長期間のシリコンシート留置が原因と考えられた中耳肉芽症例

Postoperative foreign body granulation caused by a silicone sheet in the tympanic cavity

Ⅰ　はじめに

　シリコンなどの人工材料を使用した手術の後，長期間を経て周囲組織に異物反応による炎症を起こすことがある。こうした例は眼窩底骨折整復術^1,2）や，乳房再建^3～5），隆鼻術^6～9）などで散見される。今回われわれは中耳に留置したシリコンシートによる異物肉芽反応をきたした1例を経験したので，若干の文献的考察を加えて報告する。

　A 39-year-old man with a past history of bilateral ear surgery at the age of 16 had complained of right-sided bloody otorrhea for a month. His right ear showed a central perforation with granulation tissue and a foreign body-like material seen through the perforation,and exhibited moderate mixed hearing loss in audiogram. Computed tomography revealed diffuse soft tissue shadow throughout the right middle ear. The patient subsequently underwent tympanoplasty. A silicone sheet buried in massive granulation tissue was found in the tympanic cavity,and they were removed and curetted. Histopathological diagnosis was inflammatory granulation,and middle ear inflammation rapidly subsided after surgery. Although silicone is generally thought to be a harmless and useful material in ear surgery,we should be aware that it may induce foreign body reaction.