前方穿孔的鼓膜成形术:Kerr瓣的的经验

以47例平均年龄32.5岁(10～70岁)的鼓膜前方或次全穿孔并累及前方鼓环的病人为研究组。耳后径路并取筋膜作移植物。在筋膜前部作二个平行切口以制成一个供牵引的短小突出部,将其置于耳道皮下隧道。并在基底上方增加切口使移植物易固定在槌骨柄的任何一侧。在切除穿孔边缘后,后方形成一个鼓膜耳道瓣和用内衬法使移植物固定。移植物前部小突出部由吸引器和镊子引出,通过隧道显示     

爱迪生的耳聋与留声机的发明

众所周知,托马斯·爱迪生是一位伟大的发明家,他一生总共获得1093项发明专利,是实行专利制度以来获 得个人专利最多的人。他的名言“天才是百分之九十九的勤奋加百分之一的灵感”成为激励人们勤奋努力的座右 铭。可以说,爱迪生的贡献极大地改变了人类生活。在他众多的发明中,爱迪生认为电灯最重要,但他最钟爱的是留     

中耳胆脂瘤的成因的基础研究进展

中耳胆脂瘤发病机理至今尚未十分明确，本文就中耳胆脂瘤溶骨机制，胆脂瘤上皮的增殖与凋亡及其细胞遗传学方面的研究进展进行综述。     

我的心愿是怎样实现的

去年看到广东一位医师撰文反映《中华耳鼻咽喉科杂志》投稿发表难，在上海我也听到不少类似议论。六年以前，我也曾有这样的想法，并且碰过不少壁。特别是有一篇关于新贴片法鼓膜修补研究被退稿，审稿专家在退稿附页上密密麻麻写了一页。我开始时觉得这些意见是鸡蛋里挑骨头，仔细阅读之后，觉得很有道理。审稿老师提出的“类似题目的论文已有发表”和“应进行析因分析”两点意见，说明他对我的文章有深入的了解。自己曾在高级医师进修班学习过析因分析，但在写作时没有准确应用。想到这里，冤气顿消。     

肿瘤来源的外体的研究进展

外体是由一系列细胞分泌的微小囊泡,具有抗原呈递和刺激机体产生免疫应答的作用.负载了抗原的树突状细胞所释放的外体、来源于肿瘤细胞的外体均可引起小鼠的抗肿瘤免疫排斥反应.现对外体的一般特性进行简述,着重介绍肿瘤来源的外体的生物学作用及用于肿瘤免疫治疗的研究进展.     

鼻咽癌的组织细胞与预后的关系

人体的T-淋巴细胞、特异抗体、巨噬细胞和/或组织细胞参与对肿瘤的免疫反应。郎格罕氏细胞为一种特殊类型的组织细胞,见于皮肤,也见于食管上皮、扁桃体、鼻咽上皮和淋巴组织,在皮肤细胞免疫中起重要作用。由于此细胞和T-淋巴细胞关系密切,也位于淋巴组织的T-带中,故也称之为T-带组织细胞(Tzone histiocytes)。在致密浸润型肺癌中已发现郎格罕氏细胞。鼻咽癌中是否也有此细胞?其多少是否和预后有关?为回答上述问题,作者用免疫组织化学方法,用S-100蛋白抗体和溶菌酶抗体对鼻咽癌的T-带组织细胞和巨噬细胞的分布进行了研究,并以正常人作对照。共获得49个鼻咽癌标本,原发肿瘤部位的标本40个,转移淋巴结标本9个。放疗后的病人除     

爱迪生的耳聋与留声机的发明

众所周知,托马斯·爱迪生是一位伟大的发明家,他一生总共获得1093项发明专利,是实行专利制度以来获得个人专利最多的人.他的名言"天才是百分之九十九的勤奋加百分之一的灵感"成为激励人们勤奋努力的座右铭.可以说,爱迪生的贡献极大地改变了人类生活.在他众多的发明中,爱迪生认为电灯最重要,但他最钟爱的是留声机.不过,留声机的发明者一生中大部分时间几乎是一个聋子,恐怕就不是广为人知了.在21世纪的今天,再来探究一下爱迪生的耳聋,应该说是很有意义的.     

小的及内耳道内的听神经瘤的保守处理

听神经瘤的外科治疗过去25年中由于早期诊断及手术技术的改进得到了惊人的进展。但由于听神经瘤一般生长缓慢,故有些可行保守治疗。本文目的在于提供选择非手术治疗的指征及CT扫描或CO_2CT脑池造影密切追踪观察的作用。作者报导了111例听神经瘤及其他小脑脑桥角肿瘤中的6例听神经瘤患者的保守治疗,并介绍了诊断发现、追踪期限、理论依据及有关的文献复习。     

半面痉挛的椎动脉造影的特点

对19例半面痉挛患者进行了椎动脉造影,并与突发性耳聋和小脑角肿瘤的患者进行了对照研究。结果发现,半面痉挛与对照组的椎动脉患侧与健侧直径比,于椎动脉第3区(第一颈椎至硬脑膜内)及第4区(硬脑膜至基底动脉起始部)无明显差别。说明患侧与健侧的椎动脉直径无明显差别。半面痉挛患侧第4区椎动脉屈曲的平均角度,明显锐于对照组,为74.6°±26.6°及122.8°±25.1°;而健侧椎动脉角度与对照组则无显著差别。另于4例半     

