上顎洞性後鼻孔ポリープ2例の治療

抄録

Antrochoanal polyps arising in the maxillary sinus mucosa, are relatively common in children, and are thought to be caused by chronic maxillary sinusitis. To achieve a cure, the base of the polyp must not remain in the maxillary sinus, otherwise recurrence is likely. The Caldwell-Luc procedure was previously the standard technique for maxillary sinus surgery. It is associated, however, with postoperative complications such as maxillary mucocele and paraesthesia of the cheek. In paediatric patients, there are further concerns regarding impaired development of the maxilla or teeth. Functional endoscopic sinus surgery has therefore largely replaced the Caldwell-Luc procedure.
At this institution, we have for some time used the endoscopic nasolacrimal duct inferior turbinate swing technique for maxillary sinus lesions associated with chronic sinusitis. With this technique, we strip the mucosa from the nasolacrimal duct and inferior meatus anteriorly, then detach it from the wall of the maxillary sinus. The mucosa is then cleared from the walls of the maxillary sinus, opening up the antrum. This procedure has the advantage of creating a relatively wide visual field via the nasal approach alone, and procedures within the maxillary sinus can then be readily performed. In this paper, we report 2 cases in which favourable results were achieved using this nasolacrimal duct inferior turbinate swing technique, along with a discussion of the literature.