慢性副鼻腔炎の綜合手術とOsteoplastik

抄録

In this paper the following two important problems were subjected for discussion: 1) Whether the membrane of the sinus in chr. sinusitis must be detached or not? 2) Which procedure is preferable in sinuectomy, osteoplasty or obliterating operation?
Concerning the first problem, the author has stated that excavation of the sinus mucosa should depend on the character and grade of changes in the sinus membrane.
As for the second problem, he has expressed his opinion as follows: In the frontal sinus it is un-necessary to make osteoplasty of the sinus, except in the extremely pneumatized cases, in which osteoplastic procedure on the anterior wall of the anterior ethmoid sinus may be needed to secure its cleansing.
As for the maxillar sinus its postoperative behavior must be different from the frontal sinus. The author consider that the maxillar sinus must be reserved to keep postoperatively the communication between the maxillar sinus and ethmoidal sinus, leading to the inferior nasal meatus provide better communicating rout for the ethmoidal sinus than middle nasal meatus.
For this purpose he has attempted osteoplasty of the maxillar sinus in the combinated sinusitis. The author emphasizes that the 1.5 to 2.0cm long eye brow incision in the one third is large enough to operate on the frontal sinus or the anterior ethmoid sinuse, which was previously already operated transmaxillary as completly as possible.