骨部外耳道に開口部を有した第1鰓裂奇形症例--特にその発生学的成因に関して (京都大学医学部耳鼻咽喉科学教室6年間の歩み(1977-1982年)--檜学教授還暦によせて)
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First branchial cleft anomalies are rare disorders. A case of a first branchial anomaly with an unusual fistulous tract is presented.The patient was a 6-year-old boy who complained of white gelatinous discharge from his left ear canal and recurrent abscess in the left submandibular region. Otoscopic examination revealed deformity of the tympanic membrane and a downward excavation of the bony external auditory canal at its deepest potion. Hearing was normal and there was no deformity in his left auricle or other parts of the body. The fistulous tract was extirpated. The tract extended upwards from the submandibular wound, passing medially through to the deep parotid gland lobe and opening into the bony external auditory canal. The tract was found to be lined with keratinized squamous epithelium with adnexal structures and accompanied by cartilage at the junction of the auditory canal.In the past literature we could not find a case that had a fistulous opening at the bony external auditory canal and a deformity of the tympanic membrane.We observed collected human fetuses (the fourth to eighth weeks) in order to study these anomalies from the embryological standpoint. We found by chance two other developmental stage fetuses both of which showed duplicated external auditory canal and pinna. After careful comparison with these fetuses, we concluded that the first branchial cleft anomaly with the fistulous tract running through from the submandibular area to the external auditory canal were not derived from these duplication anomalies of the external ear. This type of first branchial cleft anomaly was considered to be closely associated with Reichert's cartilage. In our case we supposed there would be interaction between Reichert's cartilage and the tympanic ring during the latter half of the fetal period.The deformity of the tympanic membrane was believed to be caused by incomplete closure of the foramen of Huschke.
- 耳鼻咽喉科臨床学会の論文
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- 骨部外耳道に開口部を有した第1鰓裂奇形症例--特にその発生学的成因に関して (京都大学医学部耳鼻咽喉科学教室6年間の歩み(1977-1982年)--檜学教授還暦によせて)
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