経外耳道的な外力による外傷性内耳損傷

Transcanal Drum Trauma with Inner Ear Injuries

I．はじめに

　外傷性鼓膜損傷は日常の外来診療でしばしば遭遇する^1,2）。その損傷の程度は鼓膜のみが損傷されるものから内耳にまで障害が及ぶものまでさまざまである^3〜8）が，とくに内耳障害を合併したものでは早期に適切な処置がなされる必要がある。われわれは最近5年間に内耳障害を合併した外傷性鼓膜損傷例を7例経験し，その臨床症状，検査所見および外耳道経由の外力が内耳に影響を与える機序につき検討したので報告する。

　In seven cases the causes of the trauma were due to ear pick in six patients and a wire stuck in one patient. The pure tone audiometry revealed mixed hearing loss except for one patient, an 1-year-old boy, who received ABR test. The spontaneous nystagmus was found in five of six patients tested. The direction fixed positional nystagmus was observed in four patients, towards the injured side in two and the opposite side in two. The direction changing positional nystagmus was observed in one patient.

　The surgery was performed in three patients with direct inner ear injuries and the remaining four patients with indirect inner ear injuries were treated conservatively, mainly with oral medication.