自拟仙泽汤并甘露醇、氟桂嗪联合治疗Ménière病的临床观察

本文应用自拟仙泽汤并甘露醇、氟桂嗪治疗Meniere病36例，并随机选择20例用仙泽汤治疗，24例用甘露醇及氟桂嗪治疗作对照。治疗组治疗结果：眩晕有效率为91．7％（P＜0．01），听觉改善率为86．1％（P＜0．05），劳动能力改善率为91．7％（P＜0．05），疗效优于对照组。表明该疗法治疗Meniere病有积极意义。     

自拟仙泽汤并甘露醇,氟桂嗪联合治疗Meniere病的临床观察

本文应用自拟仙泽汤并甘露醇、氟桂嗪治疗Ｍｅｎｉｅｒｅ病３６例，并随机选择２０例用仙泽汤治疗，２４例用甘露醇及氟桂嗪治疗作对照。治疗组治疗结果：眩晕有效率为９１．７％（Ｐ〈０．０１），听觉改善率为８６．１％（Ｐ〈０．０５），劳动能力改善率为９１．７％（Ｐ〈０．０５），疗效优于对照组。表明该疗法治疗Ｍｅｎｉｅｒｅ病有积极意义。     

倍他司汀联合盐酸氟桂利嗪治疗耳鸣的效果观察

目的观察使用倍他司汀联合盐酸氟桂利嗪对耳鸣的治疗效果和安全性，以提高耳鸣的治疗效果。方法2011年2月～2012年11月收治的70例耳鸣患者随机分为两组，实验组（35例）患者使用倍他司汀联合盐酸氟桂利嗪治疗；对照组（35例）患者单独使用盐酸氟桂利嗪治疗，比较两组患者的治疗效果。结果实验组总有效31例，对照组总有效15例，两组患者的治疗效果比较，差异具有统计学意义（P〈0．05）；实验组患者的不良反应与对照组患者比较，差异无统计学意义（P〉0．05）。结论使用倍他司汀联合盐酸氟桂利嗪对耳鸣患者进行治疗具有较好的治疗效果，且安全性更高，值得临床推广。     

氟桂利嗪治疗突发性聋31例的疗效观察

目的：探讨氟桂利嗪治疗突发性聋的疗效。方法：用氟桂利嗪治疗突发性聋31例,比较治疗前后听力的改善情况。结果：氟桂利嗪能改善大脑和内耳的微循环,氟桂利嗪治疗组有效率为74．2％。结论：氟桂利嗪能明显改善和提高突发性聋患者的听觉功能,可以作为治疗突发性聋的基本用药之一。     

盐酸氟桂利嗪胶囊联合前庭康复治疗前庭性偏头痛

目的　观察盐酸氟桂利嗪胶囊联合前庭康复治疗121例前庭性偏头痛疗效。方法　选择2016年5月～2018年8月在福建医科大学附属泉州第一医院治疗的121例前庭性偏头痛患者，随机分为实验组和对照组，实验组63例给予盐酸氟桂利嗪胶囊联合前庭康复治疗，对照组58例仅给予盐酸氟桂利嗪胶囊治疗。对比两组患者的临床治疗效果、 眩晕发作次数及持续时间。结果　经过治疗实验组患者痊愈8例，显效25例，有效24例，无效6例；对照组患者痊愈2例，显效20例，有效19例，无效17例；实验组的临床治疗总有效率90.5%，高于对照组的70.7%，差异具有统计学意义（P <0.05）。治疗后6个月内实验组患者的眩晕发作次数（3.14±1.80）次、每次发作持续时间（4.10±2.49）分钟，均少于对照组（4.26±2.32）次、（5.63±2.81）分钟，差异具有统计学意义（P <0.05）。结论　盐酸氟桂利嗪胶囊联合前庭康复治疗可以有效改善前庭性偏头痛患者的预后及生活质量。     

