内視鏡下副鼻腔炎の手術

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タイトル別名
  • ナイシキョウ カ フクビコウエン ノ シュジュツ
  • Endoscopic Sinus Surgery for Chronic Sinusitis

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Endoscopic sinus surgery (ESS) has became basic surgical treatment for chronic sinusitis instead of the Caldwell-Luc procedure. This technique is aimed at improvement of ventilation and excretion with endoscopic approach between nasal cavity and each sinus. The mucosa preservation of sinus is recognized to important as the surgery for inflammatory disease. The ostiomeatal complex (OMC) plays a significant role in the pathogenesis of sinusitis. Obstruction here predisposes to chronic sinusitis following acute inflammation. A decision of ESS for chronic sinusitis is in the presence of nasal polyp, anatomic narrowing of OMC, persistent mucosal inflammation, CT findings and clinical symptoms (nasal discharge, nasal obstruction, postnasal discharge, headache), unresponsive to medical therapy. The medical management with antibiotics in the postoperative period following surgery is significant to cure mucosal inflammation and prevent the recurrence of sinusitis. ESS is utilized for mucoceles, mycosis and benign tumor as well as chronic sinusitis, but endoscopic surgical techniques require a detailed knowledge. Because the anatomy of sinus is variant individually.

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