側頭骨外傷による中耳伝音連鎖障害の1治験例

THE SURGICAL TREATMENT OF TRAUMATIC CONDUCTIVE DEAFNESS IN A FRACTURE OF THE TEMPORAL BONE

　I．緒言

　側頭骨錐体部は頭蓋底においてかなり広い領域を占めている。したがつて頭部外傷によりその内蔵する器官に種々の器質的ならびに機能的障害の惹起されることが推測される。

　難聴もその主徴候の一つであるが，それには感音性難聴の他に伝音機構の損傷によるものも少なくない。今回，われわれは側頭部外傷により難聴を来たした症例に試験的鼓室開放術の結果，耳小骨連鎖の離断を認めたのでその修復術を行ない好成績を得たのでここに報告し，大方の御批判を仰ぐしだいである。

　A man of 26 y.o. sustained a head injury and was unconscious for half an hour and had bleeding from the right ear. Two days after the injury, he developed a right facial palsy which persisted for three months.

　He also had a bilateral deafness and x-ray showed a fracture of the temporal bone.

　In order to clarify the etiology of the conductive deafness of the right ear, tympanotomy was performed, by which the separation of the incudo-stapedial joint was found. A Wullstein tympanoplasty operation type 2, reposition of the incudo-stapedial joint was carried out and resulted in considerable post-operative hearing gain.

　The symptomatology of the temporal bone fracture and the significance of the incudo-stapedial joint separation were discussed.