鼻咽癌放疗对耳损伤的临床观察

目的:探讨放疗对鼻咽癌患者耳部结构及功能的影响.方法:选择无耳病及听力正常的163例鼻咽癌患者,于放疗前及放疗后不同时间点检测其耳部的结构及听功能状态.结果:随放疗时间及放疗结束后的时间延长,外耳道炎、分泌性中耳炎及化脓性中耳炎的发生率增加,不同性质的耳聋的发生率及听力损失的程度亦逐渐增加.结论:放疗对鼻咽癌患者的耳部的结构及功能损伤明显,严重影响鼻咽癌患者生存质量.     

慢性化脓性中耳炎骨导听阈特点分析

目的对慢性化脓性中耳炎(SCOM)患者的骨导听力损失情况进行总结和回顾行分析,探讨SCOM骨导听阈损伤情况.方法 320例患者均未接受过耳科手术治疗,对侧耳为正常耳(作对照耳),其中男11 4例,女196例;年龄12～61岁,平均34岁,病程3月～50年,平均21.16年.所有病例均采用GSI-68纯音测听仪在隔音室对患者和正常耳进行听力测试,并对骨导听阈的平均值进行统计学处理,对影响骨导听阈的因素做相关分析.结果所有患者中有201例(62.81%)发生骨导听阈损害.500～4000 Hz每个频率的骨导听力均有损失,主要损害在2000～4000 Hz的骨导听力损害程度与年龄、病程和病变程度有关.结论慢性化脓性中耳炎可以导致骨导听力损失,原因是综合性的.     

四川省WHO耳疾与听觉障碍调查方案预试验报告

目的根据世界卫生组织耳疾和听觉障碍调查方案,在四川省进行预试验,以验证此方案在我省运行的可行性,以初步了解耳疾和听觉障碍在我省的患病率,并为今后开展大规模的调查积累经验。方法在采用按容量比例概率抽样法（PPS）随机抽取的40个调查点中,选取3个点进行流行病学预试验调查。结果共有599人参与本研究。听力减退的患病率为15.7%,听力残疾率为7.5%。听力残疾的主要原因为：老年性44.4%,原因不详24.4%,中耳疾患17.8%,噪音性13.3%,药物中毒4.4%。共有70人需要干预,干预率为11.69%（9.11%-14.26%）,其中需要药物治疗的9人,需要验配助听器的58人,需要言语康复的2人,需要外科治疗的9人,其他干预2人。结论此调查方案在我省是可行的,但也充分认识到要保质保量完成任务的艰巨性。初步估计我省听力减退率和听力残疾率较高,听力障碍这一公共卫生问题对受累人群的影响,理应引起广泛的关注和相关部门的高度重视,并尽快制定相应的防治策略。     

浅谈改良乳突切除保留骨桥鼓室成形术治疗中耳乳突炎的体会

目的探讨改良乳突切除保留骨桥同期行鼓室成形术治疗慢性化脓性中耳乳突炎患者的临床疗效。方法对83例(83耳)慢性化脓性中耳乳突炎患者(含胆脂瘤型、骨疡型)施行改良乳突切除保留骨桥同期行鼓室成形术的治疗过程进行回顾性分析及总结。结果 83例患者术后观察1个月-4年,鼓膜修补愈合率为95.18%,听力改善有效率为68.67%,无效率31.32%,3个月内全部干耳。听力恢复较好者为长期反复流脓、听力渐进性下降、中耳乳突不可逆病理改变的慢性单纯型中耳乳突炎患者,治疗有效率为95.65%,其次为骨疡型,有效率为85.71%,胆脂瘤型最差,有效率为34.37%。结论长期反复流脓、听力渐进下降的慢性化脓性中耳乳突炎患者,应早日行改良乳突切除保留骨桥同期行鼓室成形术,可获得早日干耳,听力提高,防止听力丧失。对胆脂瘤型、骨疡型中耳乳突炎患者,在清除病灶的基础上尽可能保留乳突气房及骨桥同期行鼓室成形术,亦可早日干耳、提高听力。     

