術後性遅発性迷路瘻孔

Delayed Postoperative Labyrinthine Fistula

　はじめに

　迷路瘻孔は主として真珠腫性中耳炎，まれに慢性化膿性中耳炎に伴う肉芽性病変が原因となって迷路骨胞の破壊をきたすことにより生じる。

　本来，open法による乳突蜂巣削開術の目的の1つには，このような中耳炎の合併症である迷路瘻孔の予防がある。

　今回われわれは，open法による乳突蜂巣削開術の術後に長期間を経て遅発性に迷路瘻孔を生じた症例を経験したので報告する。

Four cases with labyrinthine fistula which devel-oped many years after open-type mastoidectomy were reported. All cases showed a visible fistula at the bony horizontal or anterior semi-circular canal and three cases showed the positive fistula symp-tom.

All patients had no dizziness or vertigo before and after the previous mastoidectomy, and also they did not consult with any otologist regularly after sur-gery.

Fistula in two patients was closed surgically with bony fragment and fascia using fibrin-glue, and hearing was preserved with negative fistula symp-tom. The mechanism of bony erosion resulting in fistula and the method of treatment were discussed.