鼻石の1症例とその成因について

A Case of Rhinolith and its Etiology

I．はじめに

　鼻石症rhinollthiasisに関する報告は，わが国では甲田他^1），高須他^2）の臨床集計を含め，約105例余がみられるが，比較的稀な疾患とされている。鼻石の化学的組成は，ほぼ明らかにされている^1,2）が，しかし，その微細構造についての報告^3,4）は数少ない。

　ここでは鼻石の1症例を報告するとともに，各種顕微鏡とX線マイクロアナライザーを用いて，同鼻石の微細構造，およびその化学組成を検索した。さらに本症例の成因を考察したので報告する。

　A rhinolith in the right inferior nasal meatus of a 23-year-old female with recurrent nose bleeding in the left nose was reported. The rhinolith, extracted with a forceps, was bended oval in shape, 1.05 g in weight, and 19.4, 13.4 and 8.0 mm in length. The covex surface exposed in the nasal cavity was gray-green and the rugged surface adjacent to the nasal meatus was gray-hrnown.

　The specimen was investigated by means of decalcified sections, contact-microradiography, scanning electron microscopy and x-ray micro-analysis. The rhinolith possessed the porous core based on a globular mass of cotton fibers where Ca, P, Mg, Na and S were detected. The main constituent crystals were haxahedaral forms, probably, Mg-whitolckite. The outer layer, partially laminate structures, was formed by the both extra-or intermi crobial calcified deposits which contained higher concentrations of Ca and P. It seemed that the main constituent crystals were hydroxyapatite. The outer surfaces with thin organic layers were amorphous.

　On the above mentioned observations the origin of this rhinolith was discussed.