組織学的小裂隙による外リンパ瘻と蝸牛水管との関係

ヒト側頭骨病理組織学的検討

抄録

It was known that patency of fissula ante fenestram (FAF) and microfissure near the round window niche area (RWF) may cause perilymphatic fistula. However, not all patients have symptoms of hearing loss or dysequillibrium. The perilymphatic fluid communicates with the cerebrospinal fluid through the cochlear aqueduct, thus perilymphatic fistula may depend on the aqueduct. This study is to clarify the relationship between histological patency of the cochlear aqueduct and clinical symptom in the case of patent FAF or RWF.
Nineteen human temporal bones with histologically patent FAF or RWF were used in this study. Eight bones were obtained from patients with symptoms of sudden onset hearing loss, progressive hearing loss or vestibular symptoms such as prolonged mild dysequillibrium and positional vertigo, and 11 bones from patients without any hearing or balance problems. Patency of the cochlear aqueduct was scored as one through four. Score one indicated a patent aqueduct and score four indicated a closed aqueduct. The presence of hearing loss or dysequillibrium during life time was determined from clinical charts.
The mean score of symptomatic cases was 2.88 and that of asymptomatic cases was 1.91. The difference between the two groups was significant (p<0.05, Wilcoxon-Mann-Whitney test). This finding suggested that a closed cochlear aqueduct might cause symptoms of perilymphatic fistula in patients with patent FAF or RWF.