外傷性外リンパ瘻の臨床

概要

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Seven cases of perilymphatic fistulae due to closed head injury are presented. All the patients suffered rotatory vertigo and/or dizziness with varying degrees of sensory hearing loss and tinnitus. Three of the patients complained of the sensation of water leaking in the ear. Perilymphatic leak from the round window or from both the round and oval windows was confirmed by an exploratory tympanotomy in all the cases. Rupture of the round window membrane was observed in three cases. Repair of the window membrane using the tragus perichondrium and Gelform provided effective control of vertigo in all the cases. Improvement in hearing was significant in three patients operated on 19, 22 and 69 days after the onset. In two patients operated on about 40 days after the onset and two others treated about a year later, no improvement of hearing was gained. Our own clinical experience as well as animal experiments indicates that surgical treatment should be carried out at the earlier stages of the disease, i. e. up to two weeks after the onset.
耳鼻咽喉科臨床学会の論文