大力推广新生儿听力筛查加快发展听力语言康复事业——写在第十二次全国"爱耳日"之际

2010年12月24日,中国残联、卫生部等十五个部委联合下发了<关于开展第十二次全国"爱耳日"活动的通知>将2011年全国"爱耳日"活动的主题确定为"康复从发现开始--大力推广新生儿听力筛查"[1],这一主题与当前全国听力语言康复工作所面临的形势密切相关.我国听力语言康复事业经历"十一五"期间的快速发展正跨入"十二五"的开局之年处在新的历史起点上.     

农村地区听力残疾儿童康复服务体系及保障体系建设研究

目的 了解农村地区0～6岁儿童听力残疾发生及康复状况,探索0～6岁听力残疾儿童康复服务体系与保障体系的建设途径.方法 ①对潜山县0～6岁儿童进行听力筛查;②培训安庆市及潜山县听力语言康复专业人员;③建立市、县、乡三级听力筛查网络和各级康复机构;④制定出台康复救助政策和相关管理制度.结果 对19342名儿童进行了听力筛查,确诊听力残疾儿童32名,听力残疾现患率为1.65‰;对32名听力残疾儿童实施康复干预;建立了该地区0～6岁听力残疾儿童筛查-干预-康复一体化服务机制;建立了农村地区听力、康复、远程家庭康复服务体系;培养了听力语言康复专业队伍;推动当地政府出台了0～6岁听力残疾儿童保障制度.结论 农村地区听力残疾儿童康复状况堪忧,需要政府和社会加大关注、支持力度,需要因地制宜建立听力残疾儿童康复服务体系和保障体系.     

我国儿童言语测听的现状与发展

我国听力损失儿童数量众多,调查资料显示先天性极重度听力障碍患儿发病率约为1‰~1.36‰,每年新增约2万余名极重度先天性听力障碍患儿.随着各种人工听觉技术的蓬勃发展,国家对听障儿童康复的救助力度不断增强,尤其是十二五计划<残疾儿童康复救助"七彩梦行动计划"实施方案>的发布[1],使得更多听障儿童可以免费获得人工耳蜗及助听器的救助.随之而来的问题是,如何有效地测查听障儿童的言语感知与交流能力的发展,目前中文儿童言语测听尚未在临床普及,康复成效的评估工具有待完善,这些都成为制约此项工作开展的薄弱环节,需要尽快建立我国听障儿童的听觉、言语、语言能力的评估体系,为临床和科研提供实用、严谨的数据,为政府决策提供坚实的学术依据.     

我国听力障碍儿童康复救助策略

据第2次全国残疾人抽样调查显示,我国有0～6岁听力残疾儿童13.7万人,每年新增2.3万人[1]。中国政府高度重视听力障碍儿童康复工作,20世纪80年代以来连续制订、实施了5个与全国残疾人事业5年发展规划相配套的听力语言康复工作方案,帮助30余万听力障碍儿童获得不同程度康复,极大的改变了听力障碍儿童的康复状况,推动我国听力障碍儿童康复事业实现了历史性跨越:     

携手重建听的希望——写在第十一次全国“爱耳日”之际

今年3月3日是第十一次全国“爱耳日”。中国残联、卫生部、教育部、民政部等十五个部委下发文件将今年“爱耳日”宣传教育活动的主题确定为“人工耳蜗——重建听的希望”。这一主题充分适应我国听力残疾人,特别是听力残疾儿童康复需求的变化,听力语言康复科学技术的进步以及听力语言康复工作的实际需要,有很强的现实性、针对性。     

潜山县0～6岁儿童听力残疾现况调查

目的开展潜山县0～6岁儿童听力普查,了解潜山县0～6岁儿童听力残疾发生及康复情况,为在农村地区规范开展听力语言康复工作奠定基础。方法依据第二次全国残疾人抽样调查标准,采用主观、客观测听方法对调查对象进行听力筛查和诊断,采用问卷调查方法了解确诊对象的康复状况。结果筛查儿童19 342名,确诊听力残疾儿童32例,潜山县0～6岁儿童听力残疾现患率为1.65‰,55.17%的听力残疾儿童未接受康复干预。结论农村地区听力残疾预防与康复工作亟待加强。     

