鼻中隔外鼻形成術と鼻中隔穿孔閉鎖術を同時に施行した鼻弁狭窄・鼻中隔穿孔例
近年，鼻弁の狭窄が鼻閉症状の要因となることが知られてきた。また，鼻中隔穿孔も鼻閉症状をきたし，手術治療の対象となる場合がある。当科で経験した，内鼻弁狭窄に鼻中隔穿孔を伴う鼻閉症例に対し，鼻中隔穿孔閉鎖術と鼻中隔外鼻形成術を同時に施行し良好な結果を得たので，文献的考察を加え報告する。症例は61歳男性，30年前に鼻中隔の手術の既往があった。数年前から鼻閉症状が出現，悪化したため，当科初診となった。吸気時の両鼻弁部の陥凹，鼻中隔前方にある13×8 mmの鼻中隔穿孔，左への鼻中隔弯曲を認めた。Cottle test陽性であり，内鼻弁狭窄と鼻中隔穿孔による鼻閉と診断し，鼻中隔外鼻形成術と鼻中隔穿孔閉鎖術...
Saved in:
| Published in | 日本鼻科学会会誌 Vol. 62; no. 2; pp. 322 - 331 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本鼻科学会
2023
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0910-9153 1883-7077 |
| DOI | 10.7248/jjrhi.62.322 |
Cover
| Abstract | 近年，鼻弁の狭窄が鼻閉症状の要因となることが知られてきた。また，鼻中隔穿孔も鼻閉症状をきたし，手術治療の対象となる場合がある。当科で経験した，内鼻弁狭窄に鼻中隔穿孔を伴う鼻閉症例に対し，鼻中隔穿孔閉鎖術と鼻中隔外鼻形成術を同時に施行し良好な結果を得たので，文献的考察を加え報告する。症例は61歳男性，30年前に鼻中隔の手術の既往があった。数年前から鼻閉症状が出現，悪化したため，当科初診となった。吸気時の両鼻弁部の陥凹，鼻中隔前方にある13×8 mmの鼻中隔穿孔，左への鼻中隔弯曲を認めた。Cottle test陽性であり，内鼻弁狭窄と鼻中隔穿孔による鼻閉と診断し，鼻中隔外鼻形成術と鼻中隔穿孔閉鎖術の同時手術を行った。経鼻柱切開による皮膚翻転を行い，大鼻翼軟骨，上外側鼻軟骨，鼻中隔軟骨を露出した。穿孔上部の鼻中隔粘膜は上外側鼻軟骨内側面まで，下部は鼻腔底から下鼻道まで鼻中隔および鼻腔粘膜を剥離し，鼻腔底粘膜にはコの字型の切開を入れ上下の粘膜弁を移動して穿孔部を縫縮した。右側頭筋膜と耳介軟骨を採取し，それぞれ穿孔部の介在グラフトとSpreader graftとして使用した。術後鼻中隔穿孔は閉鎖し，鼻閉症状も消失した。近年，様々な内視鏡下の鼻中隔穿孔閉鎖術が開発されているが，鼻弁狭窄を合併している場合，鼻中隔穿孔閉鎖術と鼻中隔外鼻形成術の同時手術も検討すべきと考えられた。 |
|---|---|
| AbstractList | 近年，鼻弁の狭窄が鼻閉症状の要因となることが知られてきた。また，鼻中隔穿孔も鼻閉症状をきたし，手術治療の対象となる場合がある。当科で経験した，内鼻弁狭窄に鼻中隔穿孔を伴う鼻閉症例に対し，鼻中隔穿孔閉鎖術と鼻中隔外鼻形成術を同時に施行し良好な結果を得たので，文献的考察を加え報告する。症例は61歳男性，30年前に鼻中隔の手術の既往があった。数年前から鼻閉症状が出現，悪化したため，当科初診となった。吸気時の両鼻弁部の陥凹，鼻中隔前方にある13×8 mmの鼻中隔穿孔，左への鼻中隔弯曲を認めた。Cottle test陽性であり，内鼻弁狭窄と鼻中隔穿孔による鼻閉と診断し，鼻中隔外鼻形成術と鼻中隔穿孔閉鎖術の同時手術を行った。経鼻柱切開による皮膚翻転を行い，大鼻翼軟骨，上外側鼻軟骨，鼻中隔軟骨を露出した。穿孔上部の鼻中隔粘膜は上外側鼻軟骨内側面まで，下部は鼻腔底から下鼻道まで鼻中隔および鼻腔粘膜を剥離し，鼻腔底粘膜にはコの字型の切開を入れ上下の粘膜弁を移動して穿孔部を縫縮した。右側頭筋膜と耳介軟骨を採取し，それぞれ穿孔部の介在グラフトとSpreader graftとして使用した。術後鼻中隔穿孔は閉鎖し，鼻閉症状も消失した。近年，様々な内視鏡下の鼻中隔穿孔閉鎖術が開発されているが，鼻弁狭窄を合併している場合，鼻中隔穿孔閉鎖術と鼻中隔外鼻形成術の同時手術も検討すべきと考えられた。 |
| Author | 舘野, 宏彦 將積, 日出夫 髙倉, 大匡 |
| Author_xml | – sequence: 1 fullname: 舘野, 宏彦 organization: 富山大学学術研究部医学系耳鼻咽喉科・頭頸部外科学講座 – sequence: 1 fullname: 將積, 日出夫 organization: 富山大学学術研究部医学系耳鼻咽喉科・頭頸部外科学講座 – sequence: 1 fullname: 髙倉, 大匡 organization: 富山大学学術研究部医学系耳鼻咽喉科・頭頸部外科学講座 |
| BookMark | eNpdkEtPwkAcxDcGExG5-TWK2_92u9uTMcRXQuJFz00fW2mDaFouHoseNBBClNToxWA8-Ah3E0A_TCnQbyGo4eBlZpJfZg6zijLV06pAaF3GBQYK3_A8v-wWVCgQgCWUlTknEsOMZVAWazKWNJmSFZQPAtfEGFQmY8KzqJIO-qOPXvrQSZ6jWU6GT-Or9rR7G4cvCzR5_Up6nTS6TlvRHNVvknZzfF-Pw_dxNJx2m3F4F4eP8_ognDR6k7fL-KL_rz76bKyhZceoBCL_5zl0tLN9WNyTSge7-8WtkuSBQmXJoULDFqMWUagCFDi2hUpUaihgY-C2rWoOBwscCoqpOQDcxCajtkZM6jAqSA5t_u56Qc04FvqZ754Y_rlu-DXXqgj95ypdBR3mMvtrQayy4eueQb4BcuWOUg |
