启聋汤治疗突发性聋疗效观察

目的观察西药配合启聋汤治疗突发性聋的临床疗效。方法将60例(65耳)确诊的突发性聋患者随机分为对照组(30例,31耳)和治疗组(30例,34耳),对照组采用低分子右旋糖酐、三磷酸腺苷、辅酶A及地塞米松治疗,治疗组在使用相同西药治疗基础上加用启聋汤,比较两组的临床疗效。结果治疗组痊愈5耳,显效8耳,有效13耳,无效8耳,有效率76.47%;对照组痊愈2耳,显效6耳,有效11耳,无效12耳,有效率61.29%,两组疗效经卡方检验差异有统计学意义(χ2=4.866,P<0.05)。结论西药配合启聋汤治疗突聋的临床效果优于单纯西药治疗。     

突发性聋的早期治疗及超氧化物歧化酶和丙二醛检测

目的　探讨突发性聋的早期治疗及对治疗前后血清脂质过氧化物酶的代谢产物丙二醛(malonylialdehyde ,MDA)和超氧化物歧化酶 (superoxidedismutase,SOD)的影响。方法　将本院 1995年 7月～ 2 0 0 1年 6月收治的突发性耳聋患者 14 7例 (16 8耳 )分为 3组。第 1组 2 9例 (36耳 )于发病后 6h内诊断并加以治疗 ,第 2组 5 5例 (6 3耳 )为发病在 15日内者 ,第 3组 6 3例 (6 9耳 )为发病 15日以上者。采用高压氧及药物治疗 (尼莫地平等 )。另有 30名健康志愿者做对照组。治疗前后比较纯音听力变化 ,采用硫代巴比妥酸法检测MDA ,采用放射免疫法检测SOD。结果　听力 :第 1组治疗后痊愈 18耳 ,显效 9耳 ,有效 7耳 ,无效 2耳 ;第 2组治疗后痊愈 11耳 ,显效 16耳 ,有效 15耳 ,无效 2 1耳 ;第 3组治疗后痊愈 14耳 ,显效 2 0耳 ,有效 13耳 ,无效 2 2耳。第 1组与第 2组比较差异有非常显著性 (χ2 =9 90 ,P <0 0 1) ,第 1组与第 3组比较差异有非常显著性 (χ2 =9 30 ,P <0 0 1) ,第 2组与第 3组比较差异无显著性 (χ2 =0 0 3,P >0 0 1)。SOD和MDA结果 :各组治疗前与对照组比较、治疗前后比较均为差异有显著性。结论　突发性聋的早期治疗十分必要。尽早应用自由基拮抗剂能有效的起到神经保护作用     

地塞米松鼓室内注射补救治疗突发性聋

目的 观察地塞米松鼓室内注射对经过常规治疗没有痊愈或无效的突发性聋的疗效.方法选择门诊经过常规治疗没有痊愈的突发性聋患者45耳,随机分成2组,实验组21耳,地塞米松经鼓膜穿刺鼓室内注射2毫克/次,2次（一周）一个疗程;对照组24耳,给谷维素及复合维生素B口服,用药一周.观察治疗前后纯音听阈及耳呜、耳闷感的变化情况.结果纯音测听结果显示实验组6耳有效（6/21）,对照组1耳有效（1/24）,两组比较差异有统计学意义（P＜0.05）;耳呜改善实验组有5耳（5/15）,对照组1耳（1/19）,两组比较差异有统计学意义（P＜0.05）;耳闷感改善实验组有3耳（3/11）,对照组1耳（1/13）,两组比较差异无统计学意义（P＞0.05）.结论地塞米松鼓室内注射可以改善常规治疗没有痊愈的突发性聋患者的听力及耳鸣症状.     