倍他司汀联合盐酸氟桂利嗪治疗耳鸣的随机双盲对照初步研究

目的采用前瞻性临床研究方法观察倍他司汀治疗耳鸣的疗效。方法采用随机、双盲、对照临床研究方法探讨倍他司汀对耳鸣的治疗效果。60例以耳鸣为主诉的门诊患者，排除客观性耳鸣、外中耳疾病，随机分为2组，均给予盐酸氟桂利嗪作为基础用药，试验组加用倍他司汀，对照组加用维生素B6，观察治疗1周后的疗效。治疗前患者均填写耳鸣调查表，治疗前后均进行耳鸣匹配、纯音测听检查。结果以耳鸣匹配响度为疗效判定标准，倍他司汀与盐酸氟桂利嗪联合应用治疗耳鸣的疗效优于维生素B6与盐酸氟桂利嗪联合应用的效果。用服从方案完成及意向治疗方法计算倍他司汀组的有效率分别为65．5％、63．3％，对照组的有效率分别为39．3％、36．7％。按照耳鸣主观恢复为疗效判定标准，试验组和对照组的有效率差异无统计学意义。2组均未出现严重药物不良反应，倍他司汀与盐酸氟桂利嗪联合应用并没有增加或加重药物的不良反应，对听力没有帮助。结论倍他司汀可以作为临床上治疗主观性耳鸣药物的一种选择。但是倍他司汀治疗耳鸣的确切疗效还需大样本、安慰剂对照的长期观察研究。     

突发性聋不同疗法的疗效及影响因素分析

目的：探讨不同药物及／或方法组合对突发性聋（sudden deafness,SD）患者的疗效及其影响因素。方法：84例（89耳）SD患者分为三组。I组24例（28耳）用脑血管扩张剂、降低血液粘滞性及内耳神经结构保护药物，Ⅱ组33例（34耳），在上述药物基础上加极化液。I、Ⅱ组用静脉通道给药，并用高压氧（HBO）。Ⅲ组27例（27耳），全部用尼莫地平或氟桂利嗪口服，丹参制剂肌肉注射或口服，并用神经结构保护剂，不用HBO。结果：三组有效率依次为67．86％、64．71％及70．37％，x^2检验差异不明显；不同听力曲线对疗效有影响，低频型有效率为84．6％，高频型有效率为44．4％；于发病7d内治疗的病例最有效，痊愈及显效率为77．8％及94．7％，但1个月以后仍有少数病例有效；SD的疗程：治疗15d总有效率为50．8％，至30d已达84．7％。结论：三组病人用不同药物及／或方法组合，效疗差异不明显，应以用改善内耳微循环，降低血液粘滞度，保护内耳神经结构的药物为主；HBO、极化液并不一定能提高疗效；对SD宜早期治疗，发病7d内疗效最好，疗程以15－30d为宜。     

穴位注射联合氟桂利嗪治疗前庭型偏头痛的前瞻性对照研究

目的观察穴位注射联合氟桂利嗪治疗前庭型偏头痛的临床疗效。方法 45例前庭型偏头痛患者分为治疗组(23例)和对照组(22例)。治疗组给予地塞米松+山莨菪碱翳风穴穴注射治疗,每周1次,连续应用3月,并结合口服盐酸氟桂利嗪;对照组单纯给予相同剂量和疗程的盐酸氟桂利嗪口服治疗。治疗结束后随访3月,分析比较疗效。结果两组患者症状均显著减轻(P0.05),但加用穴位注射组比单纯口服氟桂利嗪组疗效更为显著(P0.05)。结论翳风穴穴注射地塞米松加山莨菪碱并联合口服氟桂利嗪,对前庭型偏头痛有更好的治疗效应。     

声信息结合通窍活血汤加减治疗气血瘀阻型耳胀耳闭的疗效观察

目的观察声信息结合通窍活血汤加减治疗气血瘀阻型耳胀耳闭的疗效。方法在临床常规治疗方法基础上增服中药通窍活血汤加减，并在此基础上增加声信息治疗分组对照，观察两组患者的临床疗效。结果增加声信息治疗组总有效率88．76％，对照组总有效率76．40％，两组总有效率比较差异有统计学意义。结论通窍活血汤加减治疗气血瘀阻型耳胀耳闭疗效较好，增加声信息治疗疗效进一步提高。     

