10例人工耳蜗植入儿童术后听觉、言语及学习能力发展研究

目的探讨1～7岁听障儿童植入人工耳蜗后听觉言语康复进展情况。方法在标准声场对10例儿童进行人工耳蜗术后声场听阈测试。利用听障儿童听觉言语康复评估词表在开机后3．6．9、12个月分别进行听觉言语康复评估。采用希-内学习能力测试或格蕾费斯儿童精神发育测试量表进行学习能力评估。结果随着术后康复时间的增加,10名儿童的听觉、言语、学习能力评估成绩逐步提高,提高速度和幅度存在个体差异。结论人工耳蜗植入有助于重度、极重度听障儿童的听力语言康复。术后儿童听觉言语的发展受年龄、智力、耳聋病因及术前助听器配戴情况等因素的影响。     

不同听觉补偿方式下听障儿童的听觉言语康复效果比较

目的比较选配助听器与人工耳蜗植入术后听障儿童的听觉言语康复效果,探讨不同听觉补偿方式对其听觉言语康复效果的影响。方法选取32例6~43月龄选配助听器或人工耳蜗植入后的重度及极重度感音神经性语前聋患儿为研究对象,其中助听器组18名,人工耳蜗组14名,两组的听力损失程度无统计学差异,均在干预1年内进行相同的听觉言语康复训练,使用声场测听测试助听听阈;使用婴幼儿有意义听觉整合量表评估干预前及干预后3、6、9、12个月时的听觉能力;采用《听障儿童听觉言语能力评估》测试两组康复训练前后的言语能力。结果两组患儿助听听阈均优于助听前,但人工耳蜗组各频率助听听阈显著优于助听器组(P<0.05);两组听觉能力得分均随听觉补偿时间的延长而提高(P<0.05);助听器组在干预后9个月的听觉能力得分明显高于干预前、干预3个月及干预6个月(P<0.05);人工耳蜗组在术后6个月的听觉能力得分高于术前及术后3个月(P<0.05);人工耳蜗组在干预后6、9、12个月的听觉能力得分均高于助听器组(P<0.05);两组助听后康复级别及言语年龄均高于助听前,人工耳蜗组康复级别及言语年龄均高于助听器组(P<0.05)。结论对于极重度以上感音神经性聋婴幼儿,人工耳蜗植入者听觉言语康复效果优于助听器选配者。     

9月龄婴儿人工耳蜗植入1例

目前,人工耳蜗植入是能使重度、极重度感音性聋患者获得听力重建的唯一有效方法。越来越多的研究表明,早期人工耳蜗植入能使先天性极重度感音性聋患者获得更好的听力言语康复效果。1岁以内患儿人工耳蜗植入在国内尚未见报道,我科最近诊治1例9月龄先天性重度感音性聋患儿,并行人工耳蜗植入,现报道如下。     

语前聋患儿一侧人工耳蜗对侧助听器效果分析

目的:通过对人工耳蜗植入对侧耳不同听力损失的患儿联合使用助听器与人工耳蜗语前聋患儿的听觉、语言及学习能力进行评估和比较,探索对患儿更为有效的助听方法,帮助患儿获得最大限度的言语交流。方法:将30例3～6岁语前聋患儿按照植入人工耳蜗对侧耳听力损失程度及是否佩戴助听器,分为一侧人工耳蜗+对侧重度听力损失助听器组(CI+SHA组)、一侧人工耳蜗+对侧极重度听力损失助听器组(CI+PHA组)、单耳人工耳蜗组(CI组)。评估各组在康复3、6、9、12、15、18个月时听觉、语言及学习能力,并记录结果。结果:随着术后康复时间的延长,聋儿听觉、语言及学习能力逐渐提高(P<0.05),CI+SHA组听觉能力优于CI+PHA组及CI组(均P<0.05),语言能力及学习能力无明显差异(P>0.05)。结论:语前聋患儿单耳人工耳蜗植入后,若对侧耳尚有残余听力,佩戴助听器后听觉能力效果显著,长期佩戴有助于患儿的康复。     

成人人工耳蜗植入临床资料分析

人工耳蜗植入（cochlear implantation,CI）给重度、极重度听力损失患者带来了福音,患者通过行CI可以实现听力重建。而术后通过对阶段性听觉言语康复的效果进行评定,可以观察CI疗效及言语康复效果。 1耳蜗成人组的临床验证     

50例听障儿童人工耳蜗植入的康复效果分析

目的 探讨听障儿童单侧人后工耳蜗植入的康复效果及听觉语言发展规律.方法 测试50例听障患儿人工耳蜗植入术前、术后3个月和1年的助听听阈、听觉能力及语言能力,分析人工耳蜗植入前后对声音感知、言语识别及语言发展的情况.结果 50例患儿术前、术后3个月和1年的平均助听听阈分别为73.70±10.02、42.48±10.99、...     

