高周波電気凝固による下鼻甲介粘膜の組織変化

Histological Changes of Mucous Membrane of the Inferior Turbinate after High-frequency Electrocoagulation

I．はじめに

　特異的減感作療法はアレルギー性鼻炎の基本的治療であり，われわれもほぼ全例に第一選択としている。しかしこれによりくしゃみ，鼻汁の改善はみられても，鼻閉の持続する症例がある。このような症例には下鼻甲介粘膜広汎切除術を行ってきた。これに対し近年高周波を用いた下鼻甲介粘膜電気凝固術が行われるようになり，その用性が評価されている。この療法の効果機序を調べるため組織学的検索を行った。

　Histological examination of mucous membrane of the inferior turbinate was carried out to clarify the effect of high-frequency electro-coagulation.

　Electro-coagulation of the inferior turbinate using bipolar needle electrode was performed with electric power in to watts for 5 or 20 seconds. Then, mucous membranes were surgically removed and histologically examined.

　The changes of mucous membrane after 20 seconds' coagulation were stronger than that after 5 seconds'. The major histological findings were coagulation necrosis of the nasal glands and blood vessels, thrombosis of the vessels, edema, infiltration of lymphocytes and neutrophils and the desquamation of the epithelial cells. One month after electro-coagulation, their changes of the nasal glands and epithelium were still observed and fibrosis of subepithelial tissue was appeared, but blood vessels were already regenerated and blood circulation was recovered.