北京市0-6岁听力残疾儿童康复需求分析

目的了解北京市0—6岁听力残疾儿童的康复需求状况及其影响因素。方法按照《2004年北京市0—6岁儿童残疾抽样调查》实施方案，筛查0—6岁儿童28709人，筛查阳性108人，最终确诊听力残疾26例，对确诊者进行相关问卷调查。结果北京市2004年0—6岁儿童听力残疾现残率为1．04‰。调查对象中有50．0％已经配戴助听器；50．0％的学龄前听力残疾儿童接受学前教育，其中26．9％的儿童在康复机构进行康复，仍有42．3％的听力残疾儿童没有接受任何形式的治疗或康复。未使用助听器的原因是认为不必要、认为听力损失不严重、经济困难等。未配戴助听器的儿童家庭支付能力分析：未配戴助听器儿童家庭人均月收入≤1000元的有42．9％；7．7％一级聋儿家庭人均月收入≤1000元。结论北京市大多数听力残疾儿童家庭对于助听器有一定的支付能力，但经济情况是影响康复服务的因素之一，对于低收入家庭，应给予一定的优惠政策。同时，应该开发研制价格相对低廉．声学特性良好的助听器，提高听力康复辅具的普及性和利用率。     

中国听力语言康复事业征集统一标志(LOGO)

为了更好地宣传我国听力语言康复事业,体现事业规范性、统一性的特点,进一步增强公众对我国听力语言康复事业的了解和认识,现征集中国听力语言康复事业统一标志(LOGO)。征集时间:2008年5月1日至2008年9月30日     

"听力重建启聪行动"人工耳蜗捐赠项目执行效果分析

1 前言 "听力重建启聪行动"项目是由台塑集团王永庆董事长向中国残疾人福利基金会直接捐赠人工耳蜗,由中国残联委托中国聋儿康复研究中心负责组织,由卫生部协助选定手术医院,各级地方残联、27家定点医院、81所定点聋儿康复机构参与执行的救助重度听障儿童的公益项目.     

中国残联孙先德副理事长出席“聆听和谐”培训项目签字仪式

2009年5月14日，中国残联孙先德副理事长赴中国聋儿康复研究中心参加“聆听和谐”全国听力语言康复专业人员培训项目签字仪式，亲切会见了丹麦驻华使馆官员和丹麦奥迪康公司主要负责人。“聆听和谐”全国听力语言康复专业人员培训项目是中国聋儿康复研究中心和丹麦奥迪康公司合作开展的面向基层听力语言康复专业人员的培训项目。由中国聋儿康复研究中心负责组织实施。奥迪康公司将用6年时间出资120万元人民币，为基层培养约300名助听器验配师和听力语言康复教师。     

New design of a tracheostomy-cricothyroidostomy tube

In an attempt to minimize late airway stenosis, a new tube with an oval cross-section has been developed. Two to three tracheal cartilage arches are usually incised anteriorly, partially excised or inadvertently broken to fit a tracheostomy tube. The risk of post-tracheostomy stenosis seems to be greater when several cartilages have been involved. If an oval tube with the shortest diameter in its symmetry plane is used, the tissue defect along the longitudinal axis of the trachea will be shorter than that caused by a round tube. When such a stoma is healing, the adjacent intact tracheal cartilages, which are located fairly close to each other, will support the bridging scar tissue, thereby preventing collapse of the tracheal wall. The tubes come in three lengths to fit most neck sizes. An oval trial tube with the same length as the shortest one has been used for cricothyroidostomy--the aim being to spread the cricoid and thyroid cartilages apart as little as possible. A series of 23 patients were treated with this tube. At follow-up, no stenosis was found at flexible fiberoptic laryngo-tracheoscopy. Fifteen patients reported no voice change, and five, who were singers, experienced lower pitch, but four of them were still singing. None of these five patients had speech problems. The other three patients had voice problems when speaking. One of these had chronic bronchitis and another had had a stroke. The third one had a rough voice. The voice problems were milder than those reported from previous series.     

Perilymphatic fistula: a New Hampshire experience

Thirty-five patients with perilymphatic fistulas (PLFs) are presented. Of this group of 35 patients (39 ears), 4 patients did not have fistulas that could be observed with certainty but were presumed to have fistulas by virtue of their excellent response to surgical repair. Our case reports provide examples of the great variety and possible classifications of presentations and symptom complexes that lead one to suspect the diagnosis of perilymphatic fistula. Comments on diagnostic and therapeutic modalities and on postoperative care and counseling are included. The age range of patients in our series is 3 to 67 years. Four patients are under age 20, and an additional three patients probably developed their symptoms prior to age 20 but presented later. Twenty-three (79%) of 29 patients with spontaneous PLFs began having symptoms closely related to some event involving physical or mechanical stress, and a high percentage (76%) had symptoms aggravated by physical stress. Six are believed to have fistulas of congenital origin. There is a sibling pair and a mother and son in the series; these four people had bilateral fistulas.     