血栓通联合长春西汀治疗突发性聋的临床观察

目的对血栓通联合长春西汀治疗突发性聋的疗效进行临床观察。方法92例（114耳）突发性聋患者按就诊顺序分成实验组50例（59耳）和对照组42例（55耳）。实验组血栓通联合长春西汀治虎对照组用复方丹参治疗;两组均常规行激素、能量合剂、高压氧、B族维生素治疗。两组在治疗前和治疗后4d开始每3d用纯音电测听测试患者听力。结果经治疗后,实验组50例（59耳）中痊愈23例（27耳）,显效16例（18耳）,有效6例（7耳）,无效5例（7耳）,治愈率为45．8％,对照组42例（55耳）中痊愈9例（12耳）,显效8例（13耳）,有效15例（15耳）,无效10例（15耳）,治愈率为21．8％,两组统计学处理差异有显著性（K0．05）。结论血栓通联合长春西汀治疗突发性聋能显著提高疗效。     

地塞米松治疗突发性聋

目的对地塞米松(dexamethasone,DM)等综合治疗突发性聋的疗效进行临床观察及探讨一氧化氮(nitricoxide,NO)和谷胱甘肽过氧化物酶(glutat-hioneperoxidase,GSH-px)与突发性聋的关系。方法将本院60例突发性聋患者按就诊顺序随机分为DM治疗组30例(35耳)和非DM治疗组30例(36耳)。DM组采用DM治疗,非DM组采用生理盐水治疗;两组同时采用ATP等其它相同的治疗。30名健康志愿者做对照。两组在治疗前后做纯音测听及检测NO、GSH-px。结果DM组和非DM组治疗前患耳气导平均听阈分别为(70.34±18.02)dBHL和(71.23±17.45)dBHL(t=0.175,P>0.05);治疗后DM组30例中痊愈17例(21耳)、显效8例(8耳)、有效3例(4耳)、无效2例(2耳),治愈率60%;非DM组30例中痊愈6例(6耳)、显效8例(9耳)、有效10例(15耳)、无效6例(6耳),治愈率16.67%。两组经统计学处理差异有显著性(x2=13.49,P<0.01)。NO和GSH-px的检测结果:两组治疗前后比较及治疗前后与对照组比较差异均有显著性,按本实验剂量应用未发现明显副作用。结论DM治疗突发性耳聋的效果肯定,可应用于临床工作。     

突发性聋患者血浆一氧化氮、脂质过氧化酶、丙二醛水平的测定

目的 探讨突发性聋患者体内一氧化氮（NO），超氧化物歧化酶（SOD），谷胱甘肽过氧化物酶（GSH－Px)，丙二醛（MDA）水平的变化及其临床意义。方法 测定30例突发性聋患者和20例正常健康人血浆NO，SOD，GSH－Px,MDA的浓度。结果 与正常对照组相比，突发性聋患者血浆NO，SODH，GSH－Px浓度显著低于正常对照组，而MDA水平显著高于正常对照组（P＜0．01）；不同程度耳聋组之间NO，GHS－Px无显著性差异，而在SOD，MDA之间的差异有显著性。治疗后血浆NO，SOD，GSH－Px的活性明显升高。MDA水平明显降低，与治疗前相比有显著性差异。结论 突发性聋患者体内NO，SOD，GSH－Px含量下降，而MDA水平增高，建议治疗该病可应用NO合成诱导剂和外源性SOD或其他抗氧化剂，以提高突发性聋的治疗效果。     

利多卡因辅助治疗突发性聋的疗效观察

目的观察利多卡因辅助治疗突发性聋的疗效及毒副反应。方法按照就诊顺序随机将60例（72耳）突发性聋患者分为治疗组30例（37耳）及对照组30例（35耳）,两组均应用地塞米松、丹参、ATP、辅酶A、维生素B族及高压氧治疗,治疗组加用2%利多卡因,比较两组疗效。结果治疗组听力损失、眩晕、耳鸣总有效率分别为72.97%、80.00%、73.68%,均高于对照组的54.29%、61.54%、61.11%,差异均有统计学意义（P〈0.05）。结论利多卡因加地塞米松等综合治疗突发性聋疗效较好,无明显毒副作用。     

