中耳結核の2症例

TUBERCULOSIS OF THE MIDDLE EAR

　I．はじめに

　近年，結核性疾患は予防医学ないしは健康管理の確立や抗結核剤の進歩により，その発生頻度は明らかに減少し，かつその治療成績も著しく改善した。しかしながら，本症が日常診療からまつたく消滅したわけではなく，耳鼻科領域においてもまつたく等閑視できない疾患であることは言うまでもない。最近，われわれは現在ではきわめて遭遇する機会の少ない疾患とされている中耳結核の2症例を相いついで経験したので，その臨床経過の概要を述べるとともに，若干の考察を加えて報告する。

　Two cases of tubercular otitis media are reported. These cases wese treated by ordinary means for chronic purulent otitis media for a period over a year without any improvement.

　Case 1. A woman, aged 65, complained of impaired hearing in both ears, otorrhea, vertigo and right facial palsy. Operative procedure on the affected ear showed a tumor-like or tubercular appearance of the tympanic mucoperiosteum. Histological examination of the removed specimen revealed a typical tubercular lesion.

　Case 2. A woman, aged 31, was found to be affected with lung tuberculosis and a chronic purulent otitis media with narrowing of the right ear canal. A bacterial examination of the otorrhea revealed a positive findings of tubercular bacilli.

　Both cases were treated by anti-tuberculosis measures by use of streptomycin, PAS and INAH, and with topical application of streptomycin in the ear. Within a month after these treatments the ear discharge was gradually reduced and became much clearer in its content.