颞骨气房与前庭小管的发育

为探索颞骨岩部气化程度与美尼尔氏病病因的关系,作者应用病理解剖时采取的人的颞骨116个,测量颞骨发育程度和前庭小管颅后窝开口部大小。取Schüller氏位拍X线片。按照后藤等人的分类法将X线片上的颞骨岩部气房的发育程度分为6级,即气房从岩部前、后面的岩样三     

日本人镫骨的组织学研究

耳硬化症在白种人中极为多见,但日本人很少见。欧美对颞骨,特别是在鼓室及听小骨的形态学有许多研究。日本在近几年才有耳硬化症病例的散在报告,但是颞骨形态学的研究还为数不多。本文对日本人镫骨前庭窗有否硬化现象进行组织学观察。材料来自29具日本人尸体,采取43侧颞骨,年龄为新生儿至74岁,男性21例32侧,女性8例11侧,以圆筒状取骨法切取颞骨,20％福尔马林固定,经三氯醋酸脱钙后火棉胶包埋,水平断面切片,制成20～30μm标本,除HE染色外,行PAS、Van Gieson及Masson等染色,用光学显微镜观察。结果与讨论:镫骨底板的基本构造是由内     

豚鼠颞骨火棉胶制片技术

豚鼠颞骨火棉胶制片技术耿惠丁大连火棉胶切片术适用于颞骨病理、内耳胚胎发育及需要同时观察中耳、内耳及其邻近器官病理性变化的实验研究，但制片程序繁杂、费时。我们对制片技术进行了改良，报道如下。一、材料与方法将１０只豚鼠麻醉后断头，背侧取听泡，迅速浸入１０...     

开放性乳突手术后颞骨的组织病理学

为寻求更满意的乳突手术方法,以便减少复发和保存听力,作者对曾行开放性乳突手术的颞骨组织病理学进行了研究。材料来自麻省眼耳医院,在1000余颞骨中,取非恶性病变曾行乳突手术的20个。按Schuknecht法行水平切片,每片厚200μm,每个颞骨做48张切片,行苏木精和曙红染色。20个颞骨中3耳因耳源性颅内并发症术后20天死亡,17耳中12耳为慢性炎症(7耳胆脂     

颞骨骨化纤维瘤

目的：探讨颞骨骨化纤维瘤的诊断和治疗，提高对该病的认识。方法：报道1例颞骨骨化纤维瘤男性患儿，取耳后沟外切口，暴露瘤体，彻底切除肿瘤组织，封闭外耳道残端，取自体腹壁脂肪填塞术腔；术后定期随诊。结果：术后病理证实为颞骨骨化纤维瘤，术后随访1年无复发，外耳道内端封闭完好。结论：颞骨骨化纤维瘤临床罕见，虽为良性肿瘤，但可压迫和侵袭邻近重要组织和器官，引起功能障碍和颅内感染,一旦确诊，应尽早完整切除。     

美尼尔氏病患者颞骨内淋巴管和内淋巴囊的病理组织学研究

取美尼尔氏病患者积水侧颞骨和正常对照组颞骨各25块,对照组标本与美尼尔氏病颞骨大小相似,全部材料均借内面观描摹翻造法或在光镜下作组织学观察。多数迷路积水颞骨的内淋巴管和内淋巴囊,在峡部内淋巴管宽度缩小,内淋巴囊萎陷,腔面积增加,囊周围疏松结缔组织出现纤维性变以及萎陷腔嗜伊红物质增多。上述病理所见,在病变组和对照组之间有显著性差异。有关上皮细胞、内淋巴囊皱褶程度或囊周结缔组织黑素样色素沉着等在光镜下观察则无统计学差异。本文研究显示以下四项指标具有统计学意义。(1)在突发性内淋巴积水颞骨中,内淋巴囊于前庭小管的萎陷囊腔面积大于对照组(P<     

