難聴をきたした非穿孔鼓膜耳の臨床経験

抄録

It is difficult to make a diagnosis of hearing loss, either conductive or sensorineural, in the patients with intact or unperforated eardrum. We analyzed the preoperative diagnosis and postoperative results in 28 ears of 26 patients with or without middle ear abnormalities including 5 ears with final diagnosis of sensorineural hearing loss. Four ears with otosclerosis, 10 ears with congenital anomalies, 5 ears with traumatic dehiscience of the ossicular chain and 3 ears with perilymph fistula were included.
In the group of otosclerosis, stapedectomy was performed in all cases and postoperative hearing improvement was achieved in all cases. In the group of congentital anomalies, modified type M tympanoplasty was performed in 7 cases and the success rate of postoperative hearing improvement was 100%. In the group of traumatic dehiscience of ossicular chains, postoperative hearing improvement was observed in 3 of 5 patients. In the group of perilymph fistula, vertigo was disappeared in all 3 cases and postoperative hearing improvement was 100%.
Five patients was finally diagnosed as sensorineural hearing loss. Though we have to avoid the unneccesary exploratory tympanotomy for these patients with sensorineural hearing loss. The exploratin of the tympanic cavity is mondatory to make a final diagnosis in some cases.