反復性髄膜炎を呈した内耳奇形の1例

Inner Ear Anomaly with Recurrent Meningitis

はじめに

　耳性髄膜炎は，炎症，腫瘍，外傷（手術時損傷を含む），先天異常（内耳奇形）などのさまざまな原因で発症する。内耳奇形自体は通常の治療の対象とはならないが，稀に髄液腔と中耳腔との異常交通による髄膜炎を発症する場合があり，手術療法の対象となる。われわれは1側内耳奇形による反復性髄膜炎症例を経験したので報告する。

Congenital anomalies of the inner ear (Mon-dini's dysplasia etc.) result in abnormal commu-nication between the subarachnoid space and middle ear. These patients often have recurrent otitic meningitis associated with acute otitis media. In a 33-year-old male with recurrent bouts of meningitis, roentgenographic examination and CT scan of the temporal bone demonstrated a unila-teral abnormal inner ear. During surgical treat-ment, we found CSF leak from a fistula of the stapedial footplate. Surgical obliteration of the fistula with temporal muscle and fascia has pre-vented the recurrence of meningitis.