| ContentType | Journal Article |
| Copyright | 2023 日本鼻科学会 |
| Copyright_xml | – notice: 2023 日本鼻科学会 |
| DOI | 10.7248/jjrhi.62.322 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1883-7077 |
| EndPage | 331 |
| ExternalDocumentID | article_jjrhi_62_2_62_322_article_char_ja |
| GroupedDBID | 2WC ALMA_UNASSIGNED_HOLDINGS JSF KQ8 RJT |
| ID | FETCH-LOGICAL-j2451-f5e90c75c345425280de6365a42d028dd69f82c2f524b9f228b0b75d93b5f75e3 |
| ISSN | 0910-9153 |
| IngestDate | Wed Sep 03 06:30:39 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | false |
| Issue | 2 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2451-f5e90c75c345425280de6365a42d028dd69f82c2f524b9f228b0b75d93b5f75e3 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jjrhi/62/2/62_322/_article/-char/ja |
| PageCount | 10 |
| ParticipantIDs | jstage_primary_article_jjrhi_62_2_62_322_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 20230000 |
| PublicationDateYYYYMMDD | 2023-01-01 |
| PublicationDate_xml | – year: 2023 text: 20230000 |
| PublicationDecade | 2020 |
| PublicationTitle | 日本鼻科学会会誌 |
| PublicationTitleAlternate | 日鼻誌 |
| PublicationYear | 2023 |
| Publisher | 日本鼻科学会 |
| Publisher_xml | – name: 日本鼻科学会 |
| References | 6) Døsen LK, Haye R: Nasal septal perforation 1981–2005: Changes in etiology, gender and size. BMC Ear Nose Throat Disord 2007; 7: 1. 26) 勝俣量平，鈴木正宣，中薗 彬，他：篩骨動脈を茎とする鼻中隔粘膜弁を用いた鼻中隔穿孔閉鎖術の1例．耳喉頭頸 2020; 92: 757–760. 24) Alobid I: Endoscopic approach for management of septal perforation. Eur Arch Otorhinolaryngol 2019; 276: 2115–2123. 12) Goh AY, Hussain SS: Different surgical treatments for nasal septal perforation and their outcomes. J Laryngol Otol 2007; 121: 419–426. 7) 飯村慈朗：【鼻副鼻腔の希少疾患を究める】骨および軟骨疾患 鼻弁狭窄．JOHNS 2021; 37: 169–173. 25) Alobid I, Langdon C, López-Chacon M, et al: Total septal perforation repair with a pericranial flap: radio-anatomical and clinical findings. Laryngoscope 2018; 128: 1320–1327. 21) Santamaria-Gadea A, Lopez-Chacon M, Langdon C, et al: Modified nasal floor and inferiormeatus flap for septal perforation repair. Extension and limits. Rhinology 2018; 56: 386–392. 11) Kridel RWH, Delaney SW: Simultaneous septal perforation repair with septorhinoplasty: a 31-year experience. Facial Plast Surg 2018; 34: 298–311. 18) Mariño-Sánchez F, Santamaría-Gadea A, Vaca M: Technique to repair a septal perforation endoscopically with a greater palatine artery pedicled flap. Facial Plast Surg Aesthet Med 2020; 22: 301–303. 