中耳炎の内耳波及と考えられた症例の側頭骨病理 [in Japanese] Temporal Bone Histopathology in a Patient Suspected of Inner Ear Extension of Otitis Media [in Japanese]
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中耳炎の細菌感染が死亡直前に内耳に波及したと考えられた, 30歳女性の頸部食道癌症例の側頭骨病理を検討した. 本症例では, 中耳の炎症所見と共に卵円窓, 正円窓膜から多数の円形細胞浸潤が内耳に及んでいる所見が観察された. 内外リンパ腔には多数の細胞浸潤が見られ, 特に基底回転で高度であった. 内外有毛細胞は一部変性, 消失が見られるものの比較的保たれていた. 蝸牛軸内にも細胞浸潤が認められたが, ラセン神経節細胞はほぼ保たれていた. これらの所見から, 中耳炎が正円窓膜と卵円窓を介して内耳に波及し, Schuknechtの分類での化膿性内耳炎の第二段階の所見と考えられた.
We report the histopathological findings in the temporal bone of a 30-year-old female who died of cervical esophageal carcinoma. The temporal bone sections revealed severe bilateral suppurative labyrinthitis and otitis media that presumably occurred immediately before her death. Many inflammatory cells were present in the middle ear, particularly around the stapes and the round window niche. They had also infiltrated the inner ear via the annular ligament of the stapes and the round window membrane. Inflammatory cell accumulation was also observed in the peri-and endolymphatic spaces, and it was most severe in the basal turn. Most of the inner and outer hair cells were preserved, but some had degenerated or were missing. Numerous round cells were observed in the modiolus, and some of the spiral ganglion cells had degenerated. On the basis of these findings, we concluded that bacterial otitis media had extended in to the inner ear via the oval window and round window membrane and had resulted in suppurative labyrinthitis. These findings are consistent with those of stage II suppurative labyrinthitis according to the classification of Schuknecht.
- Nippon Jibiinkoka Gakkai Kaiho
Nippon Jibiinkoka Gakkai Kaiho 108(5), 533-536, 2005-05-20
The Oto-Rhino-Laryngological Society of Japan, Inc.