顔面神経麻痺に随伴せる"Hyperacusis"について

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We know from experience that the patients suffering from facial palsy complain frequently of hearing disorder, hyperacusis, especially in its early stage, which is regarded as a significa- nt symptom in focal diagnosis of the disease. That is to say, the hyperacusis in these cases has been considered to be due to paralysis of the stapedial muscle innervated by a branch of the facial nerve. However, the literature concerning it is very scanty from the otological point of view. The authors made some clinical observations on 32 patients with hyperacusis accompanied by facial palsy who visited the Oto-Rhino-Laryngological Clinic of University of Tokyo The results obtained were as follows: 1) There was no marked difference between both sexes in number of the cases. 2) The distribution of the patients in age covered from 20 to 39 years of age in the greatest proportion while none being observed under 10 years of age. 3) Etiology of the disease was undetermined in the vast majority of patients, except some cases caused by common cold, herpes zoster oticus or trauma. 4) The chief complaint as prodromal symptom was headache in most cases. 5) As to accompanied symptoms, tinnitus was frequently complained, disorder of the taste in 5 cases, that of the salivary secretion in 3 cases being observed at the same time. 6) In hearing examination, 19 cases revealed normal hearing threshold, increased in 13 cases decreased in none of the cases. 7) Based upon the audiograms, the patients were divided into four types as follows. (1) Type of normal hearing. (2) Type of abrupt high tone loss. (3) Type of gradual high tone loss. (4) Type of c5-dip. 8) In 28 cases examined by means of Fowlers binaural loudness balance test, 15 cases dis- played positive recruitment phenomenon including 8 cases of the normal hearing type, while 13 cases showed negative. 9) It was generally observed that the disappearance of hyperacusis was not paralled by the recovery of facial palsy. In some cases with permanent facial palsy, hyperacusis disappeared in early stage of the disease. 10) According to our observation, hyperacusis was complained even in a case whose facial nerve was injured at the region external to the stylomastoid foramen, peripheral to the bran- ching of the stapedial nerve. Conclusion; We gathered from these observations that the hyperacusis in facial palsy was partly due to the positive recruitment phenomenon, partly due to diplacusis. The term "hyperacusis " comp- lained in facial palsy is considered as an inadequate word to express its actual state as there was no one showed the increased hearing acuity among these cases complained of hyperacusis. For this reason, we offered the proposal to accept the term " Dysacusis stapedica" as more reasonable expression to elucidate this particular state of hearing.
社団法人日本耳鼻咽喉科学会の論文

顔面神経麻痺に随伴せる"Hyperacusis"について

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