高压氧治疗突发性聋的再评价

目的　观察突发性聋高压氧 (hyperbaricoxygenation ,HBO)治疗前后血清脂质过氧化物代谢产物丙二醛 (maiondialdehyde ,MDA)和超氧化物歧化酶 (superoxidedismntase ,SOD)的浓度变化及对高压氧治疗效果的影响。方法　 6 0例 79耳突发性聋的患者 ,随机分为综合组 30例 43耳和单纯组 (单纯高压氧组 ) 30例 36耳 ,另有 30名健康志愿者做正常组。治疗前后比较听力变化 ,用硫代巴比妥酸法检测MDA、用放射免疫法检测SOD。结果　 2组治疗后听力比较 ,差异有显著性意义 ( χ2 =6 .48,P<0 .0 5 )。SOD测试 :综合组治疗后与正常组、单纯组比较 ,差异均有非常显著性意义 (前者t=2 3 2 7,P <0 .0 1,后者t =2 7.17,P <0 .0 1) ;综合组治疗前后比较 ,差异有非常显著性意义 (t =2 9.2 7,P <0 .0 1) ;单纯组治疗前后比较 ,差异无显著性意义 (t=1.33,P >0 .0 5 )。MDA测试 :综合组与单纯组治疗后比较 ,差异有非常显著性意义 (t=8.86 ,P <0 .0 1) ;综合组治疗前后比较 ,差异有非常显著性意义 (t=7.2 8,P <0 .0 1) ;综合组治疗后与正常组比较 ,差异无显著性意义 (t=1.2 4,P >0 .0 5 ) ;单纯组治疗后与正常组比较 ,差异有非常显著性意义 (t=7.0 9,P <0 .0 1)。结论　单纯高压氧治疗突发性聋的治愈率极低。     

前期治疗对地塞米松鼓室注射治疗难治性突发性聋的影响

目的观察强的松、舒血宁治疗没有痊愈的突发性聋患者应用地塞米松鼓室内注射后的疗效,以及其疗效是否与前期的不同治疗有关。方法2005年9月-2007年11月门诊突发性聋患者53例（53耳）,分成2组：第一组为激素治疗组（27耳）,第二组为舒血宁治疗组（26耳）。上述治疗后没有痊愈的患者共34耳,给予地塞米松2mg鼓室内注射,一周内注射2次。结果激素治疗组19耳有效（70．4％）,舒血宁治疗组17耳有效（65.4％）,经检验两组疗效没有显著性差异。地塞米松鼓室内注射总有效率38．2％,其中前期激素组7耳有效（41．2％）,前期舒血宁治疗组6耳（35.3％）有效,经检验两组疗效没有显著性差异。结论鼓室内注射地塞米松可以对前期治疗没有痊愈的突发性聋患者有效,疗效与之前是否用激素无关。     

突发性聋合并眩晕的临床观察

目的：探讨突发性聋合并眩晕的治疗方案。方法：对确诊的26例伴有眩晕突发性聋患者,应用扩血管、溶栓、神经营养药物、中医中药及高压氧治疗,并对治疗前后纯音测听结果进行比较。结果：26例病人眩晕症状全部消失,根据突发性聋疗效分级标准,痊愈6例（23．1％）,显效12例（46．2％）,有效4例（15．4％）,总有效率84．6％。结论：突发性聋合并眩晕患者,其病因可能以内耳微循环障碍为主,采用以扩管、扩容、溶栓及中医中药、高压氧等为主的综合治疗措施,是目前较为可靠治疗方法。     