Sniffin'Sticks: a New Olfactory Test Battery

The olfactory test battery ?Sniffin'Sticks^®? comprises a perception threshold test, an odour discrimination test and an odour identification test. The purpose of this study was to examine the suitability of the Sniffin'Sticks^® for use in everyday practice and to obtain (at least provisional) normal values. Thirty normosmic and 15 anosmic volunteers were examined with the Sniffin'Sticks^® and the ?University of Pennsylvania Smell Identification Test? (UPSIT^®). All three Sniffin'Sticks^® tests distinguish between normosmics and anosmics in a highly significant manner. The good correlation of the individual tests with each other and with the results of the UPSIT^® documents the reliability of the test results. Critical mention must be made of the overly complex determination of the olfactory threshold. In conclusion, the Sniffin'Sticks^® test battery provides a validated instrument adapted to European conditions for the examination of olfactory disorders. It has proven successful in everyday clinical practice and constitutes a major aid for compiling medical certificates.     

Case report of a congenital lingual leiomyomatous hamartoma: New epidemiologic findings and a review of the literature

We present an unusual case of a lingual leiomyomatous hamartoma, along with a current literature review of this previously under reported lesion. Described is a case of a 5 month-old male presenting with a posterior midline tongue mass and surgical excision yielded pathology consistent with a leiomyomatous hamartoma. A comprehensive literature review revealed thirty-nine cases of leiomyomatous hamartomas, a number much greater than previously reported. We conclude that these rare lesions are notably twice as common as previously reported and have equal gender predilection.     

New guidelines for endoscopic localization of the anterior ethmoidal artery: a cadaveric study

OBJECTIVES: To determine objective data to improve the methods of identification of the anterior ethmoidal artery during endoscopic dissection. STUDY DESIGN: Cadaveric dissection of adult human heads. METHODS: A 0 degrees, 4-mm rigid endoscope was used to guide uncinectomy and frontoethmoidectomy. The location of the anterior ethmoidal artery was first determined visually and then confirmed by passing a needle through the anterior ethmoidal foramen from the orbit into the nose in all cases. The distances were endoscopically measured using a simple ruler between two nasal landmarks and the anterior ethmoidal artery. RESULTS: Fifty-six nasal fossae in 28 cadavers were dissected endoscopically. The median distance between the artery and the "axilla" formed by the anterior attachment of the middle turbinate to the lateral nasal wall was 20 mm (range, 17-25 mm), irrespective of the side. The measurement differed by less than 2 mm between the sides in the same individual. The median distance between the artery and the "axilla" formed by the medial and lateral crura of the lower lateral cartilage (superomedial edge of the nostril) was 62 mm (range, 55-75 mm) for both sides. The artery was found to be in direct alignment with the two "axillae" formed by the middle turbinate and the nostril edge. CONCLUSIONS: The distance between the ethmoidal artery and the axilla of the middle turbinate showed the least intraindividual and interindividual variations. The tip of the endoscope (or the ruler) points directly at the anterior ethmoidal artery in the fovea ethmoidalis when its edge is aligned with the two nasal landmarks. These simple guidelines can aid the identification of the artery in endoscopic frontoethmoidectomy.     

一个中国耳聋近亲婚配家系TMIE基因致病性新突变

目的对一个有近亲婚配史的常染色体隐性遗传性聋家系进行遗传学分析,明确其病因,为该家系的遗传咨询提供依据。方法首先,收集该家系成员的临床资料及外周血血样;其次,运用耳聋基因芯片对先证者进行167个已知耳聋基因检测;最后,对检出的致病变异在家系中进行Sanger测序验证。结果该家系先证者及其父亲为极重度感音神经性聋患者,均存在TMIE基因c.458_462delAAGGA纯合变异,母亲为c.458_462delAAGGA杂合变异。家系内该变异与耳聋表型共分离,此变异经查阅文献和数据库未见致病性报道。结论 TMIE基因c.458_462delAAGGA纯合变异为该家系耳聋患者的致聋遗传因素,并通过本研究首次明确了此变异为致病性变异。