急性眩晕症应用氟桂利嗪联合盐酸倍他司汀联合治疗的效果

目的 将氟桂利嗪、盐酸倍他司汀联合治疗用在急性眩晕症中的应用效果。方法 在我院随机甄选80例急性眩晕症患者为研究主体,研究时间2021年4月-2022年5月期间,所选患者按随机数表方式分为两组,即观察组和对照组,对照组40例患者用盐酸倍他司汀治疗,观察组40例患者采用氟桂利嗪联合盐酸倍他司汀治疗,观察两组治疗效果。结果 数据分析：眩晕、恶心呕吐评分相比,治疗前对比无差异,P>0.05,治疗后对比,眩晕、恶心呕吐评分观察组低于对照组（P<0.05）;数据分析：椎动脉Vm相关指标,即LVA、RVA水平相比,治疗前对比无差异,P>0.05,治疗后对比,LVA、RVA水平观察组高于对照组（P<0.05）;数据分析：血细胞压积、红细胞聚集指数、全血黏度相比,治疗后对比,观察组低于对照组（P<0.05）;数据分析：治疗总有效率相比,观察组高于对照组（P<0.05）;数据分析,统计两组不良反应发生率,观察组与对照组相比,无差异,P>0.05。结论 在急性眩晕症中,采用氟桂利嗪联合盐酸倍他司汀联合治疗方案,能改善椎动脉Vm水平与临床症状,对改善血液流变学指标、...     

声信息治疗突发性聋的临床观察

目的：突发性耳聋是耳鼻咽喉科的常见病,多发病,临床治疗方案很多,为认真总结临床经验,探索更佳的治疗方案。方法９２例突聋患者随机抽样,４０例患者采用中西医结合治疗,５２例患者在中西医结合治疗同时加声信息治疗,即采用现代电子技术,有针对性利用声信息。直接通过人体听觉系统,结果中西医结合组有效率为７０％,而中西医结合治疗加声信息治疗组有效率为８８．５％。结论中西医结合加声信息治疗组取得良好的疗效,与单纯     

Treatment of vocal cord granuloma

Combined surgical and conservative therapy (voice therapy, treatment of infections, allergy, oesophageal reflux, and psychogenic stress) has been used in the treatment of non-specific vocal cord granuloma. Such tumors have a great tendency to recur. The 41 patients with vocal cord granuloma in our study (4 women, 37 men, mean age 56 years) were treated at our hospital during 1980-1986. Nine patients were healed with conservative treatment, 32 were treated by laryngomicrosurgery under general anesthesia and jet-ventilation. The latter group was divided into three treatment groups; 8 of these patients were treated with cryotherapy, 9 with postoperative steroids (Prednisolone 40 mg/day in decreasing doses) and antibiotics, and 15 only with microsurgery. At some phase in their treatment 41% of the patients were able to participate in voice therapy. The most recurrences were found in the group treated with cryotherapy, 2.7 rec./pat.; 1.8 rec./pat. were found in the group that underwent surgery, and 1.7 rec./pat. among the patients treated with steroid-antibiotics. In all three groups, some patients experienced recurrences. In the cryotherapy group, however, recurrent granulomas were large and required reoperation, while those in patients treated with steroid-antibiotics were small and could be cured using conservative therapy. If granuloma does not disturb the voice, cause respiratory obstruction or demand histopathological diagnosis, surgery is contraindicated. Cryotherapy does not help traditional surgery, while steroid-antibiotics administered postoperatively seem to help the healing process.     