19) Hadad G, Bassagasteguy L, Carrau RL, et al: A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 2006; 116: 1882–1886. 8) Das A, Spiegel JH: Evaluation of validity and specificity of the cottle maneuver in diagnosis of nasal valve collapse. Plast Reconstr Surg 2020; 46: 277–280. 20) Morera Serna E, Ferrán de la Cierva L, Fernández MT, et al: Endoscopic closure of large septal perforations with bilateral Hadad-Bassagasteguy flaps. Eur Arch Otorhinolaryngol 2017; 274: 1521–1525. 23) Alobid I, Mason E, Solares CA, et al: Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study. Rhinology 2015; 53: 235–241. 27) 牧原靖一郎，内藤智之，津村宗近，他：Unilateral mucosal advancement flapによる鼻中隔穿孔閉鎖例．頭頸部外 2020; 30: 113–118. 13) Cassano M: Endoscopic repair of nasal septal perforation. Acta Otorhinolaryngol Ital 2017; 37: 486–492. 14) Santamaría-Gadea A, Mariño-Sánchez F, Arana-Fernández B, et al: Innovative surgical techniques for nasal septal perforations: management and treatment. Curr Allergy Asthma Rep 2021; 21: 17. 1) 宮脇剛司，大櫛哲史，浅香大也，他：Nasal valve obstruction（鼻弁狭窄）の治療経験．耳鼻展望 2013; 56: 6; 363–371. 10) 内藤健晴，宮崎総一郎，野中 聡：鼻腔通気度測定法（Rhinomanometry）ガイドライン．日鼻科会誌 2001; 40: 327–331. 17) Castelnuovo P, Ferreli F, Khodaei I, et al: Anterior ethmoidal artery septal flap for the management of septal perforation. Arch Facial Plast Surg 2011; 13: 411–414. 3) 牛尾宗貴：【鼻閉にまつわる問題とその解決策】治療上の副作用および合併症 鼻中隔穿孔．JOHNS 2019; 35: 1637–1640. 28) Foda HMT, Magdy EA: Combining rhinoplasty with septal perforation repair. Facial Plast Surg 2006; 22: 281–288. 2) 児玉 悟：鼻中隔矯正術と外鼻形成術―鼻閉に対するSeptorhinoplasty―．日耳鼻会報 2015; 118: 1406–1413. 5) 奥田 稔，大久保公裕，後藤 穣，他：日本アレルギー性鼻炎QOL標準調査票（2002年度版）．アレルギー 2003; 52(補冊): 21–56. 29) Hong SN, Mutsumay S, Jin HR: Long-term results of combined rhinoplasty and septal perforation repair. JAMA Facial Plast Surg 2016; 18: 475–480. 15) Villacampa Aubá JM, Sánchez Barrueco A, Díaz Tapia G, et al: Microscopic approach for repairing nasal septal perforations using bilateral advancement flaps. Eur Arch Otorhinolaryngol 2019; 276: 101–106. 16) Pignatari S, Nogueira JF, Stamm AC: Endoscopic “crossover flap” technique for nasal septal perforations. Otolaryngol Head Neck Surg 2010; 142: 132–134. 30) Ribeiro JS, da Silva GS: Technical advances in the correction of septa perforation associated with closed rhinoplasty. Arch Facial Plast Surg 2007; 9: 321–327. 22) Teymoortash A, Werner JA: Repair of nasal septal perforation using a simple unilateral inferior meatal mucosal flap. J Plast Reconstr Aesthet Surg 2009; 62: 1261–1264. 4) Stewart MG, Witsell DL, Smith TL, et al: Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004; 130: 157–163. 9) Gruber RP, Lin AY, Richards T: Nasal strips for evaluating and classifying valvular nasal obstruction. Aesthetic Plast Surg 2011; 35: 211–215. |
