先天性後鼻孔閉鎖の4例

Congenital Choanal Atresia: Report of Four Cases

I．はじめに

　先天性後鼻孔閉鎖症は比較的稀な疾患で1755年Roderer^1）によって初めて記載され，1880年にRonaldson^2）が出生後窒息死した児を解剖してその重大性を示した。本邦では1924年木村^3）が報告したものが最初である。われわれは昭和54年7月以来4例を経験し経過を3〜5年にわたって観察したので報告する。

　Four cases of congenital choanal atresia were reported. Two of them were bilateral and others were unilateral. All cases were treated surgically.

　As the operative method, transnasal approach using carbon dioxide LASER under microscopic technique was better for infant cases.

　On the other hand, transpalatine approach seemed better for the cases of elder children and the recurrent cases.

　he tube stent should be placed for at least 6 weeks postoperatively. Long term follow up was necessary, and when choanal stenosis was recurred after surgery, frequent transnasal dilation using rongeur after Masuda was effective.

　Discussions were made on the surgical treatment and the management after surgery.