A study on the effect of infrasound

In order to examine the influence of infrasound that is becoming topical in society, human beings and guinea pigs were exposed to infrasound. After exposure, the hearing level, vestibular functions and autonomic nervous functions of human beings were examined, and endocochlear potential (EP) and cochlear microphonics (CM) of guinea pigs were examined. Next, after guinea pigs were exposed to intense audible low frequency sound that was born secondarily from infrasound and/or vibration of whole body concerning about air pressure change of infrasound, their EP and CM were examined. The results obtained were as follows: 1) By exposure of infrasound 10-15Ha 130-135dB LSPL for 30min. to human beings, their hearing level, vestibular functions and autonomic nervous functions were not changed. 2) After exposure of infrasound 15Hz 135-140dB LSPL for 24hrs.-72hrs. to guinea pigs, their EP and CM remained normal. 3) After each exposure of audible low frequency sound 90Hz 120dB SPL for 72hrs., 150Hz 110dB SPL for 72hrs. and 200Hz 100dB SPL for 72hrs. to guinea pigs, their EP became abnormal though their CM remained normal. 4) After exposure of 15Hz 500 mu +/- 30 mu vibration for 72hrs. to guinea pigs, both EP and CM remained normal. 5) After exposure of both audible low frequency sound 150Hz 100dB SPL and vibration 15Hz 500 mu +/- 30 mu for 72hrs. to guinea pigs, their EP became abnormal though their CM remained normal.     

Focus on the effect of orthognathic surgery on condylar remodeling

Condylar remodeling is a physiologic process that aims to adapt the structure of the temporo-mandibular joint (TMJ) to meet the functional demands. It is based on an interaction between the mechanical forces sustained by the TMJ and the adaptative capacities of the condyle. Orthognathic surgery can sometimes be responsible for an excessive physical stress to the articular surfaces. In these cases, normal functional condylar remodelling shifts to the process of progressive condylar resorption. Effect of orthognathic surgery on condylar remodeling is a poorly understood and controversial issue. It is however considered as an etiology of postoperative skeletal relapse following orthognathic surgery. Based on two case reports, etiopathogenic hypotheses of this process are discussed as well as predisposing factors to condylar resorption following orthognathic surgery.     

Glycerol effect on the guinea pig tectorial membrane

Summary The tectorial membrane (Tm) of guinea pigs has been found to have an altered organization of its matrix fibers in response to intravenously administered glycerol. Following treatment, the Tm middle zone shows an increase in waviness and clumping of fibers in nonhydropic and several hydropic ears in contrast to nontreated control ears. Residue of the internal sulcus cells occasionally fills the subtectorial space. In the present study, additional investigations were performed with scanning electron microscopy in order to study the relationship between the Tm and the organ of Corti, as well as the relationship between Hensen's stripe and the inner hair cell. Present findings provide evidence for a connection between the inner hair cell stereocilia and Hensen's stripe which may be the molecular basis for the modulation of hearing during the glycerol test in a patient with Meniere's disease. Correspondence to: A. M. Meyer zum Gottesberge     

The effect of smoking on the olfactory function

Although smoking is a widely spread habit, its effect on olfaction has not been clearly established. The aim of this study was to investigate the effect of cigarette smoking on the olfactory function, using the "Sniffin' Sticks" test. Sixty-five smokers were studied, with a median period of smoking of 10 years (range: 1-45 years) and a median number of 15 cigarettes smoked per day (range: 5-20). Forty-nine non-smokers were used as controls. Olfactory function was evaluated using the "Sniffin' Sticks" test, which consists of odour threshold (OT), odour discrimination (OD) and odour identification (OI) and its overall results may be presented as a composite threshold-discrimination-identification (TDI) score. Multivariate linear and logistic regression analyses were performed. All OT, OD, OI and TDI scores were statistically significantly lower in smokers compared to non-smokers, even when controlled for gender and age. Low OT, OD, OI and TDI scores were more prevalent among smokers than non-smokers. Multivariate logistic regression analysis, adjusted for gender and age, revealed that smoking remained a strong independent risk factor for low OT, OD, OI and TDI scores. Among smokers, statistically significant negative relationships were found between pack-years and OT, OD, OI and TDI, controlling for age. In conclusion, smoking was found to be adversely associated with the olfactory ability in a dose-related manner. Smokers were found to be nearly six times as likely to evidence an olfactory deficit as non smokers, depending on the duration and the amount of cigarettes smoked.