本邦における耳硬化症例について

A RESUME OF CASES OF OTOSCLEROSIS REPORTED IN THE LITERATURE OF THIS COUNTRY

Ⅰ．緒言

　耳硬化症は1881年頃von Tröltchが鼓室粘膜の硬化を提唱し，さらに1894年PolitzerによりLabyrinthkapselに対する一次的疾患として命名され，主として卵円窓，鐙骨板に海綿様骨地殖を来たす結果，難聴，耳鳴などを訴えるもので，原因としては明かではないが代謝疾患，内分泌疾患，骨の系統的疾患，Vitamin D欠乏症および頭蓋骨の発育過程における機械的外力などが云々されている。

　本症は従来から欧米において頻度が高く，日本人，黒人においては発生は少ないとされている。この点については大正14年田中氏，細谷氏が病因論，診断についてそれぞれ宿題報告を行ない，その後，恩地氏（昭26,27），柏戸氏（昭27），角田氏（昭29），後藤（修）（昭30），堀口氏（昭30），山本（馨）氏（昭31），高原（滋）氏（昭34），切替氏（昭40）らの報告が見られるが，その頻度は欧米人に比較すれば少ないといえる。

　Following facts are gleaned from the literature of this country on otosclerosis: There were 19 cases, male and 32 cases, female; the involvement in the female being almost as twice as many.

　The ages of patients ranged from 10 to 40 years.

　Bilateral involvements were overwhelmingly in the majority; 44 cases out of the 51.

　Positive family history was obtained in 12 cases but none of them proved to be significant.

　The connection between the ear involvement and personal history was indefinite.

　The relation between this disease and menstrual cycle in the female patients was noted in 5 cases out of the 32 in whom hearing difficulty and tinnitus aurium were noted to be increased.

　This disease is characterized by having an acute onset and to be in many case progressive; paracusis was noted in 9 cases.

　Tinnitus aurium was noted in 53 ears out of the 95, no relation was established between tinnitus and the duration of the disease.

　Vertigo was noted in 8 cases.

　The appearance of the tympanic membrane was noted to be normal in 53 ears out of the 95.

　The Eustachian tube appeared to he patent in 83 ears out of the 95, Schwartzc's syndrome was found in 2 cases.

　Various hearing patterns were discovered.

　Audiometric tests showed the presence of conductive deafness in majority of cases.

　Operative treatments consisted of fenestration operation in 16 cases and stapes mobilization in 11 cases.

　Operative results were shown by improvement in 23 cases, no change in 1.1 cases, while in 6 cases the hearing became worsened. The results in fenestration opearation to be better than in that of stapes mobilization but the final conclusion should be witheld until cases are observed for longer period.