舌扁桃手術問題

1）ワルダイエル氏咽腔輪の4本柱を形成する咽頭，ロ蓋，舌及び耳管扁桃のうちで，前2者に比し後2者に就いての成書の記載は著しく簡單に取扱われ，手術法も前2者中，舌扁桃手術は申し訳け程度の記述である．

　又整備した耳鼻咽喉科臨床の手術室には，必ずマイルス氏舌扁桃切除の大小一組が備えられているが，買つたまゝ使いもせ銹びるに任せている所が多い．

Iinuma says patients often complain of dis-agreeable foreign body sensations and to the extent of becoming highly neurotic, in some cases, when lingual tonsils are enlarged to come in contact with the epiglottis. Under similar circumstances the growths should be removed. Which brings the question directly in face to the choice in method of operation and of hemostasis particularly, where hemorrhage occtur most readily and in considerable amounts. Oper-ative methods suggested by the author are as follows: (1) A piece meal exterpation by use of "double curet"; (2) By use of Mile's lingual tonsil knife which requires a certain amount of practice for results; (3) Application of tonsil snares; (4) Snapping them off by use of long-handled scissors; (5) By grasping hold of tonsillar tissues with tonsil forceps and separate them away by sharp instruments. But hemorrhages in the latter procedure are profuse. The best means by which to stop hemorrhages would be application of ties to the bleeding point. Any tonsillar tissues that might be remaining after the operation may be effectively removed by means of irradiation with roentgen rays.