分娩を契機に発症した外リンパ瘻例

抄録

We herein report a case of a perilymphatic fistula (PLF) that developed following parturition, confirmed by the detection of cochlin-tomoprotein, a specific protein found in the perilymph. A 32-year-old woman presented with vertigo, sudden hearing loss, ear fullness, and streaming water-like tinnitus in her left ear immediately after parturition. She had intense spontaneous and gaze-evoked nystagmus toward the right side. A pure-tone audiogram showed severe mixed-type hearing loss in her left ear. Exploratory tympanotomy was performed 7 days after the symptom onset, because conservative medical treatment had resulted in an insufficient response. Perilymph leakage from the round window was observed in the Trendelenburg position, but no leakage was observed from the oval window. Both windows were sealed with soft tissue grafts. The test for cochlin-tomoprotein was positive in the middle ear lavage fluid. Although the left hearing acuity was unchanged after the operation, the vertigo and nystagmus improved immediately and did not recur. In conclusion, the development of a PLF following parturition is a particularly rare occurrence, and the symptoms of PLF, especially vertigo, are expected to improve with surgery. Therefore, we should recognize PLF as a complication of parturition.