「上顎神経伝達麻酔に関する研究」補遺—特に翼状口蓋窩外側注射法に於ける一考案並びに考察

　緒言

　先に昭和27年日本耳鼻咽喉科学会々報第55巻第10号，11号に「上顎神経伝達麻酔に関する研究」（概要）と題して発表したが，其後斉藤寛^2）氏の報告，白岩教授^3）の綜説等があり上顎神経伝達麻酔法も一歩進んだ感がある。

　現在欧米に於ては殆んど，我が国に於ては一部に於て全身麻酔下に上顎洞の手術が行われているが，我が国に於ては未だ全体的に全身麻酔が此の手術に行われる段階に至つてはおらない状態である。其れ故大部分局所麻酔或は上顎神経の伝達麻酔下に手術が行われている現状である。

Nomura describes a new method of establi-shing conduction anesthesia of the infraorbital nerve which he names it as the Nomura's Ⅱ Method. The point at which the needle is to be inserted is selected by, first,determining a surface area of triangular space that is bounded superiorly by the inferior border of the zygoma, posteriorly by the anterior edge of the coronoid process and anteriorly by a line drawn from suture line of the zygoma and the maxilla to the anterior angle of the mandible at the root of the third molar tooth. On the superior border of the triangle a point is then selected 5 mm posterior to its anterior angle and from this point another line is projected parallel to the first. The pint of needle insertion will be on the second line 1.5cm below SG point. The angle with which the needle should be maintained for insertion is obtained by pointing the needle to a target spot situated midway between either eye-brow:maintaining this angular position of the needle it is, then, rotated on the same plane 40 degrees posteriorly, before insertion, to reach the fossa pterygopalatina and the infraorbital nerve.

The author applied this method in 20 cases of his surgical patients with 100% success.