眼缺血综合征与缺血性脑卒中相关性研究进展

眼与脑的大血管和微血管之间存在密切的解剖学关联和许多相似的生理特征。眼缺血综合征(OIS)是颈动脉狭窄相关的眼缺血性疾病,缺血性脑卒中是最具代表性的缺血性脑血管病。研究发现OIS相关征象对缺血性脑卒中有一定的预警作用,缺血性脑卒中可继发多种眼部缺血性改变。对OIS和缺血性脑卒中发病机制、临床症状和体征以及治疗之间相关性的研究进展进行综述,以促进多学科合作,优化临床诊疗策略。     

Sinusitis and ischemic stroke.

Acute sinusitis is a prevalent and generally uncomplicated infection that is normally resolved by medical therapy. However, severe neurological complications are known, and comprise of cerebral abscess, cavernous sinus thrombosis, meningitis, and epidural or subdural empyema. We report a case about a 10-year-old girl with a severe acute pansinusitis and ischemic stroke in the right lentiform nucleus and the anterior part of the right internal capsule. Possible explanations for this rare combination are discussed.     

Prognostic value of hearing function in ischemic stroke

The study of 70 patients with acute ischemic stroke has demonstrated that ischemic stroke is associated with central hypoacusis the symptoms of which are subjectively weak. It is suggested that development of neurosensory hypoacusis of the III-IV degree may serve a prognostic sign of a poor outcome of acute ischemic attack.     

Audiologic findings in botulism poisoning.

Botulism poisoning results in a presynaptic failure of neuromuscular transmission, and may be expected to impair Eustachian tube and stapedius reflex function. The audiologic findings in five normal-hearing patients with type A botulism poisoning are presented. Results were varied. Two patients demonstrated type B or C tympanograms during the early stages, while three with normal middle ear function demonstrated marked bilateral or unilateral stapedius reflux threshold elevation. One patient had a reversible reflex decay, and the superimposition of a second stimulus upon the first resulted in complete recovery of reflex amplitude. A number of possible pathophysiological mechanisms are discussed.     

Audiologic findings in Pierre Robin sequence

The hearing status of 20 individuals with Pierre Robin Sequence (micrognathia, cleft palate, and glossoptosis leading to respiratory distress and feeding difficulty) was examined and compared to a sample exhibiting only isolated cleft palate. The results indicate that there is no difference in the prevalence or degree of hearing loss in these two groups.     

Audiologic features of Norrie disease

OBJECTIVES: Norrie disease is an X-linked recessive disorder in which patients are born blind and develop sensory hearing loss in adolescence. The hearing loss associated with Norrie disease has been shown in a genetically altered knockout mouse to involve dysfunction of the stria vascularis; most other structures are preserved until the later stages of the disease. The objective of this study was to characterize the audiologic phenotype of Norrie disease for comparison with the pathophysiologic mechanism. METHODS: The design combined two series of clinical audiologic evaluations, with special attention to speech intelligibility. RESULTS: The audiologic results for 12 affected individuals and 10 carriers show that patients with Norrie disease retain high speech intelligibility scores even when the threshold loss is severe. CONCLUSIONS: The cochlear mechanism-- failure of the stria vascularis-- accounts for some of the higher values in the wide distribution of speech scores in cases with similar pure tone audiograms.     

Audiologic evaluation in patients with acquired hypothyroidism

Hearing loss in hypothyroidism has been reported by many authors but its pathophysiology is unclear.Aimsto study the audiological evaluation of patients with acquired hypothyroidism.Materials and Methodstwo groups were included: a hypothyroidism group (HG, n-30), and a control group (CG, n-30). Parameters studied: gender, time of hypothyroidism, comorbidities, cochleovestibular symptoms, biochemistry and hormonal exams (TSH, T4), tonal audiometry, TOAEs and BERA.Resultsall participants were women, 70% of the HG had Hashimoto thyroiditis, 60% of the HG had had the diagnostic of the hypothyroidism for at least five years. Depression and hypertension were frequent in HG. All HG patients had altered TSH values and 50% had diminished T4 values. Sensorineural hearing loss was detected in 22 ears from the HG and in seven from the CG. BERA was normal in the CG and altered in 10 ears from the HG, showing L-V increase. TOAEs were absent in 12 ears from the HG and in four from the CG.ConclusionsHG patients had more cochleovestibular symptoms, higher audiometric thresholds, increase in L-V in the BERA and absence or reduction in TOAEs amplitudes. Such alterations were not associated with THS and free T4 levels.     

