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1.

Purpose

To compare measurements made with four infrared tympanic thermometers (Genius®, Thermopit®, Quickthermo®, and Thermoscan®) with those recorded from thermocouples positioned in the contralateral ear.

Methods

Four tympanic thermometers were evaluated in 50 healthy volunteers (12 female and 38 male). Temperatures were measured, in random order, at the right tympanic membrane four times and the highest temperature was considered to be the true value measured by each thermometer. The control temperature was measured at the left tympanic membrane using Mon-a-Therm® thermocouples.

Results

The tympanic membrane temperature measured by Genius® correlated best with the Mon-a-therm® measurement (T m ) (r = 0.74). The tympanic membrane temperatures measured by Thermopit®, Quickthermo®, and Thermoscan® correlated moderately with T m (r = 0.56, 0.63, and 0.58, respectively). Mean differences between T m and each temperature (T g , T tp , T q , and T ts ) were ?0.3, 0.73, 0.42, and ?0.3°C, respectively. Likewise standard deviations were 0.33, 0.37,0.35, and 0.35.

Conclusion

We conclude that all but the Thermopit® (T tp ) are similarly useful for the management of patients during anaesthesia.  相似文献   

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Hemangioma of the tympanic membrane.   总被引:2,自引:0,他引:2  
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Parotid fistula is most commonly a posttraumatic situation. In posttraumatic cases, spontaneous closure of the fistula is the general rule. Conservative approaches to the occurrence of a parotid fistula are eliminating oral intake by the patient and applying a pressure dressing while maintaining nutrition by the intravenous route. Anticholinergic drugs decrease the production of saliva and thus would appear to be beneficial. When a parotid fistula does not heal under these conditions, then more aggressive treatment is indicated. Treatment should be based on whether the fistula is ductal or glandular in origin. Several methods of treatment have been advocated in the past. Low dose radiotherapy has been mentioned by some authorities as the treatment of choice for parotid fistula. This was used in one of our patients without response. Excision of the fistulous tract with ligation of the parotid duct has been advocated by some authorities. Tympanic neurectomy appears to be a satisfactory method of dealing with selected parotid duct fistulas, and glandular fistulas are best treated by tympanic neurectomy. Suppression of parasympathetic activity by the use of tympanic neurectomy has been said on some occasions to be transient (for example, Frey's syndrome). In dealing with parotid fistulas it would not appear to matter whether the effects are transient or permanent. The suppression of activity by tympanic neurectomy lasts long enough to allow for healing of the fistulous tract and relief of symptoms.  相似文献   

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We have evaluated a new infrared tympanic thermometer, IT-10, as an intraoperative temperature monitor in patients with or without open abdominal surgery. It determines temperature by measuring infrared radiation given off by a warm object. Temperatures measured with this device were closely correlated with those measured with rectal and bladder thermometries. We conclude that this new tympanic thermometer is safe, convenient, accurate, and easily usable in the clinical situation.(Matsukawa T, Kashimoto S, Miyaji T, et al.: A new infrared tympanic thermometer in surgery and anesthesia. J Anesth 7: 33–39, 1993)  相似文献   

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The Genius infrared tympanic thermometer   总被引:1,自引:0,他引:1  
G. EDGE  M. MORGAN 《Anaesthesia》1993,48(7):604-607
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8.
Long-term results of tympanic membrane repair   总被引:5,自引:0,他引:5  
Long-term results of tympanic membrane repair were analyzed in 605 patients operated upon from 1970 to 1975. By survival life table analysis, 81% closure of perforations was found at 11 years, and only 74% of patients had normally healed tympanic membranes. Children less than 10 years of age and with anterior perforations healed more poorly. A second group of patients--all with anterior perforations operated upon from 1982 to 1984-showed autologous temporalis fascia to be superior to homograft dura as the graft material. Analysis of results also showed a 60% chance of perforation closure at revision operation. These results are believed to represent an accurate and realistic assessment of tympanic membrane repair by use of survival life table analysis.  相似文献   

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OBJECTIVE: To review our experience with laser myringoplasty using a potassium-titanyl-phosphate (KTP) laser for pars tensa atelectasis. STUDY DESIGN: Retrospective review. METHODS: A pulsed diode KTP laser (532 nm) was used to tighten the tympanic membrane after lysis of middle ear adhesions through a myringotomy. A tympanostomy tube was then placed. Operative reports and clinic notes were reviewed. RESULTS: We reviewed 34 procedures performed on 31 ears in 29 patients. The average time of follow-up was 10.5 months with a range of 1 to 30 months. Seventeen of 34 tubes (50%) extruded during the follow-up period. Eleven cases had follow-up with the tube extruded and TM intact. Two (18%) of those had progression of atelectasis. Two (6%) cases had operative perforations and both healed spontaneously. CONCLUSION: Laser myringoplasty using a KTP laser for pars tensa atelectasis appears to be beneficial in selected patients. Patients should be followed closely for early tube extrusion and recurrent disease.  相似文献   

