聴器伝音系の先天性奇形に対する手術的療法と胎生学的考察について

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Statistical observations were carried out with the findings of 52 ears operated on congenital malformation of conductive apparatus and several interesting findings were reported and discussed in connection with the embryological views of external and middle ear.As to the hearing improvement by operatoin, it was revealed that the classical fenestration yielded the most satisfactory result compared with tympanoplasty or stapes surgery.The major points are as follows:1. Embryological aspects:Operations were performed on the cases showing air-bone gap of more than 30db.a) Even the cases with apparently normal ear canal occasionally had stapes malformation or stapes fixation.b) Most of the cases with abnormal ear canal showed malformation of malleus and incus or ankylosis between malleus and incus.c) Separation of incudo-stapedial joint was sometimes noticed in these cases irrespective of presence or absence of abnormality of ear canal. The above operative findings coincide with embryological views; malleus and incus are derived from the first branchial arch (Meckels cartilage) and stapes is from the second branchial arch (Reicherts cartilage).2. On operation method:a) Fenestration is highly recommended for hearing improvement in the cases with normal cochlear function.b) Stapedectomy is also indicated in the cases with the slightly impaired cochlear function but with normal ear canal.
社団法人日本耳鼻咽喉科学会の論文