突発性難聴との鑑別を要した心因性難聴急性発症の2症例

Two Cases of Acute Psychogenic Hearing Loss Needed to be Differentiated from Idiopathic Sudden Deafness

　はじめに

　心因性難聴は，機能性難聴または非器質的難聴と呼ばれる疾患群の一病型と考えられている。急性に発症した場合の鑑別診断として，突発性難聴やその他の急性感音難聴が挙げられる。

　今回，われわれは急性に難聴が出現し，初診時での通常の純音聴力検査と問診では突発性難聴との鑑別が困難であった心因性難聴の2症例を経験したので報告する。

We experienced two patients with psychogenic hear-ing loss that occurred acutely, which needed to be diffe-rentiated from sudden deafness. The first patient was a 32-year-old man who developed sudden hearing lossand tinnitus in the left ear. The second patient was a 20-year-old woman who developed sudden hearing loss bilaterally. Both cases showed Jerger type V on Bekesy's audiometry and normal auditory brainstem response and stapedial reflex. Speech discrimination testing suggested that their hearing acuity was better than that observed on pure-tone audiometry. Both patients were under severe stress and thereby diag-nosed as having psychogenic hearing loss. Their hearing showed recovery without medication.