慢性副鼻腔炎の治療法の選択基準

Selection of Therapeutic Modality for Chronic Sinusitis

I．緒言

　慢性副鼻腔炎は昭和50年より56年までの7年間に三重大学医学部耳鼻咽喉科外来の初診者の8.3％を占め，年間の慢性副鼻腔炎患者の頻度はほぼ一定している。学童生徒の学校検診では約3％の副鼻腔炎の有病率を認めている^1）。一般に副鼻腔炎の減少が著しいといわれているが，このように現在なお主要鼻疾患である本症は，近年，重症副鼻腔炎が減少する傾向にある^2）とされており，保存的療法，保存的手術療法の重要性が注口されてきている。三重大学耳鼻咽喉科では昭和55年9月より副鼻腔外来を設け，慢性副鼻腔炎患者に対する治療法の選択基準を設定する目的で治療を行っている。

　本論文では我々の副鼻腔外来で行っている治療方針，治療内容を紹介し，諸家の御批判を仰ぐとともに，慢性副鼻腔炎の治療の一助になれば幸いである。

　Selection of therapeutic modality for 100 patients with chronic sinusitis in our clinic was reported. The conservative treatment or the conservative operation were indicated for the patients of less than 15 years old and more than 61 years old. The patients between 16 and 60 years old were treated according to the pathologic condition of the maxillary sinus and the degree of patency of the maxillary ostium. The pathologic condition was evaluated on the radiographic findings after introduction of contrast medium into the maxillary sinus. The degree of patency of the maxillary ostium was evaluated by measuring the pressure of the maxillary sinus. Patients were treated conservatively when the sinus mucosa was thin, or when the sinus mucosa was moderately thick but the sinus ostium was open. Patients were treated with the conservative operation when the sinus mucosa was moderately thick and the ostium was small, or when the sinus mucosa was thick and the ostium was open. The radical operation was indicated when the sinus mucosa was thick and the ostium was small.