臨床 3D-CTが有用であった耳かき外傷例

概要

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We report on a case of injury caused by an ear pick in which 3D-CT was useful for diagnosis and determining the treatment. The patient was a 36-year-old woman who complained of tinnitus and hearing loss in the left since she had pushed an ear pick into the ear. The eardrum had no abnormalities at the time of the first medical examination. However, 3D-CT revealed disruption in the incudomalleolar joint, transposition of the malleus. Traumatic ossicular disruption was diagnosed. The disruption in the incudomalleolar joint and coalescence of the handle of the malleus and the incus long process were identified during a tympanoplasty, as observed on 3D-CT scans. Ossicular chain reconstruction (II-c type) by PORP was performed between the incus and eardrum. Postoperative hearing improved markedly. Therefore, we conclude that to obtain good hearing improvement it is desirable to undertake surgery for traumatic ossicular disruption and that the surgical procedure can be decided on the basis of accurate diagnosis with 3D-CT.