反復性聴力障害

FLUCTUATING HEARING LOSSES

　I．はじめに

　感音難聴において，いつたん悪化した聴力が再び改善することをくりかえすような域値の変動は，たとえば，Ménière病やLermoyez症候群の場合に前庭症状と相前後して現われるが，ときに感音難聴のみが他の症候を伴わずに反復する例が観察される。次に最近経験した3症例を示し若干の考察を加えた。

　Three cases of fluctuating hearing loss with discussions of their etiology are reported.

　Case 1: A man a teacher, aged 45, noted a sudden onset of bilateral hearing loss with tinnitus. Thereafter the hearing acuity fluctuated which was finally limited only to the left side. Investigation revealed a family history of syphilis. Further clinical and laboratory examination revealed keratitis and a positive Wasserman reaction.

　Case 2: A woman, aged 39, began to note the right-sided hearing loss from the age 20. Examination revealed the right ear to be almost completely deaf; the left showed a daily fluctuation which continued for months.

　Case 3: A woman, aged 64, complained of transcient vertigenous attacks. And thereafter, the hearing in the left ear began to fluctuate. Examination revealed a positive Wasserman test.

　The hearing fluctuations in all three cases were below 2,000 Hz. The prognosis for hearing improvements were good. The fluctuation of hearing in these cases were probably initiated by endolymphatic hydrops caused by one reason or other, including syphilis.