訴える33名に著者らの提唱する下鼻甲介粘膜広汎切除手術を施行した。

　Global turbinectomy of the inferior turbinate mucosa was employed for 33 patients with nasal allergy who complained of nasal obstruction after specific desensitization for a period of time (14 months on an average). The average age of 10 male patients was 25, and that of 13 females was 32 years. Desensitization was continued postoperatively for 27 patients. Comparison was made between the symptoms one month preceding the operation and those 18 months after operation according to the Okuda's criteria for effectiveness.

　The results showed that the treatment was most effective in 58% and effective in 26% of the patients with nasal occlusion. Sneezing and watery nasal discharge were improved 56% and 45% respectively. Four out of five patients with no improvement were in the teens (average age: 16 years). No differences were found in the severity of the preoperative symptoms, length of preoperative desensitization, and of postoperative observation period between the groups with or without effectiveness. It was assumed that postoperative results were influenced by chronological ages of the patients.