第二十届美国听力学年会报道(Ⅰ)——聆听永远 健康常驻

2008年4月2～5日,美国听力学年会在美国北卡罗莱纳州的夏洛特市召开。2008年恰逢美国听力学学会创建20周年,从最初32名听力学家倡导建会到现     

儿童变应性鼻炎舌下特异性免疫治疗的近期疗效观察

目的　观察舌下特异性免疫治疗（sublingual immunotherapy,SLIT）应用于治疗儿童变应性鼻炎的近期临床疗效。方法　采用前后自身对照,比较44例3～13岁尘螨过敏的变应性鼻炎患者治疗前及治疗3、6个月的症状评分、药物评分、视觉模拟量表（visual analogue scale,VAS）评分及血液嗜酸性粒细胞（eosinophil,Eos）水平,评价SLIT的近期临床疗效。结果　SLIT治疗3个月和6个月后,患者的鼻部症状评分、药物评分及VAS评分较治疗前显著下降,差异有统计学意义（P 均<0.05）;SLIT治疗3个月 与治疗6个月相比,患者鼻塞、流涕、喷嚏症状评分,鼻部总症状评分、药物评分及VAS评分相似,差异无统计学意义（P 均>0.05）,而鼻痒症状评分差异具统计学意义 （Z =-4.185,P <0.05）;SLIT治疗6个月与治疗前相比,血液Eos水平显著下降,差异具有统计学意义（Z=-4.544,P<0.05）。结论　舌下含服标准化粉尘螨滴剂是治疗尘螨变应性鼻炎儿童患者的一种安全有效的治疗方法,可在治疗3个月左右观察到疗效,SLIT治疗6个月后患者Eos百分比显著降低。     

Speech perception in noise: Masking and unmasking

Speech perception is essential for daily communication.Background noise or concurrent talkers,on the other hand,can make it challenging for listeners to track the target speech(i.e.,cocktail party problem).The present study reviews and compares existing findings on speech perception and unmasking in cocktail party listening environments in English and Mandarin Chinese.The review starts with an introduction section followed by related concepts of auditory masking.The next two sections review factors that release speech perception from masking in English and Mandarin Chinese,respectively.The last section presents an overall summary of the findings with comparisons between the two languages.Future research directions with respect to the difference in literature on the reviewed topic between the two languages are also discussed.     

北京地区中小学生常见吸入性变应原的调查分析

目的　了解北京地区中小学生中常见吸入性变应原的种类分布情况。方法　在北京地区参加调查的学生中,对其中1280名学生进行皮肤点刺试验,495名变应原阳性。结果　北京地区中小学生中有49.3%的人对4种及4种以上变应原呈阳性反应,对常年组和夏秋季花粉变应原均呈阳性的最为常见（37.4%）;城区中常见的前3位变应原为粉尘螨、屋尘螨、大籽嵩花粉;郊区为粉尘螨、柳树、大籽嵩花粉;按性别及年龄分组中,粉尘螨、屋尘螨、大籽嵩花粉为最常见的三类变应原,随年龄增长,阳性率降低。结论螨虫及夏秋季花粉是北京地区中小学生中最重要的变应原。     

"肾虚"对老龄豚鼠听觉功能影响的实验研究

目的研究“肾虚”对老龄豚鼠听觉器官形态及功能的影响。方法29只26月龄豚鼠，经ABR检测分为听阈异常的耳聋组和听阈正常的正常老龄组。正常老龄组又随机分为老龄组和造模组。造模组豚鼠制备“肾虚”模型。另取3月龄豚鼠8只作为正常对照组。比较各组豚鼠ABR反应阈、各波潜伏期以及耳蜗外毛细胞数量及“肾虚”相关指标差异，分析老龄豚鼠听功能变化与“肾虚”之间的关系。结果反映“肾虚”状态的各项检测值及“肾虚”总评分显示，造模组的“肾虚”最重，耳聋组其次，老龄组与3月龄组豚鼠在“肾虚”程度上差异无统计学意义。造模组听阈明显提高，ABR各波潜伏期延长，外毛细胞缺失明显（P〈0.01）。结论豚鼠在衰老过程中发生的听觉功能退化与“肾虚”状态有一定的相关性，“肾虚”状态加重时，听觉功能的退化也呈现相应的趋势。     

过敏性疾病免疫治疗国际共识（2015）解读

自2 0 世纪初期特异性过敏原免疫治疗（allergen-specific immunotherapy,ASIT）就已被用来治疗过敏性疾病。尽管大量的临床试验和Meta分析证明ASIT的有效性,但是ASIT仍然得不到广泛的应用。ASIT是唯一能够改变过敏性疾病自然病程的治疗措施,表现在能够预防哮喘的发生和新的过敏原致敏以及诱导机体对特异性过敏原的免疫耐受。因此,制定一个详细广泛的ASIT共识是非常重要的。本文通过对ASIT国际共识的解读,为临床医师采用免疫治疗过敏性疾病提供帮助。     

Exclusive endoscopic transcanal approach to lateral skull base lesions: Institutional experience of 3 cases

