老人性難聴における側頭骨および内耳血管の病理組織学的研究
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概要
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Fourteen temporal bones of aged Japanese people, on whom hearing tests were performed within six months before death, were studied histopatho-logically. Some cases were studied also on the anterior inferior cerebellar arteries.1) The collapse of Reissners membrane and/or tectorial membrane, though it had been said to be some kind of pathological findings in classical reports, was concluded by the authors cases to be the postmortem changes.Very peculiar artifacts were found in one case, in which all the Reissners membrane and saccular wall were completely missing in spite of good preservation of all the other tissues.2) The most frequent pathological type in the authors cases was “neural type” (ganglion atrophy), due to Schuknechts classification of presbycusis.3) The pathological changes of the basilar artery, the anterior inferior cerebellar artery and arteries in the internal auditory meatus had no close relation to the inner ear changes. So it is reasonable to presume that even a severe narrowing of those arteries, if it happens gradually, does not cause a constant pathological changes in the inner ear except in case of their total closures, 4) The relation between high-grade atrophy of stria vascularis and hearing loss was greatly suspected. The strial atrophy was found mainly in apical and middle turns.5) Other aging changes such as pigmentation in the modiolus and stria vascularis, psammoma bodies, corpora amylacea, etc. were found in almost all cases, but they had no close relations to presbycusis itself either histopathologically or au-diometrically. The author would like to conclude that presbycusis is not a part of general aging phenomena, but a quite independent “disease”.6) In five cases out of fourteen, hearing loss could not be explained by inner ear pathology. The unknown pathology of inner ear seemed to be still left in our hands, though, central lesions could also be probable.
- 社団法人 日本耳鼻咽喉科学会の論文