鈴木 賢二

ヒトの口蓋扁桃は胎生4ヵ月頃に萌芽し, 生後6ヵ月を過ぎると免疫グロブリン産生が活発化して陰窩上皮の発育と共に二次小節を認めるようになり, 7-8歳で最大に達する.その後思春期には免疫機能の減退が始まり, 加齢と共に扁桃実質は萎縮し結合織は増加する.50歳以降には扁桃リンパ組織の退化と間質の肥厚, 脂肪置換, 軟骨化や骨様化がみられる.<BR>加齢により扁桃感染症は減少するが, その原因として, 1つには加齢による解剖学的, 組織学的変化が挙げられ, その他には扁桃局所粘膜表面の細菌に対するレセプターの変化も考えられる.基礎的検討の結果, 加齢により口蓋扁桃上皮細胞に対するS.pyogenesの付着性も, フィブロネクチン量も減少していた.

It is well known that the inner ear and stapes function are remained normal and the hearing improvement can be expected by meatoplasty, myringoplasty and ossiculoplasty in the patients with congenital atresia or stenosis of the ear canal. The patients who underwent meatotympanoplasty are expected for having good influence on daily life because of the patients being youths.<BR>Recently, we have operated on 13 ears of 11 patients (two bilateral patients), aged from 5 to 21, 10 atresia, 2 stenosis, and one post-operative sequelae. Two dimensional target computed tomography was useful for surgical approach. We drilled the temporal bone at the external auditory meatus with the one tunnel method upto sufficient width for making the tympanic cavity and the external auditory canal.<BR>Meatotympanoplasty for congenital auditory canal atresia or stenosis is good news for the patients suffering from this disease.

A juvenile angiofibroma initially arises from the nasopharynx with high blood flow. The treatment method for the tumor should be examined carefull aynd decide bdyu sing enhance CdT, MRI and X?ray examination. Recently, we treated a 13?year-old boy with tumor recurrence. We selected Weber's incision to complete the total resection of the recurrent tumor. The patient has been tumor-free since surgery for 1.8 years. Multi-directional enhanced CT and MRI are useful for decidings urgica ml ethod asnd the limits of incision a, nd will contribut teo the preventio onf head and neck tumor recurrence.

It is well known that the inner ear and stapes function retain their normal condition and hearing improvement is achieved by carrying out meatoplasty, myringoplasty and ossiculoplasty in patients with congenital ear canal atresia or stenosis. Patients who undergo meatotympanoplasty are expected to have improved daily life because of their young age.<BR>Recently, we operated on 8 ears of 6 patients (two bilateral patients), aged from 5 to 16 years,7 with atresia and one with stenosis.<BR>Meatotympanoplasty for congenital microtia and auditory canal atresia or stenosis is good news for children suffering from this disease.

In patients with recurrent tonsillitis, the detection rates for Bacteroides spp. as well as for Prevotella spp. and Porphyromonas spp. (which are included among the genus Bacteroides spp. in the old classification) were significantly higher in patients aged 13 years or older than in the patients aged 12 years or younger (P<0.01).<BR>Bacteroides spp. and Porphyromonas gingivalis were only detected in patients with recurrent tonsillitis. In addition, the detection rate of Peptostreptococcus spp. was significantly higher in patients with recurrent tonsillitis.