内耳畸形人工耳蜗植入术后听力言语康复效果分析

目的：使用听觉和言语问卷分级及术后产生听觉的最小电流值（T值）的方法,评估并比较内耳畸形与正常解剖结构语前聋患儿人工耳蜗植入术后的听觉言语康复效果。方法：按术前影像学检查将语前聋人工耳蜗植入患儿分为正常结构组和内耳畸形组,并配对组合,对思儿家长进行问卷形式调查随访,对术后听力及言语康复效果进行评估分析,记录术后1年凋机T值。用秩和检验比较2组听觉行为分级标准（CAP）、言语可懂度分级标准（SIR）结果及T值。结果：人工耳蜗植入患儿家长术前主要担心术后效果不理想及手术并发症的发生,多数认为听力言语康复训练应由医疗机构进行;秩和检验显示：2组CAP及SIR均无显著差异,术后1年调机时产生听觉的T值无显著差异。结论：①内耳畸形患儿人工耳蜗植入术后,经正规康复训练,听力言语康复效果与内耳解剖结构正常植入者相同,人工耳蜗植入术可帮助伴耳蜗畸形的极重度感音神经性聋患者重建听力,重返主流社会;②听力言语康复训练尚有很多方面需要改进。     

人工耳蜗植入术后听力及言语康复效果相关因素的初步研究

目的 通过对55例人工耳蜗植入患儿的听力及言语能力进行评估,分析各种可能因素在人工耳蜗植入术后听力及言语康复过程中的作用。方法 通过问卷调查的方式对人工耳蜗植入患者的各项可能影响因素进行统计,并根据听觉行为分级标准（CAP）和言语可懂度分级标准（SIR）对患儿的听力及言语能力进行评估。使用卡方检验对影响术后康复效果的相关因素进行单因素分析;最后将从单因素分析中筛选出来的听觉及言语康复效果的影响因素进行logistic回归分析。结果 logistic回归结果显示植入后时间及家庭经济状况与CAP显著相关,植入后时间、居住地、术后康复模式与SIR显著相关。结论 人工耳蜗植入术后时间、经济因素是影响人工耳蜗植入术后患儿康复效果的重要因素。     

人工耳蜗及相关技术的进展

人工耳蜗植入(cochlear implantation, CI)是重度-极重度感音神经性聋患者的听觉和言语康复的主要方法, 随着人们对听觉系统和中枢可塑性的深入研究,手术技术及辅助工具的开发,以及人工耳蜗植入相关电子科技和材料科学的发展,人工耳蜗及相关技术有了很大的进步。本文分析人工耳蜗植入体,尤其是电极设计和言语处理器的升级、人工耳蜗植入适应证的拓宽、术前评估手段的完善及精准微创人工耳蜗植入和残余听力保留的开展,并对人工耳蜗植入相关技术进行展望。     

脑白质异常聋儿人工耳蜗植入后效果初步分析

目的探讨对脑白质异常的重度感音神经性聋患儿,人工耳蜗植入手术的可行性及听力言语康复效果分析。方法自2012年1月至2014年12月行人工耳蜗植入术的120例(120耳)重度感音神经性聋患儿中,有脑白质异常的患儿15例。随机抽取15例脑白质无异常的聋儿作为对照组,比较两组患儿植入人工耳蜗后手术效果、开机调试结果及听力言语康复效果。结果 130例(30耳)电极全部植入耳蜗内;2所有患者术后无脑膜炎、面瘫、脑脊液漏等并发症;3所有脑白质异常患儿在人工耳蜗植入术后都有听觉;4脑白质异常儿童术后平均听阈与对照组无明显区别;5随访6至24月后,脑白质异常患儿的听觉行为分级标准(categories of auditory performance,CAP)和言语可懂度分级标准(speech intelligibility rating,SIR)与对照组比较,差异均无显著性意义(P>0.05)。结论经过严格术前评估后,人工耳蜗植入可应用于脑白质异常伴重度感音神经性聋的患儿,其术后效果与脑白质无异常的聋儿植入效果基本一致,术后的听力言语康复效果无明显差异。     

