小児副鼻腔炎根治手術の治癒機転に関する補遺

抄録

Reported in the present paper are the results of radiographical studies on the healing patterns of the paranasal sinuses among adult subjects who underwent radical sinusectomy in their childhood and, at present, manifest no subjective symptoms of the operated sinuses.
The effect of paranasal sinusectomy done in childhood upon the later development of the sinuses was evaluated by radiographical findings, particulaly, concerning granulation vegetation patterns of the operated sinuses, development of the facial bones and of the sinus cavities and growth of the teeth.
A. Changes in maxillary sinuses
1. The healing patterns of thebmaxillary sinus after operation could be divided into 1) those sinuses with cavity formation maintaining an open communication between the fontanelle and nasoantral window, 2) those with no communication between the two due to granulation obliteration, 3) those with complete obliteration of the sinus by granulation tissue, and 4) those with formation of postoperative cyst in the sinus.
2. A tendency was noted for a depressed development of the sinus toward the infero-lateral direction and for lateralization of the lateral nasal wall of the lower nasal meatus.
3. Some relation was noted between the pattern of granulation in the sinus or depression of the facial bone and of the sinus and the shape of the preoperative sinus cavity or period elapsed after operation.
4. No appreciable effect upon the growth of the teeth was noted after operations.
B. Changes in the ethmoid cells.
1. Healing with cavity formation, with a variable extents of granulation formation, is the rule of postoperative changes of the ethmoid cells.
The size of the ethmoid cells and degree of local pathology might have affected the amount of granulation proliferation.
2. The surgical insult to the maxillary sinus. did not produce any effect on the lateral sinus wall.
3. No effect was noted on the formation of the recessus lateralis.