蜗导水管、圆窗膜、圆窗龛和面神经隐窝的解剖学测量

作者们以大量的颞骨标本对蜗导水管、圆窗膜、圆窗龛和面神经隐窝做了组织学的精确测量,并按年龄进行了分析。测量的方法是把颞骨标本固定,脱钙,并包埋于火棉胶中,做成20μ厚的切片,在连续切片中,每隔10张取一张用苏木精和曙红染色后镜下观察。除有病变的部位外均进行精确测量。结果如下:(1)549块颞骨测量了蜗导水管直径(取小管中部直径),平均值为197μ,其范围为40～600μ;一岁以下平     

豚鼠高脂血症内耳实验性研究

作者们用豚鼠实验研究高脂血症的内耳病理生理变化。取豚鼠40只,投与含胆固醇50%、胆汁0.5%、牛脂肪15%的固体饲料。30天后,开胸从左心室取血用作血清生物化学分析,其后断头取颞骨,制片在光镜和电镜下检查。在实验过程中,观察其一般状态和听力变化,豚鼠表现有体重减轻、全身脱毛,40只中有21只死亡;食     

重视颞骨恶性肿瘤的规范化诊疗

目前我国对颞骨恶性肿瘤未有足够的重视,一方面是因为颞骨恶性肿瘤发病率低且临床表现常无特异性所致的诊疗难度大,更重要的原因是尚未形成规范化的诊疗方案。本文总结了颞骨恶性肿瘤的诸多特点,包括肿瘤生长特点、临床表现、肿瘤分期等,并从诊断和治疗这两方面对颞骨肿瘤进行规范,以期提高业内对颞骨肿瘤规范化诊疗的重视,达到促进颞骨肿瘤诊疗水平的发展及提高患者生存率和生活质量的目的。     

颞骨切除后的重建

颞骨切除后软组织缺损的重建可从简单的外耳道缝合到复杂皮瓣整复大面积组织缺损。该文报道１９８７～１９９６年中３４例因肿瘤侵犯颞骨而行侧颅底切除及其重建术的经验。手术操作分为：袖套式切除术、颞骨侧切除术、颞骨次全切除术,未行全颞骨切除术。结果：７例病人行袖套式切除术／或乳突根治术,袖套式切除术后可采用鼓室成形术、外耳道重建术或外耳道封闭术进行修复;２４例病人行颞骨侧切除术,４例行颞骨次全切除术,由颞骨侧切除或颞骨次全切除术所产生的大面积缺损需要通过颞肌瓣和局部旋转皮瓣联合修复（１３例）,低位岛状斜方…     

实时荧光定量Taqman探针法检测线粒体基因1555 A》G突变

目的 建立以实时荧光定量Taqman探针技术检测线粒体DNA 1555A>G突变的方法,实现更快速、简便、准确筛查这一突变的目标.方法 设计针对线粒体DNA 1555A>G突变的Taqman探针和引物,摸索建立稳定的检测方法,同时进行可靠性验证.从解放军总医院聋病分子诊断中心耳聋DNA库选取标本132例,遵循双盲法原则,分别以实时荧光定量Taqman普通探针法、试剂盒法和直接测序法检测线粒体DNA 1555A>G突变,将三种方法 检测的结果 进行比对.结果 132例耳聋病例经实时荧光定量Taqman普通探针法检测发现线粒体DNA 1555A>G突变阳性患者32例,阴性100例,与试剂盒法和直接测序法检测结果 完全相符,未发现假阳性和假阴性.结论 实时荧光定量Taqman探针技术检测线粒体DNA 1555A>G突变的方法 具有检测结果 准确直观、简单省时(反应时间由原来的最快6 h缩短到1.5 h),特异性强,敏感性高的优点,适用于对母系遗传性耳聋线粒体DNA 1555A>G突变的大规模筛查或氨基糖甙类抗生素应用前预防性检测.     