HPV and head and neck cancer

Head and neck cancer is frequent worldwide and oropharyngeal locations are presently sharply on the increase, in relation with an increasing incidence of oropharyngeal infection by oncogenic type-16 human papillomavirus (HPV). The clinical and biologic profile of these patients is distinct from that of other oropharyngeal carcinoma patients, with earlier onset, cystic cervical nodes and basaloid carcinoma histopathology. Detection of intratumoral viral DNA is essential to confirm the role of HPV, and E6/E7 mRNA expression is the most relevant indicator for stratification. Several methods can reveal intratumoral oncogenic HPV DNA, but PCR with hybridization is the most sensitive and most widely used. According to several reports, prognosis in terms of survival and locoregional control is better in HPV-positive oropharyngeal carcinoma than in oropharyngeal carcinoma associated with smoking and alcohol consumption. The future lies in vaccination, but further studies will determine whether the rate of oropharyngeal carcinoma falls in women vaccinated against cervical cancer.     

Papillomavirus and head and neck cancer

Tobacco and alcohol consumption are the main risk factors for head and neck cancers. Papillomavirus (HPV) infection was recently associated with the development of malignant tumors of the oropharynx, according to molecular and biological arguments. We describe the oncogenic mechanisms of HPV infections, the epidemiological and clinical aspects of associated head and neck cancers, their prognosis, and issues of specific therapeutic strategies.     

紫杉醇与头颈部肿瘤

为了解紫杉醇治疗鼻咽癌、喉癌及其他头颈部肿瘤的疗效及作用机理，本文分析了近年来的文献27篇。紫杉醇通过稳定微管、阻断细胞的有丝分裂和增殖，从而显著地抑制肿瘤细胞的生长并促进细胞调亡，在头颈部肿瘤同期放化疗中能起到放疗增敏作用，单独或联合其他抗癌药物治疗亦有较佳的疗效。紫杉酵是一种具有良好抗癌活性的药物，随着研究的深入，将会在头颈部肿瘤的治疗中发挥更大的作用。     

Aging and olfactory and taste function

This article focuses on the change in olfaction and taste with aging. It discusses histopathology with an emphasis on age-related changes, causes of chemosensory dysfunction in the elderly, how to evaluate a patient with dysfunction, useful tests and imaging, clinical consequences of chemosensory impairments, and available treatment options.     

Nutrition and taste and smell dysfunction

Food selection plays a pivotal role in maintaining adequate nutrient intake, thus elucidating drivers of food choice is a meaningful strategy to maintain health and manage disease. Taste and smell are key determinants of food choice and warrant careful consideration. In this review, we first discuss how sensory stimulation influences food selection and metabolism. We then review the evidence regarding the relationship between taste and smell dysfunction and food preferences and selection, with attention given to contexts of certain chronic diseases. We conclude with brief recommendations for the management of chemosensory disorders. While sensory abilities influence food selection, the effect of taste and smell dysfunction on long-term consumption patterns and health status must be considered in light of environment, exposure, and culture.     

Pepsin and Laryngeal and Hypopharyngeal Carcinomas

Laryngeal and hypopharyngeal carcinomas are common malignant tumors of the head and neck, and the incidence of both is increasing. Laryngopharyngeal reflux refers to the retrograde flow of gastric contents into the larynx, oropharynx, and/or nasopharynx. It remains controversial whether laryngopharyngeal reflux is a risk factor for laryngeal and hypopharyngeal cancers. The refluxing substances mainly include hydrochloric acid, pepsin, and occasionally bile acids and bile salts, as well as bacteria that colonize the gastrointestinal tract. Loss of epithelium in the mucous membrane of the larynx and hypopharynx is thought to be caused by pepsin. Here, we review the relationships between laryngopharyngeal reflux and both laryngeal and hypopharyngeal carcinomas, as well as the significance of pepsin, methods of clinical detection, and the mechanism of carcinogenesis.