中耳术后迟发性面瘫的临床观察

文中回顾性分析了我科１年来收治９例（１０耳）中耳炎术后迟发性面瘫的病因、治疗及转归。术后均采用激素、能量合剂及理疗等综合治疗，观察了面瘫均发生于术后的第１周左右，全部病例均在３周左右完全恢复，且没有任何后遗症发生。由此可见，慢性中耳炎术后迟发性面瘫的发生可能为非神经损伤性、局限性反应性水肿所致     

Long-Term Middle Ear Ventilation

Successful long-term middle ear ventilation was established in 12 patients with chronic eustachian tube hypofunction that had failed to respond to repeated myringotomy and tympanotomy tube insertions by conventional techniques. The 12 patients (13 ears) had insertion of an untrimmed large flange “Per-Lee” type tube through a posterior-inferior tympanomeatal flap approach. The flange extended under the long process of the malleus, and into the hypotympanum and middle ear opening of the eustachian tube. The stem of the tube was brought out through the inferior central pars tensa. All tubes have remained in place for more than three years without serious complications providing adequate middle ear ventilation and preventing adherence of the tympanic membrane to the promontory.     

Middle Ear Promontory Osteoma

Osteomas are benign lesions of the lamellar bone that within the temporal region are common in the external ear canal. Osteomas of the middle ear are extremely rare and until now there are only 14 reported cases. They usually present with conductive hearing loss while others are asymptomatic and diagnosed incidentally.     

中耳力学研究与耳微创外科技术

中耳力学研究一直是鼓室成形术的热点。从声学水平认识中耳传声机制是耳显微外科技术提高听力的基础。耳微创外科技术理念引导下的耳显微外科技术结合中耳力学研究理论必将推动鼓室成形技术发展,进而提高鼓室成形后听力效果。     

人工中耳的实验研究

采用２０只耳廓反射阳性的健康豚鼠，将左侧耳蜗破坏。用短声、短纯音诱发豚鼠听性脑干电位，在不同声强刺激下，分别测试右耳听力正常时、取出砧骨造成传导性聋时及植入钕铁硼（Ｎｄ－Ｆｅ－Ｂ）人工中耳时波ＩＩＩ的振幅、潜伏期、阈值及频率反应特性。结果听力正常时的阈值平均为１４．７４±４．１２ｄＢｎＨＬ，在传导性聋时阈值平均为５７．００±８．６４ｄＢｎＨＬ，当植入Ｎｄ－Ｆｅ－Ｂ人工中耳后阈值平均为１６．２５±８．５６ｄＢｎＨＬ，并且频率反应较宽，其范围在０．５～４．０ｋＨｚ，基本覆盖整个语言频率范围，符合人耳听觉特征。６只豚鼠植入２个月后耳蜗形态学观察除２耳人为造成感音神经性聋见外指细胞、内柱细胞和外毛细胞有轻度改变外，其它实验耳均未见病理性变化。     

Post-Operative Evaluation of Middle Ear Surgery

The authors present a method for the post-operative evaluation of middle ear surgery. They suggest that such a framework should be worked out in greater detail by specialised international societies, so that, as a final result, an international, standardised method for data recording, processing and reporting would be established.     

Lymphotoxin in Human Middle Ear Cholesteatoma

The progressive growth of epidermis appears to be a crucial factor in the pathogenesis of cholesteatoma. How this growth is encouraged is still not well understood. In the present study, lymphotoxin was found in human middle ear cholesteatoma tissues by the immunoperoxidase method using rabbit anti-human lymphotoxin immunoglobulin G (IgG). Lymphotoxin was localized in the epithelium and connective tissues of the cholesteatomas studied. The epithelium of normal external ear canal skin was lightly stained, but the stain was much weaker than that of the cholesteatomas. In vitro, recombinant human lymphotoxin stimulated proliferation, protein synthesis, and terminal differentiation of basal keratinocytes. These findings suggest that lymphotoxin may be one of the mediators involved in the development of cholesteatoma.     

先天性中耳胆脂瘤1例

先天性胆脂瘤又称表皮样囊肿或珍珠瘤,是一种源于皮肤外胚层的先天性肿瘤,为胚胎早期神经沟封闭时,皮肤外胚层的剩件残留发展而成.按其部位,可分为颅外型和颅内型.颅外型的可以发生在中耳和乳突,因其发病隐匿,易被误诊,延误治疗.目前国内外有关先天性中耳胆脂瘤的文献不多见,本文就收治的1例先天性中耳胆脂瘤报告如下.     

Epidemiology and Aetiology of Middle Ear Cholesteatoma

A total of 500 patients with cholesteatoma diagnosed and operated during 1982-91 in the region of Tampere University Hospital and Mikkeli Central Hospital in Finland were analysed retrospectively. The mean annual incidence was 9.2 per 100,000 inhabitants (range 3.7-13.9) and during the study period the annual incidence decreased significantly. The incidence was higher among males under the age of 50 years. There was no accumulation of cholesteatoma diseases in lower social groups. The majority (72.4%) of cholesteatoma patients had suffered from otitis media episodes. Tympanostomy was carried out in 10.2% and adenoidectomy or adenotonsillectomy in 15.9% of all cholesteatoma ears prior to cholesteatoma surgery. Cholesteatoma behind an intact tympanic membrane with no history of otitis media was verified in 0.6% of patients and in cleft palate patients in 8%. In this study, 13.2% of patients had ear trauma or ear operation in anamnes.