Introduction:Majority of petrous bone and lateral skull base pathologies are benign in nature.The complex anatomy usually warrants an extensive approach with associated morbidity.Case summary:Two cases of petrous bone cholesteatoma(1 congenital cholesteatoma with facial palsy and 1 acquired cholesteatoma)and a case of glomus tympanicum were treated with exclusive endoscopic transcanal approach.The cases of petrous cholesteatoma were addressed with trans-promontorial and infra-cochlear approaches.The mean operative time was approximately 140 min.No CSF otorrhoea was noticed in the post-operative period.The average period of hospital stay was 3.7 days.Conclusion:In the subset of cases with limited benign disease an endoscopic trans-canal approach is a better alternative to an external approach.It decreases operative time,blood loss,chance of meningitis,morbidity and hospital stay.The lack of depth perception is a major hurdle which can be come over by experience in endoscopic middle ear surgery.This approach can create direct access to cochlea/petrous apex/internal auditory canal(IAC)/Supra-geniculate ganglion region.     

中耳炎基础及临床研究诊治新进展国家继续教育项目通知

西安交通大学医学院第二附属医院(西北医院)耳鼻咽喉科头颈外科病院、陕西省康复学会听力康复委员会及西安交通大学医学院人体解剖与组织胚胎学系联合主办的第十期国家级继续医学教育项目中耳炎基础及临床研究诊治新进展[No:2011-07-01-114(国)]将于2011年7月26～31日在西安市举办。学习班     

小儿人工耳蜗植入术后调试结果的变化特点

目的 探讨人工耳蜗植入小儿开机一个月调试结果 的变化特点,为其编程调试提供指导和依据.方法 受试对象为使用澳大利亚Cochlear Nucleus 24型人工耳蜗系统的31例儿童.术后一个月起行系列的人工耳蜗编程调试,在调试中运用小儿行为测听法获得阈值(threshold level,TL)、舒适阈(comfortable level,CL)等参数,并将开机及开机后一个月所获得的数据进行比较分析.结果 开机与开机一个月时相比,TL降低而CL升高,其中高频段电极通道的TL下降幅度较低频段电极通道更大,而低频段电极通道的CL增高幅度较高频段大(P＜0.001).各次调试获得的TL及CL结果 均显示高频段通道的电流水平高而低频段通道的电流水平低(P＜0.001).开机时低频段动态范围(dynamic ranges,DR)最大,而开机一个月后高频段DR最大(P＜0.001).开机一个月后高、中、低3个频段电极通道的DR均较开机时大,其中高频段的DR改变较低频段更明显(P＜0.001).结论 人工耳蜗植入小儿开机后的一个月期间,其编程调试结果 变化显著,有必要对患儿进行多次调试.     

Expression of COX-2 and transcription factor CCAAT enhancer binding proteinβin refractory sinusitis with nasal polyps and its significance

Objective To study the expression and significance of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps,and to explore the relationship between them and the recurrence of sinusitis with nasal polyps.Methods The protein expression of COX-2 and C/EBP-βin 20 cases of refractory sinusitis with nasal polyps,20 cases of sinusitis with nasal polyps and 20 cases of normal nasal mucosa were detected by western blot,and the relationship between the two was compared.Results The expression levels of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps were significantly different from those in refractory sinusitis with nasal polyps(P<0.05);The expression levels of COX-2 and C/EBP-βin sinusitis tissues with nasal polyps were significantly different from those in normal nasal mucosa tissues(P<0.05);The expression levels of COX-2 and C/EBP-βin each group were significantly correlated(P<0.05).Conclusions The high expression of COX-2 and C/EBP-βmay be closely related to postoperative recurrence of sinusitis patients with nasal polyps.Both may be used as objective indicators to judge the postoperative follow-up and recurrence tendency of patients with sinusitis with nasal polyps..     

Management of cancer of the base of tongue

The management of base of tongue cancer has evolved steadily over time. Organ preservation with primary radiation therapy has produced excellent oncologic and functional outcomes. Concomitant chemotherapy has become important in patients with locoregionally advanced disease. Planned neck dissection after organ preservation therapy continues to be an integral step for regional control. This article reports the results of a literature review of base of tongue cancer emphasizing a multidisciplinary approach to obtain optimal results in terms of cure and quality of life.     

耳廓开放性外伤的治疗方法探析

目的 探讨耳廓开放性外伤的治疗方法。方法 23耳耳廓开放性外伤经彻底清创，肝素生理盐水冲洗伤口后，对位缝合。术后用抗生素抗感染、丹参扩张血管、罂粟碱改善微循环。结果 23耳中2耳失访，18耳完全成活，1耳部分成活，2耳完全坏死。结论 耳廓撕裂伤、断伤、带有皮蒂的耳廓离断伤，由于断端双侧血管丰富，经对位缝合后容易成活。但耳廓完全离断伤由于缺乏血供，经对位缝合后不易成活，可采用去皮血管植入包埋法，带肌蒂皮瓣移植法或尝试显微外科技术施行血管吻合，以提高耳廓完全离断伤的成活率。