鼻内形態が鼻呼吸抵抗に及ぼす影響についての研究

抄録

In 90 patients with chronic sinusitis and septum deviation undergoing endonasal surgery (ethmoidectomy and sphenoidectomy with enlargement of middle meatus), submucous resection or submucous lower conchotomy, the airway resistance through nose (abbreviated as TAR hereinafter) was measured before and after sugery to determine the effect of intranasal structure on TAR. TAR was measured by 3 Hz oscillation method using TUC 5000 Rhinograph (Chest Co., Ltd).
Results showed that the ratio of change (difference in TAR before and after operation/preoperative value) showed the greatest reduction for the concave side nasal cavity in septum deviation after lower conchotomy, followed by the convex side after lower conchotomy, the convex side after submucous resection and the concave side after endonasal surgery in this decreasing order. The ratio rather elevated in the concave side nasal cavity in septum deviation after submucous resection.
From these results, it was found that the most important factor responsible for an increase in TAR is narrowing of the common nasal meatus due to hypertrophy of the lower turbinate, and the next most important one is septum deviation. In addition, 60 patients having the same disease as those described above were divided into three groups according to age as the group of young age generation under 20 years (abbreviated as the young age group hereinafter), the group of middle age generation of 21 to 40 years (abbreviated as the middle age group hereinafter) and the group of the old age generation over 41 years (abbreviated as old age group), and in each of these groups TAR was measured before and after application of adrenalin.
The greatest decrease in the ratio of change (difference in TAR before and after application of adrenalin/value before application of adrenalin) before and after application of adrenalin was recorded for the concave side nasal cavity in septum deviation in the middle age group, followed by the convex side in the middle age group, the concave side in the highage group, the convex side in the low age group, the concave side in the low age group and the convex side in the high age group. Among these changes, the difference observed between the concave side and the convex side in the middle age group was greater as compared to other values.
From these results it is considered that in the middle age group the swelling of the lower turbinate is irreversible and in this group conchotomy has great significance.