| References_xml | – reference: 29) Hong SN, Mutsumay S, Jin HR: Long-term results of combined rhinoplasty and septal perforation repair. JAMA Facial Plast Surg 2016; 18: 475–480. – reference: 26) 勝俣量平，鈴木正宣，中薗 彬，他：篩骨動脈を茎とする鼻中隔粘膜弁を用いた鼻中隔穿孔閉鎖術の1例．耳喉頭頸 2020; 92: 757–760. – reference: 28) Foda HMT, Magdy EA: Combining rhinoplasty with septal perforation repair. Facial Plast Surg 2006; 22: 281–288. – reference: 14) Santamaría-Gadea A, Mariño-Sánchez F, Arana-Fernández B, et al: Innovative surgical techniques for nasal septal perforations: management and treatment. Curr Allergy Asthma Rep 2021; 21: 17. – reference: 5) 奥田 稔，大久保公裕，後藤 穣，他：日本アレルギー性鼻炎QOL標準調査票（2002年度版）．アレルギー 2003; 52(補冊): 21–56. – reference: 15) Villacampa Aubá JM, Sánchez Barrueco A, Díaz Tapia G, et al: Microscopic approach for repairing nasal septal perforations using bilateral advancement flaps. Eur Arch Otorhinolaryngol 2019; 276: 101–106. – reference: 8) Das A, Spiegel JH: Evaluation of validity and specificity of the cottle maneuver in diagnosis of nasal valve collapse. Plast Reconstr Surg 2020; 46: 277–280. – reference: 20) Morera Serna E, Ferrán de la Cierva L, Fernández MT, et al: Endoscopic closure of large septal perforations with bilateral Hadad-Bassagasteguy flaps. Eur Arch Otorhinolaryngol 2017; 274: 1521–1525. – reference: 2) 児玉 悟：鼻中隔矯正術と外鼻形成術―鼻閉に対するSeptorhinoplasty―．日耳鼻会報 2015; 118: 1406–1413. – reference: 30) Ribeiro JS, da Silva GS: Technical advances in the correction of septa perforation associated with closed rhinoplasty. Arch Facial Plast Surg 2007; 9: 321–327. – reference: 1) 宮脇剛司，大櫛哲史，浅香大也，他：Nasal valve obstruction（鼻弁狭窄）の治療経験．耳鼻展望 2013; 56: 6; 363–371. – reference: 11) Kridel RWH, Delaney SW: Simultaneous septal perforation repair with septorhinoplasty: a 31-year experience. Facial Plast Surg 2018; 34: 298–311. – reference: 16) Pignatari S, Nogueira JF, Stamm AC: Endoscopic “crossover flap” technique for nasal septal perforations. Otolaryngol Head Neck Surg 2010; 142: 132–134. – reference: 23) Alobid I, Mason E, Solares CA, et al: Pedicled lateral nasal wall flap for the reconstruction of the nasal septum perforation. A radio-anatomical study. Rhinology 2015; 53: 235–241. – reference: 10) 内藤健晴，宮崎総一郎，野中 聡：鼻腔通気度測定法（Rhinomanometry）ガイドライン．