発症後長期間を経て診断に至った外傷性髄液耳漏の1例

A case of post-traumatic cerebrospinal fluid leakage with persistent otorrhea

Ⅰ　はじめに

　外傷性髄液耳漏は側頭骨骨折の約20％に認められる^1）。その大半は受傷直後から数日以内に発生するとされ，最も危険な合併症として髄膜炎が挙げられる。今回われわれは受傷後早期に発生したと考えられるが重篤な合併症を生ずることなく10年間経過し，鼓室形成術の際に初めて発見された外傷後髄液耳漏の1例を経験したので報告する。

　Approximately 20％ of patients with temporal bone fracture show cerebrospinal fluid（CSF）leakage. While most CSF leaks will cease without treatment,patients with persistent CSF leakage are at increased risk of meningitis. We report the case of a 61-year-old female presenting with otorrhea caused by CSF leakage after a traffic accident. She had otorrhea in the left ear for 10 years without any history of meningitis. She was diagnosed as having post-traumatic cholesteatoma of the external ear canal extending to the middle ear due to the fracture of the external ear canal wall. At the time of ear surgery,we found cerebrospinal fluid leakage from the left middle cranial fossa. The CSF leakage was successfully repaired by middle cranial fossa craniotomy.