【摘要】 目的 了解慢性化膿性中耳炎患者的聽力學檢查特點。 方法 回顧性分析2005年8月—2008年12月間就診的382例確診為慢性化膿性中耳炎患者的聽力學檢查資料。 結果 慢性化膿性中耳炎中男性和單耳患者居多，任何年齡均可發病，以中度傳導性聽力損失為主，鼓室圖形態各異，耳道容積變大。 結論 慢性化膿性中耳炎是常見的耳科疾病，需及時治療，聽力學檢查對于指導治療方案和評估預后意義重大。【Abstract】 Objective To learn the audiological characteristics of chronic suppurative otitis media patients. Methods We retrospectively analyzed the audiologic data of 382 patients diagnosed with chronic suppurative otitis media treated in our hospital from August 2005 to December 2008. Results The number of male chronic suppurative otitis media patients was more than female patients, and single ear infections are more than infections of both ears. The onset of the disease could be at any age. Most of the patients had a moderate conductive hearing loss. All kinds of tympanogram were found,and ear canal volume of the patients was enlarged. Conclusion Chronic suppurative otitis media is a common disease of the ear, which needs timely treatment, and audiological tests are important in guiding treatment plans and assessing prognosis.
In order to study the influence of tympanic membrane lesion and ossicular erosion caused by otitis media on the hearing compensation performance of round-window stimulation, a human ear finite element model including cochlear asymmetric structure was established by computed tomography (CT) technique and reverse engineering technique. The reliability of the model was verified by comparing with the published experimental data. Based on this model, the tympanic membrane lesion and ossicular erosion caused by otitis media were simulated by changing the corresponding tissue structure. Besides, these simulated diseases’ effects on the round-window stimulation were studied by comparing the corresponding basilar-membrane’s displacement at the frequency-dependent characteristic position. The results show that the thickening and the hardening of the tympanic membrane mainly deteriorated the hearing compensation performance of round-window stimulation in the low frequency; tympanic membrane perforation and the minor erosion of ossicle with ossicular chain connected slightly effected the hearing compensation performance of round-window stimulation. Whereas, different from the influence of the aforementioned lesions, the ossicular erosion involving the ossicular chain detachment increased its influence on performance of round-window stimulation at the low frequency. Therefore, the effect of otitis media on the hearing compensation performance of round-window stimulation should be considered comprehensively when designing its actuator, especially the low-frequency deterioration caused by the thickening and the hardening of the tympanic membrane; the actuator’s low-frequency output should be enhanced accordingly to ensure its postoperative hearing compensation performance.
Objective To evaluate the diagnosis value of temporal Done high-resolution computed tornography (HRCT) in cholesteatoma. Methods There were 30 causes that had received the mastoid surgery because of cholesteatoma. Each patient’s mastoid plain films (Schuller’s and Mayer’s ) and HRCT had been taken and compared with each other and surgical findings and evaluated with health economic evaluation methods. Results The sensitivity rate in diagnosing cholesteatoma with HRCF was much higher than that with mastoid film (Plt;0.005). The more important benefit with HRCT was that it can afford the detail information in ear such as the ossicular chain, facial nerve canal, tympanic sinus, etc. which were basis for otologist in surgery to remove the focus thoroughly and reconstruct the middle ear function at the same time. In the view of health economic evaluation, HRCT is also much better than mastoid X-ray film. Conclusion HRCT should replace masloid Schuller’s and Mayer’s film in diagnosis cholesteatoma and HRCT should use as ordinary examination in chronic otitis media.
【摘要】 目的 探討乳突根治術后耳內窺鏡換藥與常規換藥相比是否具有優勢。 方法 2003年3月-2008年10月對89例共89只耳行開放式乳突根治術患者按隨機數字表法隨機分為試驗組及對照組，試驗組45例45只耳采用耳內窺鏡換藥，對照組44例44只耳常規換藥；分別觀察試驗組和對照組的干耳人數及干耳的時間，計算干耳率及干耳的平均時間。 結果 試驗組45只耳中42只干耳，干耳率93.3％；對照組44只耳中40只干耳，干耳率90.9％。兩組比較差異無統計學意義（Pgt;0.05）。試驗組42例干耳患者平均干耳時間為術后（50.8±13.4） d，對照組40例干耳患者平均干耳時間為術后（60.7±12.2） d；兩組比較，差異有統計學意義（Plt;0.001）。 結論 中耳乳突根治術后耳內窺鏡下換藥與常規換藥相比不能顯著提高干耳率，但能有效縮短干耳時間。【Abstract】 Objective To evaluate the application of otoendoscope in dressing change after mastoidectomy. Method Between March 2003 and October 2008, 89 patients (89 ears) underwent mastoidectomy in Department of Otolaryngology Head and Neck Surgery, West China Hospital of Sichuan University and in Department of Otolaryngology, Nuclear Industry 416 Hospital of Chengdu. The patients were randomly divided into two groups by simple randomization (trial group and control group). Forty-five patients in the trial group underwent the dressing change under otoendoscope, while 44 patients in the control group under the routine method. The ear drying rate and the ear drying time in the two groups were observed. Results The ear drying rate was 93.3% (42 dry ears)in the trial group, and was 90.9% (40 dry ears) in the control group; the difference between the two groups was not significant (Pgt;0.01). The ear drying time was (50.8±13.4) days in the trial group and was (60.7±12.2) days in the control groups; the difference between the two groups was significant (Plt;0.001). Conclusion Dressing change under the otoendoscope after mastoidectomy may not improve the ear drying rate but can shorten the ear drying time.
Objective To assess the effectiveness and safety of adenoidectomy on otitis media with effusion (OME) in children. Methods Electronic databases were searched including Medline (1966-2001), EMbase (1974-2001), the Cochrane Controlled Trials Register (CCTR), Chinese Biomedical Database (CBM, 1989-2001). Five Chinese otolaryngology journals were handsearched. References of eligible studies were also screened for inclusion. Selection criteria were restricted to randomized controlled trials comparing adenoidectomy with other treatments in patients with OME in children. At least two reviewers independently assessed trial quality and extracted data. RevMan 4.1 was used for statistical analysis. Results Of the 248 literatures identified, 13 trials with 1 430 patients were eligible and were included in the systematic review. Overall, the methodological quality of the included trials was high, all from developed countries. None of the trials showed that the effects of adenoidectomy better than those of myringotomy and no treatments for OME in children. Four trials comparing adenoidectomy with grommets showed that the effects of grommets were better than those of adenoidectomy. Ten trials described post-surgical bleeding, velopharyngeal incompetence and nasopharyngeal stenosis. Conclusions At present, there is no evidence to either ascertain that adenoidectomy is better than other treatments for OME, or to suggest which type of surgery is the most effective one. Current trials indicate that early administration of adenoidectomy concomitant with grommets might be the most appropriate therapy for OME in children who fail to response to drug treatment, if multiple risk factors exist.
