著者
宮之原 郁代 宮下 圭一 黒野 祐一
出版者
日本耳科学会
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.21, no.5, pp.821-826, 2011 (Released:2013-05-24)
参考文献数
20
被引用文献数
1 3

右耳閉感と発疹で発症しHIV感染、内耳梅毒が判明した1例を報告する。症例は、55才男性で、2009年7月末に右耳閉感と発疹が出現し、8月下旬、右難聴が突然出現した。前医にて右突発性難聴の診断を受け、プレドニゾロン30mgから漸減療法を受けるも改善が得られず、当院受診となった。標準純音聴力検査4分法平均聴力レベルで右43.8dB、左25.0dBと感音難聴を認めた。梅毒血清反応ならびにウエスタンブロット法にて梅毒、HIV感染が確認され、HIV感染を合併した内耳梅毒の診断となった。アモキシシリン500mg×3/日、9週投与で、聴力は改善した。HIV感染症例の感音難聴では、内耳梅毒の鑑別が必要なことが示唆された。
著者
高井 禎成 加我 君孝 菅澤 正 篠上 雅信
出版者
日本耳科学会
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.8, no.2, pp.83-86, 1998-05-25 (Released:2011-06-17)
参考文献数
14

To determine the indication of cochlear implant, an electrical auditory test on the promontry isperformed to investigate sense of sound at the auditory nerve or the nerve terminal. However, theroutinely used promontry stimulation test requires penetration of the tympanic membrane. Becauseof this harmful procedure, the promontry stimulation test is not easy to apply to normal subjects.Recently, one electroaudiometer has developed by MED-EL which has adopted a non-invasivemethod. A silver ball electrode is placed near the tympanic membrane to give electrical stimulationto the cochlea.Using this procedure, we investigated how people with normal hearing can feel electrical stimulation.Our results showed that no one could feel the stimulation as sound at low frequency of electricpulse, but considerable number of people could feel the stimulation as real sound at high frequencyof electric pulse. This auditory sensation could possibly be caused by electrophonic effect.This electroaudiometer with a silver ball electrode is less harmful and easily used for varioussubjects.
著者
小森 正博
出版者
日本耳科学会
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.22, no.3, pp.219-222, 2012 (Released:2013-07-12)
参考文献数
19

一側性難聴をもつ私の体験を述べ、本邦では検討が少ない日常生活や学業上の不自由さ、心理的問題などについて考察する。患耳側からの聞き取りの困難さにより、私は学会発表時に時にマイクの音が聞き取れないことや、患耳側の方と話すときに不便さを感じ座る席に気を遣うこと、話が聞き取れずに時に会話に入るのを諦めることがある。これらは社会人には支障となるもので、心理的負担となり、何らかの支援を必要としている例があるかもしれない。両親からの支援や学校の配慮により私は特に問題がなく幼少期や小学期を過ごせたが、大学卒業時に手術を受けることは両親に反対された。家族から患者へ正しい情報が伝わるとは限らず、また、先天的な疾患をもつ患者は治療によって何が改善するのか十分認識できていない可能性もあるので、しかるべき時期に正しい情報を提供してあげる必要があると思われた。
著者
大森 治紀
出版者
日本耳科学会
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.18, no.1, pp.7-11, 2008-03-21 (Released:2011-06-17)
参考文献数
6
著者
野村 恭也 原田 勇彦 林田 哲郎
出版者
日本耳科学会
雑誌
臨床耳科 (ISSN:18845800)
巻号頁・発行日
vol.10, no.1, pp.228-229, 1983 (Released:2011-08-10)
参考文献数
6
著者
井上 敬子 高山 幹子 石井 哲夫
出版者
日本耳科学会
雑誌
Ear Research Japan (ISSN:02889781)
巻号頁・発行日
no.19, pp.83-85, 1988

The tympanic membrane of frog is exposed directoly to the external environment. It is almost round in shape, and is thickened in the central part. Circumferential part is thinner than central part. The tympanic mebrane was uniformly spread along the outer edge of the annular cartilage, and no pars flaccida was observed. Fibrous tissue of the lamina propria consist of radial collagen fiber. The tip of the columella consists of cartilage, loosely adhered to the dorsal surfase of the center of tympanic membrane. Along the columella, there was a loose, wrinkly connective tissue between the tympanic membrane and columella, that is the archetype of malleus handle. The annular cartillage was considered to be the original form of the external auditory canal.
著者
岸保 鉄也 霜村 真一 久松 健一 中澤 勉 中島 司 野沢 出 村上 嘉彦
出版者
日本耳科学会
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.4, no.1, pp.90-94, 1994