13.
Chemical closure of chronic tympanic membrane perforations   总被引:1,自引:0,他引:1  
BACKGROUND: The purposes of closing chronic dry perforations of the tympanic membrane are to improve hearing and prevent middle ear infections. Before the use of the operating microscope and improved instrumentation, tympanic membrane perforations were closed by application of chemicals or with a temporary patch. Today, although surgery is the treatment of choice, small dry perforations may be successfully closed by chemical means in an office setting. METHODS: Twenty-eight of the 69 patients with chronic dry tympanic membrane perforations on the surgical waiting list at Hawke's Bay Regional Hospital, Hastings, New Zealand, underwent attempts at chemical myringoplasty. Two techniques were used: (i) cautery of the rim of the perforation with a silver nitrate bead on a metal probe and (ii) application of a urea ointment patch covering and overlapping the perforation. RESULTS: Eighteen of the 28 patients (64%) treated by chemical means experienced closure of their tympanic membrane perforations. Successful closure was achieved in 26% of the patients on the waiting list during the 6-month period. CONCLUSION: Chemical myringoplasty is not only of historical interest. It is an effective means of tympanic membrane closure in selected patients, thereby reducing the surgical waiting list and saving time and money for the patient, surgeon and hospital.  相似文献   

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PROBLEM: To provide a less expensive and more convenient protocol for the treatment of tympanic membrane perforations (TMPs). METHODS: Several materials were prepared and compared for TMP repair including Carbylan-SX, Gelatin-DTPH-PEGDA (GX), Carbylan-S/Gelatin-DTPH (Carbylan-GSX) (injectable and sponge), Gelfoam, Epifilm, and crosslinked thiolated chondroitin sulfate (CS-DTPH-PEGDA [CS-SX]). Hartley pigmented guinea pigs (Elm Hill) underwent bilateral myringotomy with 1 ear left as a control and the other treated with one of the previously mentioned materials. RESULTS: Carbylan-GSX (injectable and sponge), Gelfoam with saline, and CS-SX had the shortest time for TMP closure. Epifilm, Carbylan, and gelatin preparations resulted in closure rates similar to controls. CS-SX showed a marked inflammatory reaction compared with controls and other materials based on neutrophil, lymphocyte, epitheloid counts, and degree of fibrosis. CONCLUSIONS: This study shows the validity of Carbylan-GSX compared with Gelfoam as a material to promote TMP closure in an acute TMP guinea pig model.  相似文献   

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Shortly after tympanoplasty the cause of conductive hearing loss may be difficult to ascertain. If the cause is related to poor eustachian tube function, early aeration of the middle ear should produce an immediate improvement in hearing. A procedure for aerating the middle ear consists of introducing 0.5 cc of air through the graft with a tuberculin syringe and an angled 1.25-inch, 27-gauge needle. Between 1978 and 1983, 75 patients, or 19% of those having tympanoplasties or mastoid tympanoplasties, underwent the micropuncture procedure. Forty-five patients had a hearing improvement after the procedure and there were no complications. It appears that micropuncture of the tympanic membrane is an easily performed, relatively painless, safe procedure after tympanoplasty. It is a useful diagnostic procedure that may also improve the ultimate results of tympanoplasty surgery.  相似文献   

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BACKGROUND AND OBJECTIVE: To assess the utility of the CO(2) Flashscanner laser for treatment of selected middle ear diseases other than otitis media with effusion (OME) and acute otitis media (AOM). STUDY DESIGN/MATERIALS AND METHODS: A retrospective review of the records of 144 patients treated with the OtoLAM((R)) device, a Flashscanner laser, between July 1, 1998, and February 29, 2000. Patients treated for AOM or OME were excluded. RESULTS: Data are presented on 11 patients (17 ears). Four indications were identified: Elimination of middle ear fluid before auditory brainstem response with or without otoacoustic emission testing (ABR +/- OAE), barotrauma, eustachian tube obstruction, tympanocentesis when a culture of middle ear fluid was deemed necessary. All tympanic membranes (TM) healed. CONCLUSIONS: Fenestration of the TM can be accomplished for both diagnostic and therapeutic purposes. Laser assisted tympanic membrane fenestration seems to be effective in the management of middle ear fluid before ABR +/- OAE, barotrauma, eustachian tube dysfunction, and for tympanocentesis.  相似文献   

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We examined 187 males to evaluate the hypothesis that short-headed persons more often have otitis media than long-headed persons. The subjects were seen as part of routine health screening before attending recreational summer camp. The photographic appearance of each tympanic membrane was judged on two separate occasions by an otolaryngologist who categorized them as "normal", "abnormal", or "cannot determine". The repeatability of the categorizations was fair: kappa = 0.44. Only the tympanic membranes categorized identically twice were used for data analysis. The left-right symmetry of the tympanic membrane categorizations was fair: correlation coefficient phi = 0.42. Subjects categorized as having bilaterally normal tympanic membranes were considered to have not had previous otitis media (N = 95). In contrast, subjects categorized as having at least one abnormal tympanic membrane were considered to have had previous otitis media (N = 13). Head length and width, measured by calipers, and the cephalic index (width divided by length) x 100 were determined for each person. On the average, the cephalic index of the normal subjects was lower than that for the subjects with otitis media (t = 3.06, p less than 0.005). These data support the suggestions of Pautow (1925) and Worley et al. (1987): dolichocephalic persons have otitis media less often than do brachycephalic persons. Though this association is not useful in clinical care of the individual patient, it may be considered a weak external manifestation of the different cranial base and eustachian tube anatomy found in persons with otitis media.  相似文献   

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Body temperature monitoring via the tympanic membrane   总被引:2,自引:0,他引:2  
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