副鼻腔気管支症候群に対する副鼻腔手術の効果—補遺

The Effect of Sinus Surgery on Sinobronchial Syndrome

Ｉ．はじめに

　副鼻腔気管支症候群（sinobronchial syndrome，SBS）は慢性の鼻副鼻腔炎に慢性の下気道の非特異性炎症を合併した病態を指す。その歴史は19世紀末に遡る^1）が，ごく最近になって本症候群が遺伝的体質に基づいた疾患であるとする説^2）が有力になっている。SBSの下気道病型は慢性気管支炎（chronic bronchitis，CB），気管支拡張症（bronchiectasis，BE），びまん性汎細気管支炎（diffusepanbronchiolitis，DPB）の三つに分けられる。その一つDPBは予後の悪い疾患の代表とまでいわれている。SBSに対する治療も一筋縄ではいかない代物である。

　In order to investigate the effect of surgical treatment for affected sinuses upon both upper and lower airway lesions of sinobronchial syndrome (SBS), eight patients with SBS were evaluated pre- and postoperatively. Regarding the change of the nasal condition, four claimed to be improved, while the rest still felt unchanged. All still had bronchial symptoms. Among them 3 felt getting better, 3 unchanged, and 2 worse. Patients who were improved in bronchial symptoms were also improved in nasal symptoms, but not vice versa.

　It is concluded that even best surgery on paranasal sinuses cannot cure the bronchial lesion in itself, and an addition of elaborate, long term local treatment should be mandatory to improve the nasal condition. As an improvement even only in nasal lesion is a mercy for the patients. sinus surgery can be recommended unless their bronchial conditions are too bad to continue the postoperative topical treatment on sinuses.