耳迷路外科の經驗（第3報）—耳鳴に對するポルトマン氏手術の効果に就いて

　1．緒言

　著者は前回の報告に於て所謂メニエール氏病の場合に於ける眩暈その他の症状が迷路内淋巴液の排除によつて比較的容易に消退する実事からこれ等諸症状の発現に対する直接の責任は矢張迷路内淋巴圧の昂進に帰せらるべきものであると推断した．而して眩暈発作は偶々これ等一群の迷路疾患に主要なる症候であり，臨床上これ等疾患の発見に端緒を與うるものであるけれども，時にはこれ等疾患が眩暈を伴はず難聽耳鳴などのみを以て経過する場合もあらうと想像した．その後著者は頑固な耳鳴を訴うる一例の難聽患者に於て同じく迷路内淋巴圧に対する減荷的処置を施すことによつて耳鳴を完全に消失せしめることを得た．この事実は偶々著者の考の一端を実証し得たものであると信ずるを以て此処にこれを報告し聊か考察を加へて見たいと思う．若しそれ大方の御批判と御叱正とを得ることが出來れば著者の最も幸とする所である．

Tsuiki says tnat, in face of the fact that vertigo and other associsted symptoms in the so-called Meniere's Syndrone are readily relie-ved by establishment of labyrinthine fluids as it has been shown in rrevious reports, imme- diate cause for manifestation of symptom com-plex of this disdase might be reasonably assum-ed as to be found in the pressure increase of the intra-labyrinthine fluids. Although vertigo per se is generally coasidereb as an important symptom of labyrinthine disease and which of-ten serves as a lead to diagnosis, there are pos sibiIities of observing cases in which the disea-se may be manifested with symptoms of impa-ired hearing and tinnitus alone, without refere-nce to that of vertigo.

The case in site is a patient, a girl 19 years of age, a stndent, whose symptoms of tinnitus, resisting various modes of treatments previously applied, were finally cured by Poltma. The operation relief of intra-labyrinthine pressure patient complained of persistently severe tinn-itus of the left ear which interfered with hearing Iectures at school. Onset of the symptoms dated back three years to the time when the patient was exposed to an attack of suu-stroke, during compulsory student labor, with subsequent hyperbyrexia. The fever subsi-ded in about 4 days of duration after which ve-rtigo persisted to such an extent that maintaine-nce of standing posture was altogether impossi-ble.