高齢慢性副鼻腔炎患者に対する治療とその効果

Management of Chronic Sinusitis in Aged Patients

I．はじめに

　成人の慢性副鼻腔炎高度病変例に施行される^1）上顎洞飾骨洞根本手術は手術適応年齢の上限はないとはいえ，60歳以上の高年齢者では基礎疾患の存在により根本手術が不可能な場合や，患者自身が高齢を理由に手術を望まない場合が多い。

　慢性副鼻腔炎は昭和30年代までは10〜20歳代の患者が全体の2/3を占めていたが，その後は10〜29歳代が減少し10歳未満，50歳以上の患者数が増加して，昭和54年では各年齢層の分布が均等化しているといわれている^2）。さらに近年の平均死亡年齢の上昇に伴う老人人口の増加は近い将来に高齢者の慢性副鼻腔炎患者数を増加させる可能性を有している。

　Managements and results of chronic sinusitis in 36 aged patients (60~82 years old) were reported. Seventy per cent of the patients were treated with antral washing with physiological saline solution. The pathologic conditions of the maxillary sinus were evaluated by radiologic findings after instillation of contrast medium into the sinus (X-MFT) before and after treatment. Before the treatment, mild, moderate and severe lesions were 11%, 39% and 50%, respectively. The antral washing produced improvement of 81% of the maxillary lesions, and also improvement of nasal mucociliary clearance in the patients whose nasal clearance were decelerated. These results indicated that the antral washing is an useful therapy for aged patients with chronic sinusitis