臨床外リンパ瘻を疑い手術を施行した6例の検討

概要

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The diagnosis of perilymphatic fistula (PLF) is made by the presence of a fistula found intraoperatively. It is difficult to make a diagnosis without surgery. The timing of the surgery is still controversial. We studied the clinical features and neuro-otlogical test results to analyze the factors influencing the diagnosis and treatment results. Six patients with PLFs were treated surgically at our institutions from January, 2010 to August, 2010. All patients complained of a hearing loss. In all patients, the hearing recovered after surgery. Positional nystagmus and vertigo were observed in 66.6% of the patients. Vertigo improved in all patients postoperatively. The period from the onset to surgery was 8.2 days in average. In 4 patients, the presence of a fistula or lymphorrhea was confirmed surgically but were not found intraoperatively in 2 patients. The period from the onset to surgery contributed more to hearing recovery than the hearing level at the first consultation. Improvement of vestibular symptoms is expected regardless of the period from the onset to surgery. The signs, such as progressive hearing loss, nystagmus-related changes, and an increase in dizziness in the position with the affected ear down are important. These results suggest that surgical treatment should be considered at an early stage when PLFs is suspected.
耳鼻咽喉科臨床学会の論文