外傷性Facial spasmおよびStapedius spasm症例

TRAUMATIC FACIAL AND STAPEDIAL SPASMS

　I．緒言

　顔面神経損傷の病態は近年かなり明らかとなつては来たが，個々の症例についてはなお理解に苦しむものや，比較的に注目されずに見逃されている症状も少なくない。今回顔面神経の外傷例で興味ある所見を呈した2症例を経験したので報告する。

　Two cases of traumatic facial palsy with uncommon signs arc reported. In the first case a 41 year old female suffered hemifacial palsy 3 days after the traffic accident. Conservative treatment administered for 4 months failed to show any improvement; electromyographic test taken during the interval of spasms revealed fibrillation voltage of inactive type. When the stapedial portion was being thinned by a diamond burr an intensive spasm was induced. This fact seems to suggest the location of the trigger zone of spasm to be in this area. Immediately after the operation the spasm had completely disappeared and the facial palsy was recovered.

　In the second case a 23 year old male suffered tinnitus, deafness and facial palsy whenever the patient attempted to move his face that occurred 6 months after a traumatic injury. Audiometric examination taken during the tinnitus attack showed 10 to 15 dB loss of hearing in low-frequencies. The patient was operated with severence of the stapedial tendon which brought relief to the tinnitus and deafness.