眩晕的发病与植物神经的关系

近年来眩晕患者有增加之趋势。日本大阪大学耳鼻咽喉科门诊眩晕患者于1956年为1.8%,到1982年初诊5941名中有626名(10.5%)以眩晕为主诉就诊,增加了5倍,其中无法查明原因的有132名(21%).确诊及可疑为美尼尔病者分别为55名(6%)及105名(17%)。已有许多报告说美尼尔病叮能足由于植物神经不稳定导致内耳循环障碍而发病的,为了探讨眩晕的发病与植物神经的关系进行厂一系列的研究。     

Aspirin-induced hearing loss as a model of sensorineural hearing loss

Performance in forward-masking, temporal-integration, and gap-detection tasks was measured in five normal-hearing subjects before and during a five-day period of aspirin use. The drug regimen was 3.9 g per day, taken in four equal doses at 6-h intervals. In the subjects showing substantial temporary hearing loss induced by the aspirin. (1) forward masking declined at about a normal rate as the masker-to-signal interval was increased. (2) the temporal-integration functions were flatter than normal, and (3) detection of a temporal gap was worse than normal at low sound-pressure levels (SPLs) but was essentially normal at levels above about 60 dB SPL. These aspirin-induced changes in performance are similar to the differences observed between normal listeners and listeners with mild sensorineural hearing loss. Thus, temporary, aspirin-induced hearing loss offers promise as a model condition for sensorineural hearing loss. The advantages offered by this model include all those typically attributed to within-subjects experimental designs, as well as the ability to manipulate the amount of hearing loss. Its primary disadvantages are that the hearing loss is not asymmetrically distributed toward the high-frequency region, as it typically is with sensorineural deafness, and there are large individual differences in the amount of temporary hearing loss induced by fixed doses of aspirin.     

Noise-induced hearing loss

Hearing loss affects 30 million people in the United States; of these, 21 million are over the age of 65 years. This disorder may have several causes: heredity, noise, aging, and disease. Hearing loss from noise has been recognized for centuries but was generally ignored until some time after the Industrial Revolution. Hearing loss from occupational exposure to hazardous noise was identified as a compensable disability by the United States courts in 1948 to 1959. Development of noisy jet engines and supersonic aircraft created additional claims for personal and property damage in the 1950s and 1960s. These conditions led to legislation for noise control in the form of the Occupational Safety and Health Act of 1970 and the Noise Control Act of 1972. Protection of the noise-exposed employee was also an objective of the Hearing Conservation Act of 1971. Subsequent studies have confirmed the benefits of periodic hearing tests for workers exposed to hazardous noise and of otologic evaluation as part of the hearing conservation process. Research studies in laboratory animals, using scanning electron microscopical techniques, have demonstrated that damage to the inner ear and organ of hearing can occur even though subjective (conditioned) response to sound stimuli remains unaffected. Some investigators have employed an epidemiologic approach to identify risk factors and to develop profiles to susceptibility to noise-induced hearing loss. The need for joint involvement of workers and employers in the reduction and control of occupational noise hazards is evident.     

Physician hearing loss

PURPOSE: Hearing is an important sense for physicians, making communication and stethoscope use possible, yet not much is known about the impact of hearing loss on professional function. The purpose of this study was to explore hearing-related issues affecting physicians. MATERIALS AND METHODS: We administered a hearing test and questionnaire to 107 physicians and medical students. RESULTS: The proportion of physicians reporting trouble with their hearing increased with age, reaching almost 100% in those older than 60 years. Audiometric hearing loss also increased with age. Perceived hearing trouble was significantly associated with audiometric hearing loss, yet 46% of physicians with hearing loss described their hearing as good. Older physicians more frequently reported difficulty communicating with patients, staff, and colleagues owing to hearing problems (P = .007). Reported stethoscope difficulties did not significantly increase with age; there was no association with hearing thresholds. No physician reported use of electronic stethoscopes or hearing aids. Noise exposures were common, yet 51% of respondents never used hearing protection. Younger physicians were less likely to use protection (P = .002). CONCLUSION: Physicians lose hearing with age but may not notice or report the loss. Physician hearing loss is associated with difficulty communicating with patients, staff, and colleagues. Neither age nor hearing level predicts problems with stethoscope use; possible explanations include a training effect or denial. Many physicians, especially younger ones, never use hearing protection around noise. Strategies to recognize and reduce the impact of hearing loss on professional function throughout a physician's career deserve greater attention.     

Postirradiation hearing loss

Hearing loss due to irradiation of the head-and-neck region is a rarely reported complication of such a treatment. Although experimental work had been performed in laboratory animals as early as at the turn of the century, substantiated clinical data in large series are lacking. The few reports published are somewhat contradictory as to the incidence, time of onset, type and severity of the hearing loss. Although infrequently encountered, the possibility of radiation-induced hearing loss should be kept in mind. The pertinent literature is reviewed.     

Sudden hearing loss

Sudden sensorineural hearing loss is a medical emergency in search of an appropriate treatment. Almost all aspects of this disease process are disputed in the literature. The natural course of the disease process has not been well defined, although spontaneous recovery in a percentage of patients appears well accepted. Little scientific data exist to develop an evidence-based treatment protocol. The more common elements of treatment in the United States include oral steroid therapy, transtympanic steroid therapy, and potentially oral antiviral therapy. Other therapies are used with great frequency, and their potential should not be discounted.     

Sensorineural hearing loss

New developments in diagnosis aid in the treatment and have improved the outlook for those patients with sensorineural hearing loss. Not all such hearing loss is untreatable and it should be approached systematically and enthusiastically. Thorough evaluation should be performed in all patients.