Microvascular anastomosis using histoacryl glue and an intravascular soluble stent

OBJECTIVE: The purpose of this study was to assess a new technique for microvascular anastomosis on small arteries using Histoacryl glue and an intravascular soluble stent. METHODS: Sprague-Dawley rats were randomly assigned to either of two experimental groups or one control group. The first author (DL, a postgraduate year 4 resident) performed 12 end-to-end anastomoses on rat carotid arteries (1-mm vessel) (group A) using the experimental technique with Histoacryl glue and an intravascular stent. Thirteen microsuture carotid anastomoses performed by the senior author (DD), an experienced microsurgeon, served as control (group C). Permeability was assessed at 1 week for half of the animals and at 6 weeks for the others. Pathologic examination was done on both groups. To evaluate the influence of vessel size on the experimental technique, eight end-to-end anastomoses on rat abdominal aorta (2 mm) (group B) were also done by the first author. Permeability was assessed at 24 to 48 hours for this group. RESULT: In the experimental groups (A and B), two predictable failures (both in group A) were observed. Median anastomosis times were 11 minutes and 7 minutes, respectively. The control group had no failure and a median time of 17 minutes. Pathologic examination revealed more inflammation in group A than in group C. Coagulative necrosis of the arterial wall was observed exclusively in group A. CONCLUSION: This new technique is easy to learn and readily accessible to less experienced microsurgeons. The technique is fast and efficient. The calibre of the vessel has a great influence on ease and speed of the technique. However, histotoxicity of Histoacryl glue was observed. This technique can be valuable for free-tissue transfer in head and neck reconstruction. A less toxic glue would be useful.     

兔蜗神经直接动作电位的特征

目的　探讨新西兰大白兔蜗神经直接动作电位 (directcochlearnerveactionpotential,DCNAP)的记录方法和特征 ,建立术中听觉监护动物模型。方法　纯种新西兰大白兔 6只 (12耳 ) ,乙状窦后进路暴露小脑、脑干及双侧桥脑小脑角区 ,插入针状电极于蜗神经 ,记录DCNAP ,并按常规方法记录听性脑干反应 (auditorybrainstemresponse ,ABR)。结果　用本方法记录的DCNAP具有振幅大、波形稳定、重复性好、记录时间短的特点 ,但个体差异较大。结论　在蜗神经桥脑小脑角区用针状电极可以可靠记录到DCNAP ,是术中听觉监护的可行方法     

Percutaneous tracheostomy in a head and neck unit.

A recent innovation in the technique of tracheostomy is now available as a commercial kit. A standard tracheostomy tube is inserted using a guidewire and dilator as in the Seldinger technique. The kit was used in nine cases in a unit with a head and neck oncology interest. Two failures were experienced but no serious or fatal complications. The technique is limited when applied to necks which are not anatomically 'ideal', and hence will have application in head and neck surgery only after careful patient selection.     

Resection of endobronchial tumors using a tracheoscope and neodymium:YAG laser.

A modified technique for palliative resections of malignant endobronchial tumors with the Nd:YAG laser is described. A special tracheoscope was used in conjunction with the instrument guide of a laser bronchoscope. The main advantage of this technique is easy and simultaneous access to both lungs for ventilation and surgical procedures. The method helps to separate surgical from anesthetic manipulations. The experience of over 70 operations using this technique provides evidence that the use of a tracheoscope is a safe and efficient method of endoscopic resections of larger intrabronchial tumors.     

