滲出性中耳炎を契機に発見された Tornwaldt 病例

We reported a case of nasopharyngeal cyst (Tornwaldt's disease) found from otitis media effusion. A 49-year-old woman showed hearing loss and left ear fullness since December, 2000, and was hospitalized at our related hospital on February 3rd, 2001. Otitis media effusion of bilateral ears were identified by an otoscopic exam. Her mean hearing level was 40.0dB on the right side (A-B gap 12.5dB) and 56.3dB on the left side (A-B gap 35.0dB). The finding of the tympanogram was B type on both sides. By fiberscopic examination, a smooth and slightly reddish globular mass was found in the center of the nasopharynx. No apparent stenosis of the pharyngeal opening of auditory tube and lesions on the other upper air-ways were identified. On enhanced brain CT, a round and uniform inner low density area was identified in the middle of the nasopharynx, adjacent to the front of bilateral musculus longus capitis. It was low on enhancement. On an MRI T1 enhanced image, an inner uniformly low intensity area was identified at the center of nasopharynx, and on a T2 enhanced image, a uniformly high intensity area was identified. From the above-mentioned findings, we diagnosed it as a nasopharyngeal cyst supposed to be Tornwaldt's disease that caused otitis media effusion, according to the infection on the remains of the nasopharyngeal bursa of the embryonic period.