It is said in Japan that approximately half of the entire out-patients visiting to Oto-rhinolaryngology Clinics are suffering from chronic paranasal sinusitis.
Therefore, it is not surprising that numerous and voluminous works have been made concerning its symptomatology, etiology and treatment.
Yet types of the chronic paranasal sinusitis in Japan are denitely different from the types seen in Europe or in U. S., and so are treatments. Thus problems encountered in Japan should be solved by own Japanese ways. So far the final answer for these subjects have not been made.
When school children are inflicted by the paranasal sinusitis it presents problems because it hinders learning and the satisfactory treatment has not been 'established.
For the past ten and more years, the author directed his studies to the long term nasal on the school children, both living in the urbun and in the rural areas.
Natural courses of the intranasal diseases were studied and followed. The nasal cativities were well examined and particular attentions were paid on, the middle nasal meatus and its adjacent area, since the local findings of these areas were thought to be closely related to pathology of the paranasal sinuses.
Relationship between nasal discharge and the intranasal findings of the inferior turbinate was investigated.
In general, pathology of the nasal mucous membrane was found more frequently in the elder children and found to be more extensive as the children grew older. Such propensity was more pronounced among the children living in the rural areas. Rhinorhea was a symptom observed in the younger age group and it was found less as they became older.
The more children living in the urban areas had mucoid nasal discharge, while it was of purulent in nature among majority of the children in the rural areas.
The inferior turbinate was more or less atrophic in the younger children and found to be thickened as they became older. But it was interest of note that some children in the rural areas showed continous atrophic change of the inferior turbinate was not always associated with diseased state, but the atrophic change was closely related to pathologic state.
These findings, gross local findings of the mucous membrane, were found to subject to change in the younger school children. The pathology was easily reversible and could return to the normal. Preceeding to establishment of the chronic paranasal sinusitis, mucoid nasal discharge was usually seen. The discharge underwent changes, mucoid to purulent in nature, as the sinusitis progressed in severity.
In another word, the rhinorrhea became more purulent as the chronic paranasal sinusitis was aggravated. Reverse was true with recovery.
It appeared that the intranasal findings became worse more often when the children were in the early middle school days and in the middle of grammer school years.
Lastly it was confirmed that the paranasal sinusitis in the young could be reversed and cured, even if it was severe.
Early detection and early institution of the treatments are again principles of the treatment.
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