副鼻腔炎に対する鼻内視鏡手術の成績

―自覚症状の評価から―

抄録

Between December 1986 and February 1991, endonasal sinus surgery under endoscopic guidance was performed on 95 patients with chronic paranasal sinusitis. Forty-six of the 95 patients were followed for more than one year, ranging from 12 to 53 months with an average of 26 months. Each patients rated the severity of nasal symptoms on admission to the hospital and during the latest visit after one year follow-up. Rating was based on a 4-point scale (O: normal, 1: slight, 2: moderate, 3: severe). Nasal symptoms checked include 1) times blowing nose per day, 2) difficulty in blowing nose, 3) amount of choanal discharge, 4) difficulty in expelling choanal discharge, 5) nasal obstruction, 6) disturbance in the sense of smells, and 7) headache. The number of patients with grade 2 or 3 nasal obstruction and headache decreased to 4-6% of the total. On the other hand, more than 20% still complained of choanal discharge or hyposmia. Nasal obstruction was relieved in 88.4% of the patients who had complained of it while choanal discharge was relieved in only 65.9%. Other symptoms were relieved in over 70% of the patients. Greater improvement in each symptom on long-term follow-up occurred when the preoperative degree was more severe. Choanal discharge appeared in four patients and worsened in two patients. The nose became slightly stuffy in one patient.