耳小骨Ankyloseによるロイマチ性難聴例

　多発性関節ロイマチスに屡々難聴の併発することは古くから知られていた。嘗つてKatz andToynbeeは耳硬化症の原因を鐙骨靱帯のロイマチス性炎症と考え，Arthritis rheumaticaなる名称を用いたが，耳硬化症の病理組織像が明かになつた今では過去の憶説に過ぎなくなつた。現在でも屡々原因不明の難聴の原因としてロイマチスが挙げられているが，何れも既往症より推定されたものであつて聴神経性のものと考えられ，これとても確実な証明がなされたものでない。著者は最近多発性ロイマチス患者に見られた臨床的耳硬化症に遭遇し，本症が耳小骨連鎖のAnkyloseにょるものであることを発見し，内耳開窓術，コルチゾン使用の経験を得たので報告する。

KOBAYASHI replrts a case of severe loss of hearing that recovered when treatment for rheumatic arthritis was instituted. A Woman, aged 32, complained of loss of hearing that began after the onset of rheumatic arthritis which she was suffering from. Fenestration operation is performed in one ear with no resultant improvement of hearing. Examina-tion of the ossicles removed at the time operation showed that there was a firm adhe-sions in maleo-incus and inco-stapedial joints. However, with administration of cortisone in large doses, 300 to 200mg a day for the first few days and 10mg a day as a maintainance dose thereafter for the period of 30 days in all, directed against rheumatic arthritis, the hearing both by air and bone conductions was completely recovered. The loss of hearing in this case was apparently due to ankylosis of the ossicles of the middle ear which in turn was caused by rheumatic arthritis.