レ線的粘膜機能検査より区分せる慢性上顎洞炎の影像に就て

1）造影剤を副鼻洞内に注入して其の排泄移動状態をレ線的に観察し粘膜機能を検査しようとする企ては約15年程前より試みられその排泄の原動力である粘膜上皮繊毛運動の生理学的研究と相俟ち種々の成績が挙げられ最近の我邦でも大藤教授石川氏又小倉氏等の興味ある成績が報告せられている．私共も年来慢性副鼻洞炎の診断治療等に関心を持つていたのでこのレ線的粘膜機能検査がどの程度に診断に寄与し得るやに就て先ず検討した所認むべき成果を得たので此処に第1報的にその影像型に就て御報告し度い．

2）私共は造影剤の洞内注入と撮影に次のような方法を採つた．造影剤は10％の上行性モルヨドール（以下Mと略す）を使つた．この10％をルンバール針を通じて下鼻道側壁より4〜5c.c，穿剌注入し以後撮影迄座位にて数10分以内に腹臥位前後脛左右脛の撮影を行い（内容のある時も之を排除しない）次いで3-4日後前後脛撮影を行つたが尚過半数の症例に於てMの注入前に普通の前後左右徑のレ線撮影を行い各の比較検討をした今迄の検査撮影数500側の中本報告では其の半数に就ての検討の結果を述べる．穿剌にルンパール針を用いたのはシユミツト針より疼痛が少い為めである．

　TAKAHASHI and Gonta made observations on maxillary sinus by means of roentgenograms after instillation of radio-opaque "Moljodol" About 4 or 5 cc of 10 per cent moljodol was instilled in the sinus with-needle puncture through the inferior meatal wall.

　In each procedure a roentgenogram was taken immediately after the instillation and another a few minutes later: The pictures obtained in this way was divided into 4 different types according to the shedd-ow projected on the plate.

　1. The spreading type; in which the shadow spreads out in blurred haziness from the point of introduction.

　2. Spotted type; in which the shadow appears in a irregular forms.

　3. Localized type; in which dark shadow is seen as a unit of mass.

　4. Mutilocular type; in which dark shadows are present in two of nore units of mass.

　Clinically, when spreading type was present there were Various degrees of pathological involvement of the sinus, and, the time required for eliminaton of the agent was directly proportional to the degree of that involvement. Similar relations were not established with localized or mutilocular types. In general, the elimination time per se did not constitute a criterion upon the degree of sinus involvement may be measured but the types of shadows produced played an important role is arriving at a clinical diagnosis. Changes in the mucous membrane of the nasal cavity appeared to be highly influenced and in correspondence by and to pathological changes within the sinus and in the tissues about the natural orifice. Comparison were made for diagnosticac umen with pictures taken with and without the use of moljodol; the former was definitely more accurate than the latter.