Ikeda Ryoukichi, Miyazaki Hiromitsu, Kawase Tetsuaki, Katori Yukio, Kobayashi Toshimitsu
Department of Otolaryngology-Head & Neck Surgery, Tohoku University School of Medicine, Sendai, Japan; Sen-En Rifu Otological Surgery Center, Sendai, Japan.
Department of Otolaryngology-Head & Neck Surgery, Tohoku University School of Medicine, Sendai, Japan; Sen-En Rifu Otological Surgery Center, Sendai, Japan.
Auris Nasus Larynx. 2017 Feb;44(1):119-121. doi: 10.1016/j.anl.2016.04.009. Epub 2016 Apr 29.
Although tympanic bulging is commonly encountered, tympanic herniation occupying the external auditory canal is extremely rare. A 66-year-old man was presented to our hospital with left aural fullness, bilateral hearing loss and otorrhea. Preoperative findings suggested tympanic membrane (TM) hernia located in the left external auditory canal. We performed total resection of the soft mass by a transcanal approach using endoscopy. Ventilation tubes were inserted into bilateral ears. Histopathological findings confirmed diagnosis of TM hernia. Passive opening pressure of this patient was higher than normal condition of the Eustachian tube, where active opening was not observed. Hernia of the TM most likely resulted from long-term excessive Valsalva maneuver.
虽然鼓膜膨出很常见，但占据外耳道的鼓膜疝极为罕见。一名66岁男性因左耳闷胀、双侧听力减退和耳漏前来我院就诊。术前检查发现左侧外耳道鼓膜疝。我们采用经耳道内镜入路对软组织肿块进行了全切除。双侧耳朵均插入了通气管。组织病理学检查结果证实为鼓膜疝。该患者的咽鼓管被动开放压高于正常情况，未观察到主动开放。鼓膜疝很可能是长期过度进行瓦尔萨尔瓦动作所致。
