ZöllnerのTympanosclerosisについて
1972 年 15 巻 4 号 p. 429-436,418
詳細
1972 年 15 巻 4 号 p. 429-436,418
In the year 1955 Zöilner has described the pathogenesis, diagnosis and special surgical management of “Paukensklerese”. Since then tympanosclerosis has attracted great attention from otologists concerned with improvements of hearing through reconstructive microsurgery of the middle ear.
Although extensive studies and clinical observations of tympanosclerosis have been carried out, there are still unsolved problems relating the origin and the cause of the grotesque calcified masses in the middle ear space.
For an attempt to clarify the pathogenesis of this disease Zöilner has carried out extensive studies on the subjects applying modern techniques and powerful scientific instrument such as X-ray microanalysis in electromicroscope.
Deposition of calcium phosphate apatites in cytoplasmic elements of degenerating cells and in the ground substance of the sclerotic focus were closely related to the progress of the diseases.
Prick test or intracutaneous test revealed that the patients are more prone to allergic than the control.
Hyperparathyroidism caused experimentally in guinea pig accelerated deposition of calcium in tympanic cavity.
Total protein and electrolyte (potassium, calcium, sodium, chloride) in serum were found to be normal by applying various tests and tuberculin test and antistreptolysin test were negative.
Relationship of the tympnosclerosis with the autoimmune diseases have being under investigation.
The precise site of an ossicular fixation could readily be determined with careful microscopic examination and palpation. Hyaline tissue in the ossicular chain had been successfully microdissected. Where hyaline is removed reflxation will ready occur. This is minimized by placing paraffin wax between the apposing bone surface where mucous membrane has been removed. Fixation by hyaline limited to the stapedius tendon is easily corrected simply by resecting the focus. Stapes effodation or stapedectemy in staged operation is recommended in cases of calcified fixation on oval window niche or entire tympanic cavity.
