迷路破壊と蝸牛機能の残存症例

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It is well known that labyrinthine destruction by cholesteatoma or chronic otitis mediaresults in cochlear dysfunction and makes bone conduction worse. However, we have infrequently encountered cases which maintained good bone conduction despite of labyrinthine destruction or improved the hearing after surgical removal of pathological lesion.In this paper such 9 ears of 8 cases are reported. Regarding protective mechanism in the endolymphatic space, Schuknecht et al speculated that the utriculoendolymphatic valve serves to protect the pars inferior from the disease of the pars superior. The disease is, however, considered to usually initiate in the perilymphatic space of semicircular canal after destruction of its bony wall and to spread through perilymphatic space to the cochlea.Protective mechanism in the perilymphatic route can not be explained only by the utriculoendolymphatic valve theory. The present authors postulate on the anatomical basis that a loose connective tissue in the perilymphatic space of the pars superior and membrana limitans may play a defensive role against the spread of inflammation from the perilymphatic space of the pars superior into the pars inferior.
社団法人日本耳鼻咽喉科学会の論文