耳性硬膜下膿瘍の1例

A Case Report of Subdural Abscess due to Middle Ear Cholesteatoma

　I．はじめに

　耳性頭蓋内合併症は抗生物質の登場とともに減少したが，依然としていったん発症すれば重篤な疾患であることにかわりはない。筆者らは最近中耳真珠腫に硬膜下膿瘍を合併した症例を経験した。最近の文献を見る限り，耳性硬膜下膿瘍に対しては地方会報告に数例認められるだけで文献としてまとまったものを見ない。また本邦の成書にもその記載が少ないため，ここに若干の文献的考察等を加えて報告する。

　A 17-year-old boy developed fever and earache of the left ear of several days' duration, and underwent radical mastoidectomy for cholesteatomaand received antibiotic therapy. He developed, however, seizure followed by right hemiplegia and motor aphasia. CT scan showed three low-dencity areas which located between the brain and skull. He was transfered to neurosurgical department and craniotomy was carried out, and there appeared subdural abscess. Fortunately, he recovered without any neurological sequelae.

　Otogenic subdural abscess is very rare, how-ever, we think its incidence is higher than ever reported. As subdural aboscess is one of the most severe intracranial complications, differential diagnosis is important. Cerebrospinal fluid examination and CT scan are useful for the diagnosis.