鼻すすりによりめまいを生じた耳管開放症例 A Case of Patulous Eustachian Tube Complicated by Vertigo Induced by Sniffing
Patulous eustachian tube syndrome has become rare and we report here a 33-year-old male diagnosed with a patulous eustachian tube in the right ear, resulting from severe weight loss. The patient reported that sniffing gave a transient improvement of his symptoms such as ear fullness and autophony, but the frequent sniffing seemed to induce vertigo. The fistula symptom was positive and the movement of the eardrum sympathized with breathing was observed under an operation microscope. Although the vertigo disappeared after the patient stopped sniffing, the fistula symptom and the movement of the eardrum remained. At the time of the exploratory tympanotomy, no perilymphatic fistula was observed in the mesotympanum. We reinforced the round window membrane using soft tissue, and in addition, injected atelocollagen around the pharyngeal orifice of the eustachian tube. After the operation, both the fistula symptom and the abnormal movement of the eardrum had disappeared. These results suggested that the excessive negative pressure to the mesotynpanum caused by sniffing may have affected the inner ear through the round window membrane.
耳鼻咽喉科臨床 94(6), 511-516, 2001-06-01