日鼻科会誌 2001; 40: 327–331. – reference: 17) Castelnuovo P, Ferreli F, Khodaei I, et al: Anterior ethmoidal artery septal flap for the management of septal perforation. Arch Facial Plast Surg 2011; 13: 411–414. – reference: 27) 牧原靖一郎，内藤智之，津村宗近，他：Unilateral mucosal advancement flapによる鼻中隔穿孔閉鎖例．頭頸部外 2020; 30: 113–118. – reference: 19) Hadad G, Bassagasteguy L, Carrau RL, et al: A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 2006; 116: 1882–1886. – reference: 18) Mariño-Sánchez F, Santamaría-Gadea A, Vaca M: Technique to repair a septal perforation endoscopically with a greater palatine artery pedicled flap. Facial Plast Surg Aesthet Med 2020; 22: 301–303. – reference: 6) Døsen LK, Haye R: Nasal septal perforation 1981–2005: Changes in etiology, gender and size. BMC Ear Nose Throat Disord 2007; 7: 1. – reference: 24) Alobid I: Endoscopic approach for management of septal perforation. Eur Arch Otorhinolaryngol 2019; 276: 2115–2123. – reference: 22) Teymoortash A, Werner JA: Repair of nasal septal perforation using a simple unilateral inferior meatal mucosal flap. J Plast Reconstr Aesthet Surg 2009; 62: 1261–1264. – reference: 3) 牛尾宗貴：【鼻閉にまつわる問題とその解決策】治療上の副作用および合併症 鼻中隔穿孔．JOHNS 2019; 35: 1637–1640. – reference: 12) Goh AY, Hussain SS: Different surgical treatments for nasal septal perforation and their outcomes. J Laryngol Otol 2007; 121: 419–426. – reference: 4) Stewart MG, Witsell DL, Smith TL, et al: Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004; 130: 157–163. – reference: 25) Alobid I, Langdon C, López-Chacon M, et al: Total septal perforation repair with a pericranial flap: radio-anatomical and clinical findings. Laryngoscope 2018; 128: 1320–1327. – reference: 13) Cassano M: Endoscopic repair of nasal septal perforation. Acta Otorhinolaryngol Ital 2017; 37: 486–492. – reference: 21) Santamaria-Gadea A, Lopez-Chacon M, Langdon C, et al: Modified nasal floor and inferiormeatus flap for septal perforation repair. Extension and limits. Rhinology 2018; 56: 386–392. – reference: 7) 飯村慈朗：【鼻副鼻腔の希少疾患を究める】骨および軟骨疾患 鼻弁狭窄．JOHNS 2021; 37: 169–173. – reference: 9) Gruber RP, Lin AY, Richards T: Nasal strips for evaluating and classifying valvular nasal obstruction. Aesthetic Plast Surg 2011; 35: 211–215. |
| SSID | ssib002671038 ssib002670969 ssib058493773 ssib002003995 ssj0066762 |
| Score | 1.8990912 |
