Quantification of hearing loss in patients with posterior semicircular canal dehiscence

Conclusion: Patients with posterior semicircular canal dehiscence (PSCD) have low frequency conductive hearing loss similar to patients with superior semicircular canal dehiscence (SSCD) secondary to a pathologic third window. Objectives: PSCD can result in conductive hearing loss, but the magnitude of this hearing loss remains to be quantified. Patients with SSCD have been shown to have low frequency conductive hearing loss. The underlying pathophysiology of hearing loss from PSCD and SSCD is similar and related to a pathologic third window. Method: A PubMed search was completed for a meta-analysis of patients with PSCD. Articles with quality audiograms were obtained. Air conduction thresholds for ears with posterior semicircular canal dehiscence were compared to the opposite ear as well as normal control data. Results: Eight articles with 21 patients with PSCD and quality audiograms were included. Two patients had bilateral PSCD and one of those was excluded because hearing thresholds were at the limit of the audiometer. Patients with posterior semicircular canal dehiscence have statistically significant lower air conduction thresholds in frequencies at and below 2000 Hz.     

声频共振辅助治疗突发性耳聋的临床观察

目的探讨声频共振辅助治疗突发性耳聋中的效果。方法我科住院治疗的突发性耳聋患者136例,随机分为两组,每组68例。对照组采用常规药物治疗及心理护理;治疗组在对照组治疗基础上加用患耳声频共振治疗。治疗1、2 w后评定疗效。结果治疗1 w后,治疗组总有效率73.8%,对照组总有效率66.2%,治疗组疗效优于对照组,差异有统计学意义(p<0.05);治疗2 w后,治疗组总有效率92.6%,对照组总有效率80.9%,治疗组疗效优于对照组,差异有统计学意义(p<0.05)。结论声频共振治疗的应用可提高突发性耳聋的治疗效果,总有效率有明显提高。     

北京市西山3家煤矿井下作业工人听力损伤情况调查

目的了解北京市西山煤矿噪声危害和在职职工听力损伤情况。方法调查3家煤矿数个工作面噪声强度,对在岗工人进行煤尘和噪声作业的职业健康检查,收集数据进行统计分析。结果煤矿井下作业条件差,检测噪声作业点56个,超标率为51.79%;检测井下作业人员10 200人,听力损伤发生率为12.75%;煤矿噪声聋检出较多的年龄组为20-30岁,工龄为5-10 a,并有随年龄和工龄延长发病率增加的趋势。结论该3家煤矿井下作业噪声危害严重,工人听力损伤发生率高,应综合防治。     

武汉市某钢铁公司冷轧和条材厂噪声作业工人听力检查结果

目的分析不同工龄、性别与噪声作业工人听力损伤的关系,为钢铁企业开展噪声危害控制提供参考依据。方法根据GBZ188—2006噪声作业工人健康检查规范,对武汉市某钢铁厂1697名噪声作业工人听力检查结果进行分析。结果不同暴露工龄组听力损伤发生率的差异有统计学意义（X^2=175．69,P〈0．01）;随着噪声暴露时间的增加,作业人员语频、高频损伤发生率的变化总体呈现递增趋势,且随工龄增长,听力损伤的轻、中、重程度发生率也出现逐渐增加趋势。不同性别人员的听力损伤情况差异有统计学意义（X^2=30．879,P〈0．01）。结论噪声作业人员听力损失的发生率及严重程度与工龄有关,且存在性别差异。     

Outcome of rail fixator system in reconstructing bone gap

Background:

Bone loss following open fracture or infected gap nonunion is a difficult situation to manage. There are many modes of treatment such as bone grafting, vascularized bone grafting and bone transport by illizarov and monolateral fixator. We evaluated the outcome of rail fixator treatment in reconstructing bone and limb function. We felt that due to problems such as heavy apparatus, persistent pain, deformity of joints and discomfort caused by an Ilizarov ring fixator, rail fixator is a good alternative to treat bone gaps.

Materials and Methods:

20 patients (17 males and 3 females with mean age 30.5 years) who suffered bone loss due to open fracture and chronic osteomyelitis leading to infected gap nonunion. Ten patients suffered an open fracture (Gustilo type II and type III) and 10 patients suffered bone gap following excision of necrotic bone after infected nonunion. There were 19 cases of tibia and one case of humerus. All patients were treated with debridement and stabilization of fracture with a rail fixator. Further treatment involved reconstructing bone defect by corticotomy at an appropriate level and distraction by rail fixator.

Result:

We achieved union in all cases. The average bone gap reconstructed was 7.72 cm (range 3.5-15.5 cm) in 9 months (range 6-14 months). Normal range of motion in nearby joint was achieved in 80% cases. We had excellent to good limb function in 85% of cases as per the association for the study and application of the method of ilizarov scoring system[ASAMI] score.

Conclusion:

All patients well tolerated rail fixator with good functional results and gap reconstruction. Easy application of rail fixator and comfortable distraction procedure suggest rail fixator a good alternative for gap reconstruction of limbs.     

