Diagnostic Labyrinthotomy : その臨床例と基礎的研究

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Since the Silversteins first report(1966) on elevated protein concentration in the perilymph of the patients with acoustic tumor, it appears that "diagnostic labyrinthotomy" can be useful and worthwhile in certain cases of unilateral sensorineural hearing loss where acoustic neurinoma or Menieres disease is suspected. The objective of the present clinical study is to appraise the correlation between the clinical pictures of 8 cases of acoustic tumor suspect and of 2 cases of Menieres disease suspect and pictures of 8 cases of acoustic tumor suspect and of 2 cases of Menieres disease suspect and the results of microchemical analysis of the inner ear fluid. Increase in perilymph protein concentration was confirmed in 5 cases of cerebellopontine angle tumor who underwent craniotomy, while one false negative case of acoustic tumor was observed. In normal subjects, the level of inner ear fluid protein was substantially less than that in acoustic tumor cases.Two cases of Menieres disease and one case of acoustic tumor suspects were judged as negative.However, one false positive result was obtained in the case of ac-oustic tumor suspect, in which no internal auditory cannal lesion was present on posterior fossa myelography. On the basis of the present clinical evidence, it seems likely that any condition which causes blockage of the internal auditory canal such as cerebellopontine angle tumor and/or arachnoiditis results in elevated perilymph protein concentration. High potassium concentration in the inner ear fluid was found in one patient with Menieres disease and was considered to indicate the etiology of vertiginous episodes of this patient.The result would also suggest that "Diagnostic labyrinthotomy" is applicable for the diagnosis of Menieres disease.

Diagnostic Labyrinthotomy : その臨床例と基礎的研究

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