The role of nasal cavity disinfection in the bacteriology of chronic sinusitis

OBJECTIVES: Several factors may influence the results of bacteriological studies in chronic rhinosinusitis. We investigated the potential role of nasal cavity disinfection in the bacteriology of the bulla ethmoidalis in patients suffering from chronic sinusitis. MATERIAL AND METHODS: Bacteriology of the bulla ethmoidalis was studied in 176 consecutive adult patients presenting a chronic sinusitis refractory to standard medical treatment who underwent functional endoscopic sinus surgery. Two different techniques were used: (A) a technique with nasal vestibule and facial disinfection with chlorhexedin (N = 89 patients and 165 samples) vs. (B) a technique with facial, nasal vestibule and nasal cavity disinfection with a povidone-iodine solution followed by a cleansing of the nasal cavity (N = 87 patients and 166 samples). RESULTS: Culture rate was 89.6% (183 bacterial isolates) for technique (A) vs 76.5% (164 bacterial isolates) for technique (B) (p < 0.001). Major bacteria encountered in the (A) group and in the (B) group were respectively: Coagulase Negative Staphylococcus: 77 vs 40 isolates (p < 0.001); Coagulase positive Staphylococcus: 44 vs 30 isolates (p = 0.061); Streptococcus pneumoniae: 4 vs 5 isolates; Others: Streptococcus sp.: 12 vs 16 isolates; Haemophilus influenzae: 8 vs 6 isolates; Enterobacteriacea: 33 vs 53 isolates (p = 0.013) and others Gram Negative Bacilli: 3 vs 7 isolates. CONCLUSIONS: The standard (A) technique to study the bacteriology of the bulla ethmoidalis in patients with chronic sinusitis yielded a higher percentage of positive culture and of bacterial isolates than a more advanced (B) technique. This is mainly due to the higher percentage of contaminant bacteria such as Coagulase Negative Staphylococcus recovered with the standard technique. Enterobacteriacea and others Gram Negative Bacilli were more often encountered into the bulla ethmoidalis with the technique where disinfection of the nasal cavity was performed.     

Tracheal stoma reconstruction

A simple surgical technique prevents or corrects tracheostoma stenosis. Forty-eight (96%) of patients undergoing laryngectomy in whom this technique was used have maintained adequate stomal size for cleaning, ventilation, and tracheoesophageal fistula speech restoration.     

Middle turbinate medialization technique in functional endoscopic sinus surgery

The middle turbinate is an important surgical landmark in functional endoscopic sinus surgery (FESS). Postoperatively, lateralization may obstruct the middle meatus, thereby increasing the risk of complications and recurrences. A new medialization technique using metallic clips between the head of the middle turbinate and the septum is described. The aim of this study is to evaluate the clip medialization technique applied in 56 cases of bilateral FESS. We think that this simple technique, with its low rate of complications, is an adequate and simple procedure for middle turbinate medialization. A good and accessible middle meatus was observed in 54 patients.     

Linear versus non-linear recordings of transiently-evoked otoacoustic emissions--methodological considerations

A non-linear technique is predominantly used for the recording of transiently-evoked otoacoustic emissions (TEOAEs). The aim of this study was to compare linear and non-linear TEOAE recordings. TEOAEs were recorded in 22 normal hearing subjects to clicks from 90 to 30 dB SPL in 10 dB steps with the ILO88 system using both linear and non-linear recording techniques. The non-linear recording technique reduces stimulus artifacts for early latencies, but total elimination could not be proved. Both artifact reduction and significant differences between the two kinds of TEOAE recordings were reduced for longer latencies and lower stimulus intensities. For longer latencies (>10 ms) there was no significant difference between "linear" and "non-linear" TEOAEs. A higher signal-to-noise ratio was found for "linear" TEOAEs, resulting in better identification and a higher test-retest correlation. The linear recording technique, which includes new methods of artifact cancellation in comparison to the mainly utilized non-linear recording technique, should be used especially in hearing screening.     

The antrum exclusion technique in cholesteatoma surgery.

A new surgical technique for the treatment of cholesteatoma is reported. The technique involves auto-exclusion for exteriorization of the attic and tympanic box only. The resulting cavity is rather small. The technique allows visual post-operative control of the attic and tympanic membrane. There is no visual access to the mastoid cavity which, however, is the most unlikely site for occurrence of a residual cholesteatoma. The proposed technique was applied to 102 patients and both the anatomic and functional results obtained are reported.