鼻内镜下咽鼓管置管术治疗分泌性中耳炎

目的探索有效治疗分泌性中耳炎的方法。方法将分泌性中耳炎患者63例（78耳）随机分成两组：实验组：在鼻内镜下,对31例（38耳）分泌性中耳炎患者行咽鼓管置管术,留管并反复注药治疗;对照组：对32例（40耳）患者使用传统的鼓膜切开置管术治疗,术后随访6～9个月,比较两组疗效。结果实验组治愈16耳,占42．1％,好转18耳,占47．4％,总有效率89．5％：对照组：治愈8耳,占20．0％,好转21耳,占52.5％,总有效率72．5％。治疗后两组差异有显著性（P〈0．05）。结论在鼻内镜下行咽鼓管置管术是在直视下操作,通过咽鼓管的自然通道插入导管,不仅避免了损伤鼓膜,也避免了咽鼓管吹张的重复操作,为临床治疗分泌性中耳炎提供了一个良好途径。     

T3和T4期梨状窝癌的综合治疗

目的评价不同治疗方式治疗梨状窝癌T3、T4病变的治疗效果。方法回顾性分析了1974年1月-1999年12月中国医学科学院肿瘤医院头颈外科初治的287例T3、T4梨状窝癌患者。根据治疗方式，分为4组：单纯放疗组（Ra组）134例，平均放疗剂量68．8Gy；术前放疗加手术组（R＋S组）125例，平均术前放疗剂量45．5Gy，其中32例行喉功能保留手术；单纯手术组（Sa组）13例，全部为非喉功能保留手术；手术加术后放疗组（S＋R组）15例，全部为非喉功能保留手术，平均术后放疗剂量56．3Gy。结果Kaplan-Meier方法计算Ra组、R＋S组、Sa组和S＋R组的5年生存率分别为23．13％、46．51％、18．33％和44．44％。综合治疗（R＋S组和S＋R组）与单纯治疗（Ra组和Sa组）的5年生存率分别为46．22％和22．60％，两组间差异有统计学意义（P=0．000）。Cox模型对生存时间的多因素分析显示，对生存时间有影响的是治疗模式（P=0．000）和放疗效果（P=0．0070）Ra组、R＋S组、Sa组和S＋R组的喉功能保存率分别为14．08％、13．61％、0和0。Ra组、R＋S组、Sa组和S＋R组的并发症的发生率分别为14．93％、37．60％、53．84％、33．33％。结论术前放疗有助于T3、T4梨状窝癌患者喉功能的保留。     

改良Valsalva法(玩具式自家鼓气吹鸣器)治疗分泌性中耳炎临床观察

目的评估使用玩具式自家鼓气吹鸣器治疗分泌性中耳炎的疗效.方法24名分泌性中耳炎患儿采用改良Valsalva法行咽鼓管吹张,每日3次以上,持续2周后复查,行耳科检查及听力学评估,包括耳镜检查、声导抗及纯音测听,无效者继续3月;另23名同样患儿作为对照组.结果治疗组患儿68%骨气导差减至小于15 dB,对照组为26%,治疗组患儿有62%其声导抗鼓室峰压值恢复正常(大于-100dapa),对照组有29%,统计学分析两组差异有显著性.结论玩具式自家吹鸣器进行改良Valsalva吹张治疗分泌性中耳炎是有效的,儿童使用时有浓厚兴趣,可作为一种治疗分泌性中耳炎的辅助器械.     

Sequential sound therapy in tinnitus

Sequential sound therapy, which uses wide-band white noise distinguished by some unique characteristics, is applied in the treatment of tinnitus. The methodology is described, as are the differences from and similarities to tinnitus retraining therapy. We have performed sequential sound therapy in 26 patients from 2002 through part of 2003. Thirty-eight generators of sounds were adapted for use in this therapy and, of these, 34 incorporated an earphone. The results of sequential sound therapy in our 26 patients were compared with the results of tinnitus retraining therapy in 15 patients treated during the years 2000 and 2001. Satisfactory results obtained with sequential sound therapy totaled 100%, whereas only 33% of subjects treated with tinnitus retraining therapy obtained satisfactory results. In 6 patients who received sequential sound therapy, tinnitus disappeared altogether. In addition, no patient receiving sequential sound therapy has left the treatment protocol, whereas 53% of patients receiving tinnitus retraining therapy abandoned the treatment protocol.     

