简介:AbstractObjective:To evaluate the necessity and effectiveness of a preplanned technique for drilling during transcanal endoscopic ear surgery.Methods:Study design: Retrospective case series study from June 2011 to June 2015. Setting: Private tertiary care hospital. Patients: Eighty-five ears of 78 patients, age ranging from 9 to 57 years underwent transcanal endoscopic drilling for various types of pathology in their middle and external ear. Interventions: Application of a preplanned technique for transcanal drilling in endoscopic ear surgery that involved short timed drilling with use of intermittent irrigation and suction. Every events of the procedure were done one after another with the single hand of the surgeon. An attachment providing protecting sheath around rotating burr was used during each time of drilling. Main outcomes measure: Efficacy of such drilling technique in single handed endoscopic ear surgery. Presence of any postoperative thermal injury of facial nerve and any lacerated injury of skin of external ear.Results:This preplanned technique was found suitable for transcanal endoscopic drilling with the single hand of the surgeon. Postoperative facial nerve palsy or laceration of skin of external ear was not noted in any patient.Conclusion:After using the present technique, transcanal endoscopic drilling could be done easily and safely with single hand of the surgeon.
简介:摘要本文报道一例外耳圆柱瘤病例,老年女性,主诉发现右外耳肿物12年,初步诊断为右外耳肿物,全身麻醉下行右侧外耳肿物切除术+游离全厚皮片移植术。术后病理报告为圆柱瘤,随访观察1年无复发。
简介:AbstractObjective:To determine anatomic relationships and variation of the round window membrane to bony surgical landmarks on computed tomography.Study design:Retrospective imaging review.Methods:100 temporal bone images were evaluated. Direct measurements were obtained for membrane position. Vector distances and angulation from umbo and bony annulus were calculated from image viewer software coordinates.Results:The angle of round window membrane at junction with cochlear basal turn was (42.1 ± 8.6)°. The membrane’s position relative to plane of the facial nerve through facial recess was (14.7 ± 5.2)° posterior from a reference line drawn through facial recess to carotid canal. Regarding transtympanic drug delivery, the round window membrane was directed 4.1 mm superiorly from the inferior annulus and 5.4 mm anteriorly from the posterior annulus. The round window membrane on average was angled superiorly from the inferior annulus (77.1 ± 27.9)° and slightly anteriorly from the posterior annulus (19.1 ± 11.1°). The mean distance of round window membrane from umbo was 4 mm and posteriorly rotated 30° clockwise from a perpendicular drawn from umbo to inferior annulus towards posterior annulus. Together, these measurements approximate the round window membrane in the tympanic membrane’s posteroinferior quadrant.Conclusions:These radiologic measurements demonstrate normal variations seen in round window anatomy relative to facial recess approach and bony tympanic annulus, providing a baseline to assess round window insertion for cochlear implantation and outlines anatomic factors affecting transtympanic drug delivery.
