末梢迷路疾患に関する臨床的研究 : 前庭機能を中心にみた突発性聴平衡覚障害の臨床的研究
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概要
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Vestibular function and of principle cause of sudden loss of cochleo-vestibular function which did not occcure repeatedly was studied.The results were as follows:1) Many patients with this disorder seemed to have vasomotor disturbances showing sudden flushig and chills, headaches and stiff shoulders. The next main factor was allergic diathesis. Chiefly they complaind of mental and physical fatigue and cold. A few cases showed attacks after extraction of teeth and under a drier for permanentwave.Furthermore some cases accompanied with acoustic tumor, subarachnoideal bleeding and cranial polyneuritis, were seen. Two cases, in which numerous Dihydrostreptmycin injections had been carried out, attacks appeared shortly after the chest surgery under general anesthesia.2) Nystagmus in 91 cases out of 113 cases was found. Abnormal nystagmus were found especially by positional and positioning nystagmus test. Many kinds of nystagmus, namely direction fixd, direction changing, horizontal, rotatoric and vertical nystagmus were found. That findings of nystagmus had very important meaning for the diagnosis of the affected area was also emphasized.3) In Caloric Test 71% out of 113 cases were CP. This test is also important for the diagnosis of the degree of lesion and of the affected area. When there is no response of the Caloric Test we must differentiate it from acoustic tumor.4) In Optokinetic Nystagmus (OKN) Test, examined by Optokinetic Pattern (OKP) Test, many cases showed peripheral type, but some cases showed semicentral and central type.5) Many cases showed laterality in Optokinetic After Nystagmus (OKAN) Test. This finding is useful for the diagnoss of DP.On the other hand rotatoric test is not useful for the diagnosis of the side and degree of the lesin.6) In Counterrolling Test of the eye, many cases showed abnormal value at the affected side. This finding is helpfull for the diagnosis of affected area as a method of diagnosis of otolithic function.7) Some cases showed abnormality in neurological findings, vertebral angiography and electroencephalography. This fact shows that some cases of sudden loss of cochleo-vestibular function hav central, especially brainstem lesion.From the results above mentioned it can be concluded that the genesis and the affected area of these disease were various, and we could locate the affected area in the labyrinth and centrum more fully by not only the hearing tests, but also by varius vestibular function tests and vertebral angiography, electroencephalography etc, as the case may be.And furthermore it was indicated that some cases, in this disease, having their genesis in the lesion of the central nervous system.
- 社団法人 日本耳鼻咽喉科学会の論文