内視鏡を併用した外リンパ瘻閉鎖術の有用性と問題点

抄録

Since the 1990's, endoscopes assisted ear surgery has been employed because of its excellent view of surgical field. Two cases of idiopathic perilymphatic fistulas were treated using endoscopes. A 52-year-old woman presented with dizziness and deterioration of the right hearing. The neurotological examination revealed the right sensorineural hearing loss with an average of 63 dB and spontaneous nystagmus toward the right side. Exploratory tympanotomy was performed and middle ear observation using a 30 degree angled endscopy revealed perilymphatic leakage from the round window. Both the round window and the vestibular window were covered with fascia. Case 2 was a 69-year-old woman who presented with dizziness after she was singing. In the outpatient clinic, audiometry showed sensorineural hearing loss with an average of 40 dB and spontaneous nystagmus toward the left was noted. In the operation, after tympanomeatal flap was elevated through the left external ear canal, the middle ear was observed by an endoscopy. Perilymph leakage was observed through the mucous membrane of the round window niche. Both window were covered with fascia. Endoscopic repair of perilymphatic fistula is useful especially for idiopathic perilymphatic fistulas in terms of the minimal invasive surgery.