突発性難聴の臨床—一診療所における

CLINICAL EXPERIENCE OF AN OTOLOGICAL PRACTITIONER FOR SUDDEN DEAFNESS

　I．はじめに

　突発性難聴（以下突難）については，わが国においても多数の報告があるがそのほとんどは大学病院その他の大病院の臨床統計^{1）〜5）8〜11）}であつて，第一線診療所におけるものはない。余は金沢市（人口40万，石川県100万）の市街地の一有床診療所であるが，昭和50年1月より昭和52年12月までの3年間に取り扱つた突難患者で経過を追求できた40症例について報告する。

　なお突難の診断については厚生省突難研究班の基準^7）に従い，これに対して星状神経節ブロック（以下SB）とステロイドホルモン内服を主軸とする治療法を施し，同じく研究班の基準に従つて治癒判定を行なつた。

　Forty cases of sudden deafness observed in my private clinic from 1975 to 1977 were clinically investigated. As a rule, all of these patients were treated with stellate ganglion block and administration of betamethason supplemented with vitamin B₁ and vasodilator (Euclidan). These treatments were effective in 35 patients (87.5%) including 30 who resulted in the remarkable hearing improvement.

　According to my studies, it was evident that the patients treated early from the onset and showed a low-tone or a flat type of hearing loss in audiogram had the good prognosis. Regarding to the patients' age, the recovery was commonlyseen in the younger age group.

　Out of 36 patients treated within 10 days from the onset of sudden deafness, 34 cases were improved and 29 were remarkably improved. All patients treated within 3 days (23 cases) showed the hearing improvement and 19 were completely cured or markedly improved. Even though a severehearing loss was found at the onset, 83.3% of the cases showed the remarkable recovery.

　In my experience, it is emphasized to say that the sudden deafness is a state of emergency, and we, the otological practioners, have a very important role in establishing the diagnosis and starting the adequate treatment in early stage.