In middle ear diseases including otitis media with effusion (OME), there are various lipids mediators such as leukotoriene C<SUB>4</SUB>, D<SUB>4</SUB> (LTC<SUB>4</SUB>, LTD<SUB>4</SUB>) and prostaglandin E<SUB>2</SUB> (PGE<SUB>2</SUB>) in the effusion of the tympanic cavity. Therefore, it is important to examine the effect of these mediators on middle ear clearance. We studied on the effect of LTC<SUB>4</SUB>, LTD<SUB>4</SUB> and PGE<SUB>2</SUB> on mucociliary transport of the eustachian tube both in vitro and in vivo. Healthy guinea pigs with normal Preyer's reflexes were used in vitro study. Normal ciliated epithelium was carefully obtained from the tubotympanium and incubated with RPMI solution in the from of tissue culture. The epithelial specimens were incubated with LTC<SUB>4</SUB>, LTD<SUB>4</SUB> and PGE<SUB>2</SUB> respectively, ranged at the concentrations of 10<SUP>-8</SUP>M and 10<SUP>-6</SUP>M. Ciliated cells of the specimens were observed under an inverted microscope. Ciliary activity of each ciliated cell was photo-electrically measured on a TV monitor. LTC<SUB>4</SUB> and LTD<SUB>4</SUB> inhibited ciliary activity at the concentrations of 10<SUP>-8</SUP>M and 10<SUP>-6</SUP>M in vitro. PGE<SUB>2</SUB> promoted ciliary activity at the concentrations of 10<SUP>-8</SUP>M and 10<SUP>-6</SUP>M. Healthy chinchillas were used in vivo study. The animals were free of middle ear infection and hearing loss as determined by otomicroscopy, tympanometry and auditory brainstem response (ABR). One ml each of 10<SUP>-5</SUP>M LTC<SUB>4</SUB>, LTD<SUB>4</SUB>, PGE<SUB>2</SUB> and the control solution (10<SUP>-3</SUP> ethanol/saline) was directly injected into the tympanic bulla with a 27-gauge syringe under anesthetization. The middle ears were examined by otomicroscopy, tympanometry and ABR across time. LTC<SUB>4</SUB> and LTD<SUB>4</SUB> inhibited mucociliary transport of the eustachian tube. However, there was no significant difference between PGE<SUB>2</SUB> and the control.
著者
古田 一郎 山本 典生 平海 晴一 坂本 達則 伊藤 壽一
出版者
日本耳科学会
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.23, no.2, pp.131-135, 2013-05-25
参考文献数
9

当科で経験した8例10耳の耳硬化症再手術症例につき検討した。10耳中2耳は再々手術例であった。初回手術から再手術までの平均期間は4年9か月で、再手術のきっかけとなった主訴は9耳が難聴で1耳がめまいであった。術中所見では8耳(80%)でピストンの脱落を認めたが、術前にコルメラの評価を行った側頭骨CTでは、5耳しかピストンの変位を指摘できなかった。術前、術後の聴力評価は気導3分法で行ったが、再手術により難聴を主訴にした9耳のうち7耳で15dB以上の聴力改善を認め、再手術による内耳障害等、重篤な合併症を認めた症例は1耳もなかった。このことより、耳硬化症術後に難聴をきたした場合は、再手術により聴力改善が大きく期待され、原因精査の意味も含め、積極的に再手術を行うべきだと考えた。
著者
小川 郁 神崎 仁 小川 茂雄 土橋 信明 井上 泰宏 山本 美奈子 池田 俊也
出版者
日本耳科学会
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.1, no.5, pp.1-8, 1991
被引用文献数
7

For the purpose of clarifying the clinical features of perilymphatic fistula, we investigated the clinical symptoms, tests results and therapeutic results in 24 recent patients with perilymphatic fistula. The inducing factors of perilymphatic fistula, such as blowing the nose, landing in an airplane or diving were found in about half of the patients, while, the other patients had no inducing factors. Hearing loss was the most common symptom, which occurred suddenly in most patients. There was no characteristic tinnitus of the perilymphatic fistula. Pop sound and tinnitus expressed as a stream were observed in only 10% of the patients. Audiogram showed profound deafness in many patients and the configuration of audiogram varied from patient to patient. Positional nystagmus was observed in 33.3% of the patients. Fistula sign was also observed in 50% of the patients. Perilymphatic fistula was commonly found in the round window. Hearing was improved in 5 patients (20.8%) postoperatively. Tinnitus was improved in 7 out of 22 patients (31.8%), and blocked sensation in the ear was improved in 5 out of 14 patients (35.7%). Vertigo or disequilibrium was diminished in 18 out of 21 patients (85.8%). From these results, we contemplated the diagnostic and therapeutic problems in perilymphatic fistula.
著者
清水 佐和道 青木 和博 本多 芳男
出版者
日本耳科学会
雑誌
Ear Research Japan (ISSN:02889781)
巻号頁・発行日
vol.15, no.1, pp.178-181, 1984