| Snippet | ... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 322 |
| SubjectTerms | 鼻中隔外鼻形成術 鼻中隔穿孔 鼻中隔穿孔閉鎖術 鼻弁狭窄 |
| Title | 鼻中隔外鼻形成術と鼻中隔穿孔閉鎖術を同時に施行した鼻弁狭窄・鼻中隔穿孔例 |
| URI | https://www.jstage.jst.go.jp/article/jjrhi/62/2/62_322/_article/-char/ja |
| Volume | 62 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本鼻科学会会誌, 2023, Vol.62(2), pp.322-331 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnR1da9RAMJQKIoj4id_0wX28M9ns52OSy1GUCkILfQt3-UAPqVLaF9-u-qC0SNFyoi9S8cEP-i601R9zvbb3L5zZJNe0iNS-7G1mZ2YnM9nM7N7OxrLutKjkVGQpjDQmavCWjGuawWUG78EEHLDQFHOHpx6IyRl2b5bPjo2frexaWlxo1-Pnf80rOYlVAQZ2xSzZ_7DsiCkAoA72hRIsDOWxbExCTfyA-D4JGfEV8RoI0R7RjISceIxoUcHhxG8Qj5JQEKWItkkIJA7RLgldiCiJp_7JUBIPWpuGc8NANPJXGisqNH1VGVKiKSJDRyrATrVGYNGXbyACRcqpEMc0aVlWmoeFDxAIYijfCAbyeEQxg-wanP8SHnBCYFWNzo1IgMlNJSBeUOEJcEm0U3DwhOEQIP-DijIijRaeEYCaNnpVEpUET7ThAF03S4uIA3wA2IiZy6saOf5IKo5tvlcY1_MPCDVqFBSMKDbapOyIodgIhdtxqms8eQK2GY8nu-_qKi-4We3k5zHX09zHKeXWpF18PadwgoJWBjuteDQ3TxsvgqMive6o35WUYS5JpzP_6HFd0PqI6NBJ5sU4iQxaJGhEsQDcqGzBTMOoA9OdU1RKB3fo3n9YmQ1jInn1ND48e1BUT8uTeNx_eQ2hNcTechSY4W5u86diqZM8DwZlv1uVHGLRDszMyl2dJtCcPm-dK2aIE14u7AVrrNO6aJ2eKvbAXLKeDLc2d35uDD-uDb70oD7Y_rz7anV__V2_-3XUtPft92Bjbdh7PXzTw6alt4PVld0PS_3uj93e9v76Sr_7vt_9hORb3b3ljb3vL_svNo-Q7_xavmzNNMPpYLJWfDOl1qGMO7WMp9qOJY9dxsEdU2UnqXAFbzGawFQiSYTOFI1pxilr64xS1bbbkifabfNM8tS9Yo3PPZ1Lr1oTWeo6KUtsHWO-vStbLZgLUscWsQO_3L5mqVxP0bP8YJzo2Aa-fnLSG9YZHCH5KuhNa3xhfjG9BfOChfZt87T8AT4k5eM |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E9%BC%BB%E4%B8%AD%E9%9A%94%E5%A4%96%E9%BC%BB%E5%BD%A2%E6%88%90%E8%A1%93%E3%81%A8%E9%BC%BB%E4%B8%AD%E9%9A%94%E7%A9%BF%E5%AD%94%E9%96%89%E9%8E%96%E8%A1%93%E3%82%92%E5%90%8C%E6%99%82%E3%81%AB%E6%96%BD%E8%A1%8C%E3%81%97%E3%81%9F%E9%BC%BB%E5%BC%81%E7%8B%AD%E7%AA%84%E3%83%BB%E9%BC%BB%E4%B8%AD%E9%9A%94%E7%A9%BF%E5%AD%94%E4%BE%8B&rft.jtitle=%E6%97%A5%E6%9C%AC%E9%BC%BB%E7%A7%91%E5%AD%A6%E4%BC%9A%E4%BC%9A%E8%AA%8C&rft.au=%E8%88%98%E9%87%8E%2C+%E5%AE%8F%E5%BD%A6&rft.au=%E5%B0%87%E7%A9%8D%2C+%E6%97%A5%E5%87%BA%E5%A4%AB&rft.au=%E9%AB%99%E5%80%89%2C+%E5%A4%A7%E5%8C%A1&rft.date=2023&rft.pub=%E6%97%A5%E6%9C%AC%E9%BC%BB%E7%A7%91%E5%AD%A6%E4%BC%9A&rft.issn=0910-9153&rft.eissn=1883-7077&rft.volume=62&rft.issue=2&rft.spage=322&rft.epage=331&rft_id=info:doi/10.7248%2Fjjrhi.62.322&rft.externalDocID=article_jjrhi_62_2_62_322_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0910-9153&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0910-9153&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0910-9153&client=summon |