臨床聴神経腫瘍によって誘発されたと考えられる管内結石症が原因の良性発作性頭位めまい症例

概要

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We report on two cases of acoustic neuroma, which showed posterior semicircular canal (pSCC) type BPPV. As the canalith repositioning maneuver was effective, these cases were thought to be caused by canalolithiasis. This symptom was a peripheral vestibular disorder in the inner ear and was not a retrolabyrinthine disorder associated with the tumor in the internal auditory meatus. Our two cases were also accompanied by hearing loss on the affected side, so the common cochlear artery which supplies the cochlea and pSCC was thought to be the affected artery. Interruption of the blood supply in this artery seems to impair and yet not to totally destroy pSCC function. This may detach otoconia and cause pSCC type BPPV. An acoustic neuroma localized in the internal auditory meatus at the early stage, may influence the peripheral endo-organs in any way and mimic the symptoms of a peripheral vestibular disorder such as BPPV, before it will show paralytic nystagmus caused by the retrolabyrinthine neural disorder due to the progression of the tumor.
耳鼻咽喉科臨床学会の論文