输血对老年股骨粗隆间骨折隐性失血的影响

目的探讨输血治疗是否是老年股骨粗隆间骨折围手术期隐性失血量的影响因素,并为是否需要输血治疗提供参考。方法回顾性分析2009年3月至2012年10月期间接受股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)内固定手术的176例老年股骨粗隆间骨折患者的临床相关资料,依据是否接受输血治疗将患者分为输血组(56例)及未输血组(120例),对两组患者术前、术后血常规指标以及根据Gross线性方程计算得到的总失血量、隐性失血量进行分析,比较输血治疗对隐性失血量的影响。结果输血组平均隐性失血量为353.0 mL,占平均总失血量比例为83.1%,未输血组患者平均隐性失血量为427.0 mL,占总失血量比例为84.6%。两组平均隐性失血量相比,有统计学意义(P0.05),平均隐性失血量占总失血量比例,两组比较无统计学意义(P0.05)。结论输血治疗能减少围手术期隐性失血量,但并不能降低老年粗隆间骨折的隐性失血量占总失血量的比例,术后应根据红细胞压积(hematocrit,Hct)及血红蛋白量(hemoglobin,Hb)的变化,合理选择输血治疗,减少并发症的产生。     

Wagner SL 翻修型股骨柄在人工髋关节翻修术中的疗效分析简

目的探讨采用WagnerSL翻修型股骨柄在人工髋关节翻修中的方法及疗效。方法自2006年3月至2012年3月,采用Wagner自锁式无骨水泥固定型翻修股骨柄对31例患者（共31髋）行人工髋关节翻修术。其中男性16例,女性15例;年龄41～75岁,平均63．2岁。髋关节翻修术距离初次人工全髋置换的时间是1—20年,平均65．3个月。翻修原因：无菌性假体松动25例,髋关节假体周围感染6例,均为第一次翻修。结果31例均获得了随访,随访时间为0．5—6年,平均为2．7年。患者手术后切口均为I期愈合,无下肢深静脉血栓及坐骨神经损伤等并发症出现。在随访期间没有出现假体松动和感染,假体周围可以看到明显骨长入。有9例患者出现了不同程度的假体下沉,但均无明显的髋部疼痛症状,因此未做特殊处理。末次随访时,Harris评分由（36．24±8．27）分提高到（83．78±4．92）分,MedeD’Aubigne评分由（2．54士5．38）提高到（13．42士3．26）分,VAS疼痛评分由（7．32士0．72）分减低到（1．26±0．61）分,与手术前比较差异具有统计学意义（P〈0．05）。结论使用WagnerS“L”型翻修股骨柄进行人工髋关节翻修术后,近期疗效满意,能明显地缓解疼痛,改善了髋关节的功能。     

自体脂肪颗粒加毛囊干细胞移植在脱发治疗中的应用

目的:观察自体脂肪颗粒加毛囊干细胞移植治疗脱发的疗效。方法:自体脂肪颗粒分离纯化后,加毛囊干细胞第一代培养细胞,对头顶脱发部位进行注射治疗。结果:36例患者,经过多次注射干细胞移植,均获得了明显改善,可见新生头发,效果满意,没有出现特殊并发症。结论:对于大面积脱发患者,应用自体脂肪颗粒加毛囊干细胞移植是一种安全、有效的方法,值得临床推广应用。     

地塞米松麻黄素混合液滴鼻预防高压氧治疗突发性聋继发的中耳气压伤

目的探讨地塞米松麻黄素混合液滴鼻预防高压氧治疗突发性聋继发中耳气压伤的应用价值。方法回顾性分析2016年1月~2019年12月确诊为突发性聋并接受高压氧治疗的368例(392耳)患者的临床资料,其中190例(204耳)为观察组,高压氧治疗前给予地塞米松麻黄素混合液滴鼻联合山楂、陈皮咀嚼;178例(188耳)为对照组,治疗前不给予地塞米松麻黄素滴鼻,比较两组患者治疗效果、继发中耳气压伤情况。结果治疗后两组纯音听阈均较治疗前改善,差异有统计学意义(均为P<0.05),但观察组与对照组间总有效率(分别为91.18%和88.30%)差异无统计学意义(P>0.05)。两组共38例(42耳)发生中耳气压伤,观察组中耳气压伤发生率(6.8%,14/204)和损伤程度均低于对照组(14.8%,28/188),差异有统计学意义(P<0.05)。38例继发中耳气伤病例中,32例(84.21%,32/38)存在鼻腔鼻咽部或/和咽后壁不同程度病变(下鼻甲肥大、鼻息肉、鼻咽部淋巴组织增生等),28例(73.68%,28/38)(30耳)有中耳功能异常(鼓室导抗图As型8耳,Ad型6耳,B型6耳,C型10耳)。结论地塞米松麻黄素混合液滴鼻联合山楂陈皮咀嚼可有效降低突发性聋患者高压氧治疗继发中耳气压伤的发生率及损伤程度。     

3~5岁听障与健听儿童情感语调发音的声学特征研究

目的探讨3~5岁听障儿童情感语调发音的声学特征。方法选取3~5岁17例(3岁8例,4岁4例,5岁5例)佩戴助听器(hearing aid,HA)儿童(HA组)、51例(3岁19例,4岁17例,5岁15例)人工耳蜗植入(cochlear implant,CI)儿童(CI组)以及32例(3岁10例,4岁9例,5岁13例)健听(normal hearing,NH)儿童(NH组),以自编6个语义中性的高兴和难过情感语调测试语料分别检测各组两种情感语调的平均基频(F0)、基频标准差(F0 SD)、基频范围(F0 range)、平均强度(intensity)、强度标准差(intensity,SD)、强度范围(intensity range)及时长(duration),比较三组儿童情感语调的声学特征。结果三组儿童高兴和难过语调发音的平均基频、平均强度和时长差异无统计学意义(P>0.05);相比难过语调,NH组儿童高兴语调的基频标准差和基频范围更大,而HA组和CI组儿童的强度标准差和强度范围更大,与NH组儿童差异有统计学意义(P<0.05);各项声学指标值在不同年龄儿童间差异均无统计学意义(P>0.05)。结论在情感语调发音中健听儿童主要利用更多的频率变化来改变语调,而佩戴助听器和人工耳蜗植入儿童则倾向于用更多的强度变化来表达情感;听障儿童在情感语调发音中展示了对韵律线索的利用能力。