麻疹後に感音難聴と平衡障害を呈した1例—側頭骨病理組織所見を中心に

A Case of Deafness and Vestibular Loss due to Measles: Comparative Study on Pathology of the Inner Ear

　はじめに

　麻疹による感音難聴は，現在ではワクチンの普及により稀である。

　麻疹による小児の高度難聴に占める割合はShambaughら^1）（1928）の6.7％，Yearsley（1934〜1935）の9.3％，Goodman （1949）の4.4％，Simpson （1949）の5.0％，Bordley （1952）の6.4％，Kinney （1953）の10％などが報告されている。ワクチン接種の普及により報告は稀となった。しかし，MMRワクチン接種による後遺症が注目されてからは，麻疹ワクチン接種率が低下の傾向にあり，再び麻疹による難聴の発生が危惧されている。

　麻疹による感音難聴と平衡障害の側頭骨病理組織の研究報告は少ない。今回われわれは，麻疹罹患後に感音難聴と平衡障害が発症したと思われる1例の側頭骨病理組織所見を報告する。

A 7-year-old-boy presented with profound bilat-eral hearing loss and truncal ataxia after suffering from measles at one year of age. The conditioned orientation relex audiometry revealed remarkable threshold elevation and the auditory brainstem response showed no responses on both ears. Thedamped rotation test for vestibular examination showed no perotatory and postrotatory nystagmus. He died at the age of seven years because of respira-tory accident. The temporal bone pathology revealed that the organ of Corti, spiral ganglion and vestibular sense organs were severely atrophied. The nerve fibers of Corti's organ and vestibular endorgan were markedly lost. Moreover as an un-usual feature of measles, roll up phenomenon of the tectorial membrane was observed. These pathologi-cal changes demonstrated that deafness and ves-tibular loss of the patient were resulted from laby-rinthitis due to measles.