擤鼻後に発症した外リンパ瘻の2症例

Two Cases of Perilymph Fistula Developed afer Blowing Nose

I．はじめに

　外リンパ瘻（内耳窓破裂症）とはなんらかの原因により正円窓あるいは卵円窓に破裂を生じ外リンパが中耳に漏出することにより，急性の感音難聴，耳鳴り，めまいなどの蝸牛・前庭症状をきたす疾患を指し，新しい疾患概念として認められつつある。本症は外傷，手術などに伴ってあるいは先天性に発症するが，単に日常生活の動作，たとえばくしゃみ，咳，擤鼻などにより発症する例が知られるようになり，突発性難聴の原因の一つとして注目されている。今回われわれは擤鼻後に発症したと思われる外リンパ疲の2症例を経験したので若干の考按を加えて報告する。

　Two cases of rupture of the inner ear window most likely caused by blowing of the nose are presented as follows.

　Case 1

　A 34-year-old woman developed tinnitus, deafness in the left ear and vertigo after blowing her nose. The symptoms were not improved by conservative treatment. A perilymph fistula in the round window was closed surgically on the 18th day after the onset. Thereafter, her hearing for the low frequency tones was gradually improved.

　Case 2

　A 62-year-old woman developed deafness in the right ear after blowing her nose. The symptoms were not improved by the conservative treatment. A perilymph fistula in the round window was closed surgically on the 16th day after the onset. However, her hearing remained unchanged, but showed a sudden improvement to almost normal level on the 15 postoperative day.