Medial arytenoidectomy versus transverse cordotomy as a treatment for bilateral vocal fold paralysis

OBJECTIVES: Transverse cordotomy (TC) and medial arytenoidectomy (MA) are procedures performed to enlarge the glottic airway in patients with bilateral vocal fold paralysis (BVFP). Both are less destructive than total arytenoidectomy and have distinct theoretical advantages for voice preservation, but they have never been compared. METHODS: The records of patients with BVFP treated with TC or MA were reviewed; information regarding the outcome measures of tracheotomy decannulation, dysphagia, Voice Handicap Index score, voice intensity, clinical course, and preoperative and postoperative voice quality was obtained. RESULTS: Seventeen patients were available for evaluation (11 with TC, 6 with MA). All 6 patients with a preoperative tracheotomy were decannulated. Four patients in the MA group and 2 in the TC group had an increase in their postoperative Voice Handicap Index score. Two of the patients in the MA group had a decrease in phonatory sound pressure level of 3 dB, and 1 in the TC group had a decrease of 2 dB sound pressure level. Patient self-report of airway status following TC or MA showed that 62.5% (10 of 16) were significantly better and 25% (4 of 16) were somewhat better. Blinded audio perceptual analysis comparing preoperative and postoperative voice quality showed no difference between the MA and TC groups. A swallowing quality-of-life instrument confirmed a lack of swallowing difficulties postoperatively. CONCLUSIONS: Both TC and MA are good treatment options for BVFP, with a low incidence of complications in postoperative voice or of swallowing difficulties and a consistent improvement of laryngeal airway restriction symptoms.     

Carotid stenosis after adjuvant cervical radiotherapy in patients with head and neck cancers: a prospective controlled study

Clin. Otolaryngol. 2012, 37 , 376–381 Objectives: To determine the prevalence of radiation‐induced carotid stenosis, in patients who were treated for head and neck malignancies, using colour‐flow duplex scanning. Design: Prospective controlled study at a single medical centre. Participants: We enrolled two groups of patients. The first (radiotherapy group) consisted of patients who received surgical treatment and adjuvant radiotherapy of the neck. The control group consisted of patients with head and neck malignancies who received only surgical treatment. Main outcome measures: All patients were evaluated with carotid artery ecoDoppler imaging 1 week before and 36 months after the surgical procedure. Intima‐media thickness was measured bilaterally at the internal carotid artery and at the bifurcation. Carotid obstruction was classified as low (0–30%), moderate (31–49%) or severe (≥50%). Results: The preoperative stenosis grade did not differ between groups. In 15/25 patients (60%) in the radiotherapy group, mild stenosis evolved to moderate stenosis, while only 6/37 (16%) of the controls did (P = 0.004). Additionally, 9/39 (23%) patients in the radiotherapy group progressed to severe stenosis compared with only 3/54 (6%) controls (P = 0.029). The overall evolution showed that stenosis worsened in 24/32 (62%) patients in the radiotherapy group and 9/54 (17%) patients in the control groups (P < 0.0001). Conclusions: These results highlight the need to study the long‐term incidence of cerebrovascular events in these two different populations (radiation treated and surgically treated) to identify increased cerebrovascular morbidity.     

Evidence on the efficacy of insert earphone and sound field VRA with young infants

Visual reinforcement audiometry (VRA) with insert-earphone stimulus delivery provides a means of obtaining early ear-specific information on the auditory status of infants. The aim of this study was to investigate the efficacy of VRA in young infants, and to compare the use of sound field and insert-earphone stimulus presentation. VRA was performed on 41 normally developing infants aged between 20 and 42 weeks. Infants were tested in the sound field (n=22) and with insert earphones (n=19). Results showed significantly more minimum response levels (MRLs) obtained with sound field testing, and with older children. Nevertheless, in the insert-earphone group, 36% of those aged 32 weeks or more gave two or more MRLs, and 25% of the infants aged 25 weeks or less gave one or more MRLs. This study provides data from developmentally normal infants which confirms the efficacy of insert-earphones as well as sound field VRA with 32-42-week-olds, with reasonable expectation of success. The data in this study also suggest that VRA could be usefully employed for younger infants aged approximately 20-26 weeks where information, although less easily obtained, may be of particular value to early diagnosis and habilitation.