感音性耳鳴に対する星状神経節遮断

THE STELLATE GANGLION BLOCK IN TREATMENT OF NERVE DEAFNESS

　星状神経節遮断は1930年Whiteにより初めて報告され，ついで1936年LericheならびにFontaineにより発表されて以来，脳循環障害に基づく頭部疾患の積極的な治療法として注目され，耳鼻咽喉科領域においても局所の循環障害が疾患の原因として考えられるもの，たとえば，種々の感音性難聴，耳鳴，メニエル病，ベル麻痺などには，星状神経節遮断を施行した多くの報告があり，かなりの効果が認められている。

　私どもの教室においても，これらの疾患には積極的に星状神経節遮断を施行しているが，今回はこれら疾患のうち，治癒し難いとされている感音性難聴を有する耳鳴，すなわち感音性耳鳴について，星状神経節遮断を施行し，その後約4カ月間の経過を観察したものについてその成績を報告する。

　One hundred twenty eight cases of nerve deafness, consisting of 45 cases of Ménière's disease, 4 cases of streptomycin deafness, 41 cases of spontaneous deafness and 38 cases of undeterminable cause, were treated by stellate ganglion bloock by injecting 5cc of 1% xylocaine into the stellate ganglion biweekly for the total of 4 to 25 occasions. The results were as follow:

　(1) The treatment appeared to be effective in most cases where it was administered early in the course of the disease.

　(2) In the treatment of Ménière's disease its effectivity appeared to be in turn of eliminating the vertigo, tinnitus aurium and the hearing loss.

　(3) In spontaneous loss of hearing the treatment was effective if it was initiated within 14 days of the onset of the disease; the present treatment appeared to be by far the superior when compared to that of administration of pilocarpine for the same purpose. However, if the disease has lapsed more than a month after its onset the prognosis appeared to be exceedingly poor.

　(4) Towards treatment of streptomycin deafness the procedure appeared to be inffective.

　(5) In cases of deafness of undeterminable cause the treatment was not at all encouraging but, in a goodly number of cases it appeared to have allayed tinnitus aurium.