内耳奇形による髄液漏の1治療例

Spontaneous Cerebrospinal Fluid Fistula in Association with Congenital Inner Ear Anomaly: A case report

I．はじめに

　外傷性髄液漏は側頭骨及び，頭蓋底骨折に伴いしばしば遭遇する疾患である^2）．それ以外に髄液漏は中耳及び側頭骨の手術損傷，炎症性耳疾患，脳神経外科領域では聴神経腫瘍の術後などに認められるが^9），こよような原因を持たない，いわゆる特発性髄液漏と呼ばれる疾患群がある^{1,14,20,24）}．このなかに，内耳奇形を合併し，幼小児に発症して特徴的な臨床像を示す1群が報告されている^4,13,15）．今回われわれは，髄膜炎を繰り返した特発性髄液漏の1例を経験したので報告する．

A case of inner ear anomaly (Mondini dysplasia) associated with recurrent meningitis found in a 10 year-old boy is reported.

The patient had suffered from bacterial meningitis and CSF rhinorrhea five times in 7 years. The origin of CSF leakage had not been detected by bifrontal cra-niotomy or trans-sphenoidal operation. In May 1985, the dysplasia of the temporal bone and the inner ear had been pointed out by an otologist. And he under-went operations a few times for closing the CSF fistula at the floor of the internal auditory meatus by trans-labyrinthine approaches, but in vain.