重症の糖尿病に併発したGradenigo症候群の1例

A Case of Gradenigo Syndrome with Diabetes Mellitus

I．はじめに

　Gradenigo症候群は外転神経麻痺，三叉神経痛，耳漏を3主徴とし，錐体尖端炎によって生じる症候群であるが，抗生物質の普及した近年ではほとんどみられなくなった。しかし，糖尿病患者の増加や耐性菌の出現，高齢化社会など，感染症に対し抵抗性の弱い宿主の増加で，現在でもなお錐体尖端炎は稀ではあるがみられることに注意しなければならない。

　今回われわれは，重症な糖尿病患者でGradenigo症候群を呈した症例を治療したので報告する。

　A 68-year-old man with severe diabetes mellitus suffered from right temporal pain and abductor nerve palsy. He had been treated as acute otitis media,but the disease expanded into the petrous apex because of poor immunity and nonappropriate use of antibiotics. He did not show any response to conservative treatment with use of broad spectrum antibiotics,ear irrigation and his diabetes has not been controlled. Therefore,surgery was performed. After the operation,neural palsy was improved. For preoperative diagnosis,MRI was very useful to show the focus of the lesion in the canal of Dorello.