In order to determine development of each part of human middle ear, the development processes of various parts from the middle tympanum to the antrum were observed and compared relatively based on the epithelial invasion the auditory tube at each stage of fetal development using fetal temple from 17th to 26th weeks of gestation. The middle ear cavity is considered to be formed through combined effects of various processes such as epithelial invasion of the auditory tube, resorption of the fetal connective tissue, thinning of the bone wall of the otic capsule, outward proliferation of the temporal bone due to cartilaginous and fibrous bone formations, and active bone metabolism at the mastoid cavity, with formation of a series of pneumatic space. It was found that the resorption process of the fetal connective tissue did not occur uniformly, with a persisting tendency for the area from the superior tympanum to the periovular window for a prolonged period. These findings are interesting embryologically in terms of the causal relation in development from the posterosuperior area of the steatoma to the superior tympanum of the middle ear.
著者
吉岡 哲志 竹内 健二 斎藤 正治 内藤 健晴 藤井 直子 片田 和廣
出版者
日本耳科学会
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.13, no.2, pp.111-117, 2003-05-31
参考文献数
20
被引用文献数
2

We demonstrated high-resolution multiplanner reformation (MPR) and 3-dimentional CT (3D-CT) imaging of Eustachian tube (ET) using a 1-mm, 8-row multislice CT scanner.<BR>CT scans were performed in 5 normal adult volunteers during quiet breathing and the Valsalva maneuver.<BR>Bony portion of ET was clearly detected on MPR, however cartilaginous portion of the ET was still elusive during quiet breathing scan.<BR>MPR and 3D-CT images during Valsalva maneuver improved visualization of cartilaginous portion of the ET and surrounding soft tissues including cartilage, muscle and fat.<BR>Imaging of the ET obtained by multislice CT during the Valsalva maneuver can propose further investigation for various middle ear disorders.
著者
大谷 真喜子
出版者
日本耳科学会
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.22, no.2, pp.123-129, 2012-05-25
参考文献数
5

数十年間の耳管開放の経験をもとに、症状、開放症分類、治療法、そして開放機序の仮説を、内視鏡所見とともに紹介した。開放症状にレベルがあり、そのレベルによって病的開放は、分単位の発作型と数十分単位の持続型の2種類に分類できる。発作型は体重減少時に下顎挙上して会話した際に突然発症する。持続型は急性中耳炎後に徐々に発症する。治療も異なり、発作型には、嚥下のみ、または、下顎角の内側を上方に圧迫しながら嚥下する方法が著効する。反対に、持続型には嚥下は無効で、同部位への圧迫を持続する方法や生理食塩水を点鼻する方法など症状が消失するまでの時間稼ぎの方法しかない。発作型は内視鏡所見より、耳管軟骨内側板と挙筋との位置異常が原因と考えられるため治療には嚥下が必須であるが、持続型は耳管構成物の体積減少が原因と考えられるため嚥下によっては改善するはずもなく原因が解消されるまでの対処療法しかないと推察した。
著者
池田 元久 渡辺 勧
出版者
日本耳科学会
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.2, no.5, pp.686-691, 1992-12-28 (Released:2011-06-17)
参考文献数
16

Six male patients complained of vertigo or disequilibrium accompanied with occupational hearing loss.Two of them worked in very noisy places for three years in the past and theothers have been working for 15 years or more. Their audiogram showed bilateral C5dip or high tone hearing loss. All of them were suffering from unilateral or bilateral tinnitus. Three of them (group A) have often felt static and gait imbalances while the others (group B) have experienced repeated rotatory vertiginous attacks. All cases of group Bshowed positional or positioning vertigo, rotatory nystagmus and decreases of caloric response. Onthe contrary, all cases of group A did not show any nystagmus or abnormal caloricresponse. The authors speculated that the patients of group A have received excessive stress by noisy circumstance in long terms, and this stress could cause insufficiency of cardiovascular system, vertebrobasilar arteries and autonomic nerve system. In the patients of group B, their inner ears were damaged not only in the cochlear but also in the vestibularsystems because of exposure to high intensity noise for a long period of time.