简介:【摘要】目的:分析局部涂药治疗外耳道炎的临床疗效。方法:选择我院2019年6月—2020年6月纳入治疗的100例患有慢性外耳道炎的患者作为本次研究的研究对象,将其按照随机分组方法分为对照组(50例,使用雷火灸于耳道口治疗)和治疗组(50例,使用复方酮康唑软膏于耳道局部涂药进行治疗),分析对照组与治疗组两组患者的治疗效果,结果:两组在治疗后均有一定好转,但治疗组使用复方酮康唑局部涂药治疗有效率明显高于对照组使用雷火灸治疗有效率,治疗组患者治疗有效率为94%,对照组治疗有效率为78%(P
简介:摘要:目的:分析霉菌性外耳道炎患者联合应用耳内镜下外耳道冲洗、派瑞松布药治疗的临床效果。方法:抽取我院2020年3月至2021年7月收治的霉菌性外耳道炎患者一共56例为研究对象,采用随机数字表法将其分为对照组和观察组,各28例患者,对照组行耳内镜下外耳道冲洗常规治疗,观察组行耳内镜下外耳道冲洗联合派瑞松布药治疗,比较两组患者治疗效果、不良反应发生情况、复发情况。结果:观察组治疗总有效率高于对照组,具备统计学意义(P<0.05);外耳道红肿、耳痛、耳痒、轻度头晕等不良反应发生率观察组低于对照组(P<0.05);观察组复发率低于对照组(P<0.05)。结论:霉菌性外耳道炎患者联合应用耳内镜下外耳道冲洗、派瑞松布药治疗的临床效果突出,安全性较高,且降低了患者病情复发率,建议广泛应用。
简介:摘要:目的 探究对霉菌性外耳道炎患者实施耳内镜下外耳道冲洗联合曲安奈德益康唑乳膏进行治疗的具体情况与治疗效果。方法 研究资料是在2020年1月至2021年9月期间本院选取收治的霉菌性外耳道炎患者共计200例,将全部患者平均分组,共计分为两组来进行分析:观察组、对照组,每组纳入患者100例。给对照组患者应用耳内镜下外耳道冲洗治疗,给观察组患者实施耳内镜下外耳道冲洗联合曲安奈德益康唑乳膏治疗。之后比较治疗效果情况。结果 对比两组患者治疗总有效率、复发率情况,观察组治疗情况明显好于对照组,两组结果比较,差异显著(P<0.05)。结论 将耳内镜下外耳道冲洗联合曲安奈德益康唑乳膏这种治疗方法用于对霉菌性外耳道炎患者的治疗中,能够取得理想治疗效果且安全性较高。
简介:【摘要】目的:探析在真菌性外耳道炎的治疗中应用碘伏消毒液的效果。方法:从2019年1月至2020年1月来我院接受真菌性外耳道炎治疗的患者当中,选择60例患者的临床资料作为此次研究对象,依据随机数字表法,按照治疗方式不同分为对照组和实验组,各30例,其中对照组使用曲安奈德益康唑乳膏进行治疗,实验组则实施碘伏联合曲安奈德益康唑乳膏进行治疗,对比两组患者的治疗效果。结果:两组患者均为不良反应,实验组患者的治疗效果优于对照组(p<0.05),具有统计学意义。结论:相较于单独使用曲安奈德益康唑乳膏,联合碘伏对真菌性外耳道炎的治疗效果更显著,且治疗后,复发率更低,值得在真菌性外耳道炎的治疗中推广应用。
简介:摘要目的初步评估粘贴式骨导助听器对单侧外耳道骨性闭锁患儿双耳聆听效应及主观满意度的影响。方法2019年1—8月就诊于首都医科大学附属北京同仁医院的10例单侧外耳道骨性闭锁患儿,男、女各5例,年龄5~15岁,平均8.3岁。统一于患侧配戴粘贴式骨导助听器,分别于裸耳和助听状态下行自由声场下听力阈值、安静下言语识别率、噪声下言语识别阈和水平方位声源定位能力测试,并发放主观问卷。采用SPSS 26.0统计软件,应用配对t检验和配对Wilcoxon符号秩检验,比较裸耳与助听后效果差异。结果自由声场中,助听后听阈较裸耳改善了(21.9±4.4)dB,差异具有统计学意义(t=15.8,P<0.05)。患儿在安静和噪声下言语识别能力总体均有提高(P值均<0.05),当单独分析中枢冗余、双耳抑噪和头影效应时,双耳抑噪效应助听前后差异无统计学意义(P>0.05),其余两种效应在助听后均有提高(P值均<0.05)。声源定位能力测试中,有6例患儿助听后有改善,但助听前后总体差异无统计学意义(P>0.05)。父母版言语空间特性问卷中,患儿言语感知、空间听力和听力音质及其8项子类别在助听后均有不同程度的提高(P值均<0.05);国际助听器效果问卷平均得分为4.1分。结论粘贴式骨导助听器能显著提升单侧外耳道骨性闭锁患儿安静和噪声环境下言语识别能力,提高患儿生活质量。
简介:摘要目的探讨耳廓再造二期与骨桥植入同期手术治疗双侧外中耳畸形外耳道骨性闭锁的可行性及安全性。方法回顾性分析2017年2月至2020年1月北京同仁医院行双侧耳廓再造二期手术时同期行单侧骨桥植入的36例(72耳)双侧先天性外中耳畸形外耳道闭锁患者的临床资料。其中男性31例,女性5例;植入手术年龄6~12岁,平均8.1岁。所有患者均诊断为双侧先天性外中耳畸形,双侧外耳道骨性闭锁,双侧传导性聋。所有患者均采用Nagata二期法耳廓再造术,且双侧同时进行手术;于耳廓再造第二期手术时同期行单侧骨桥植入手术。分别测试患者术前及骨桥开机后纯音听阈和言语识别率,应用SPSS 17.0软件进行统计学分析。结果36例患者术后均一期愈合。患者术后骨导平均阈值较术前无明显变化[术前(8.5±5.8) dB HL,术后(8.4±5.2) dB HL],差异无统计学意义(P=0.724)。术前气导平均听阈为(64.9±7.4) dB HL,术后声场中骨桥助听听阈为(24.0±5.3)dB HL,差异有统计学意义(P<0.001)。骨桥助听下,安静环境下单音节词、双音节词及短句的言语识别率与术前相比分别提高了62.5%、63.5%及72.2%,差异有统计学意义(P值均<0.001);噪声环境下单音节词、双音节词及短句的言语识别率与术前相比分别提高了55.9%、58.9%及69.9%,差异有统计学意义(P值均<0.001)。经过平均18.3个月的随访,听力效果稳定,耳廓外形良好。远期随访发现植入体部分外露并发症1例,经皮瓣修复手术后愈合。结论采用整合手术方案,双侧外中耳畸形外耳道骨性闭锁患者可在6个月内完成双侧耳廓再造及骨桥植入,手术周期缩短,安全有效,患者听力改善及耳廓外形效果佳。
简介:【摘要】目的:分析针对性护理干预对真菌性外耳道炎患者心理状态及疗效的影响。方法:本次研究对象共60例,均为2020年1月到2021年1月期间本院接收的真菌性外耳道炎患者,按照计算机随机抽选的方式,组中