【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.
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.
Otitis media is one of the common ear diseases, and its accurate diagnosis can prevent the deterioration of conductive hearing loss and avoid the overuse of antibiotics. At present, the diagnosis of otitis media mainly relies on the doctor's visual inspection based on the images fed back by the otoscope equipment. Due to the quality of otoscope equipment pictures and the doctor's diagnosis experience, this subjective examination has a relatively high rate of misdiagnosis. In response to this problem, this paper proposes the use of faster region convolutional neural networks to analyze clinically collected digital otoscope pictures. First, through image data enhancement and preprocessing, the number of samples in the clinical otoscope dataset was expanded. Then, according to the characteristics of the otoscope picture, the convolutional neural network was selected for feature extraction, and the feature pyramid network was added for multi-scale feature extraction to enhance the detection ability. Finally, a faster region convolutional neural network with anchor size optimization and hyperparameter adjustment was used for identification, and the effectiveness of the method was tested through a randomly selected test set. The results showed that the overall recognition accuracy of otoscope pictures in the test samples reached 91.43%. The above studies show that the proposed method effectively improves the accuracy of otoscope picture classification, and is expected to assist clinical diagnosis.
【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.