Audiologic presentation of cerebellopontine angle cholesteatoma

OBJECTIVE: The aim of this study was to examine the audiologic presentation of patients with cerebellopontine angle (CPA) cholesteatoma. DESIGN: Retrospective case review. SETTING: Neuro-otologic tertiary referral centre. METHODS: The study population consisted of 11 patients with CPA cholesteatomas. The patients underwent a standard audiologic investigation in the preoperative setting, which consisted of pure-tone audiometry, speech audiometry, and auditory brainstem response (ABR). MAIN OUTCOME MEASURES: The audiologic parameters that were analyzed were the pure-tone threshold, pure-tone average (PTA), and speech discrimination scores (SDSs). The morphology and latency of the ABR were evaluated. In addition, the clinical and radiologic presentations of the lesions were reviewed. RESULTS: The mean PTA in the diseased ear was 22.6 dB HL (SD 18.2), whereas in the contralateral ear, it was 19.1 dB HL (SD 19.6). In 4 patients, the hearing loss was asymmetric, with the diseased ear being the worse ear. The mean SDS was 82.28% in the affected ear and 95.28% in the contralateral ear. ABR was abnormal in 9 of 10 cases (90%), with only the affected ear being abnormal in 4 cases. In the other 5 cases, the ABR was bilaterally abnormal. CONCLUSIONS: CPA cholesteatomas are very slow-growing lesions that involve the eighth cranial nerve. The paucity and insidious onset of symptoms mean that the diagnosis is often late, permitting the lesions to reach impressive dimensions at the time of diagnosis. Although magnetic resonance imaging represents the gold standard in the diagnosis of these lesions, ABR proved to be of value in the assessment of the auditory pathway, especially in those patients referred with a vague symptomatology and with normal hearing.     

感音神经性聋患儿的听功能综合评估

目的探讨听力测试组合（ABR＋ASSR＋声场环境中的行为测听）在感音神经性聋患儿残余听力评估中的应用价值。方法48名（96耳）感音神经性聋患儿中能配合纯音测听的患儿19人（38耳）设为PTA组,进行纯音测听及ASSR检测;不能配合纯音测听的患儿29人（58耳）设为BA组,进行声场环境中的行为测听（behavior audiometry,BA）、ABR及ASSR检测。结果①PTA组0．5、1、2、4kHz各频率ASSR反应阈与纯音听阈显著相关（P〈0．01）,各频率相关系数分别为0．75、0．76、0．76、0．83,建立本实验室的ASSR—PTA直线回归方程;②BA组23耳ABR无反应但仍可引出ASSR,而ASSR无反应耳ABR均未能引出;BA组29例患儿中ASSR检测反应较好耳（29耳）在0．5～4kHz四个频率上,ASSR可测得83个反应阈值,行为测听可测得89个反应阈值,综合ASSR和行为测听可以得到96个反应阈值。结论与单项听力测试方法相比,听力测试组合（行为测听＋ABR＋ASSR）能为更小年龄、听力损失更重的患儿进行残余听力的评估,同时能对双侧耳间听力差异、各频率的听力损失程度进行评估,为听力损失病变的定位判断提供参考。     

Audiologic correlates of hearing handicap in the elderly

This investigation was conducted to determine the relationship between self-assessed hearing handicap and audiometric measures in a large sample of noninstitutionalized elderly individuals. Eighty subjects underwent a complete audiological evaluation and responded to the Hearing Measurement Scale (HMS). Each of the correlations between measures of sensitivity and the HMS score was statistically significant. The speech discrimination scores showed a somewhat lower correlation with the HMS score than did pure-tone measures. The implications of the above findings are discussed.     

鼻咽癌早期筛查的研究进展

目的鼻咽癌作为我国南部地区常见的恶性肿瘤,对人类健康及生命带来了极大的危害,鼻咽癌的病理及解剖特性决定了其以放射治疗为主的治疗方法,鼻咽癌的分期与患者的预后密切相关,因此早期干预可以极大地提高患者的远期生存率,而寻找合适的筛查手段对鼻咽癌的早期发现至关重要,基于此,本文对鼻咽癌的早期筛查的研究新进展作一综述。