儿童腺样体形态学与分泌性中耳炎的相关分析

目的通过儿童腺样体的大体形态、影像学形态、细胞学形态三方面分析,探讨儿童腺样体形态学与分泌性中耳炎的相关性。方法通过检查98例184耳（双耳患病者86例,单耳患病者12例）分泌性中耳炎患儿的腺样体,从腺样体的大体形态、影像学形态、细胞学形态三方面分析腺样体形态学与分泌性中耳炎的相关性。结果 98例腺样体的形态学检查中,肥大型、A/N值≥0.71、炎症性、过敏性的腺样体易患分泌性中耳炎,导致咽鼓管功能障碍致鼓室图异常,中耳压力变小,会造成儿童听力下降,而平坦型、A/N值≤0.60、单纯肥大的腺样体对儿童听力的影响较小。结论儿童腺样体的形态学与分泌性中耳炎有相关性,故有必要对分泌性中耳炎患儿进行腺样体的相关检查,行腺样体切除术有助于治疗分泌性中耳炎。     

A comparative study of common ear morbidity pattern among the primary school children of an urban slum of Kolkata and rural area of Hooghly

A cross-sectional, clinical and epidemiological study was undertaken among 627 primary school children (rural 145, urban 482) to compare the common ear morbidity pattern between an urban slum of kolkata and a rural area of Hooghly. Middle ear pathology was found to be present in 20% and 12.6% among rural and urban students respectively. Cerumen in the external auditory canal was the commonest clinical finding in both the areas and was found to be present in 35.86% of rural and 30.70% of urban population respectively. Smoke nuisance, bathing in open ponds and overcrowding were some of the predisposing factors causing ear diseases, like chronic suppurative otitis media and serous otitis media.     

成人与儿童分泌性中耳炎的听力状况分析

[目的]探讨成人与儿童分泌性中耳炎听力的不同状况.[方法]成人分泌性中耳炎患者36例(共59耳),儿童分泌性中耳炎21例(39耳),对照组25例(50耳).对儿童及成人分泌性中耳炎纯音听阈结果与对照组进行比较分析.[结果]成人与儿童分泌性中耳炎气导听阈与对照组差异有显著性意义(P<0.01).成人分泌性中耳炎骨导听阈(...     

慢性化脓性中耳炎鼓膜成形术的时机选择

目的探讨慢性化脓性中耳炎鼓膜成形术的时机选择,为临床治疗提供依据。方法选择2009年6月至2011年6月我院收治的慢性化脓性中耳炎患者50例(56耳),根据干耳时间,选择7个组段干耳时间,每组干耳时间选择8耳行鼓膜成形术,记录每例患者的听力水平,并随访观察3个月,分析治疗后听力水平与干耳时间的关系。结果通过拟合最佳方程Y^=12.5567+0.19671x-0.03221x2,发现鼓膜成形术选择在干耳时间2～4个月,听力水平提高最高。结论慢性化脓性中耳炎鼓膜成形术的最佳时机选择在干耳时间2～4个月能够提高手术成功率,使听力阈值最大,患者生活质量得到改善。     

Chronic granulomatous otitis media in bottle-fed Inuit children.

Otitis media in Inuit children is a problem of relatively recent origin and unknown cause. The prevalence of otitis media in 238 Inuit and 47 Caucasian children in Nain, a small community in Labrador, was determined by examination, and the history of breast-feeding or bottle-feeding was obtained. The prevalence of otitis media was found to be inversely related to the age at which bottle-feeding was started. Clinical observations suggest that otitis media in Inuit children is part of a process leading to chronic foreign body granuloma of the middle ear, and that the granuloma is formed from milk introduced into the relatively short and straight eustachian tubes of Inuit infants by the high negative intraoral pressure necessary for bottle-feeding.     

中耳变压疗法治疗儿童分泌性中耳炎的疗效观察

目的探讨用中耳变压疗法治疗儿童分泌性中耳炎的疗效。方法采用中耳变压疗法治疗37例（70耳）分泌性中耳炎患儿,与同期行Valsalva法治疗的36例（70耳）进行对照。结果治疗组显效61耳,有效3耳,无效6耳,有效率为91．43％;对照组显效35耳,有效8耳,无效27耳,有效率为61．4％。治疗组疗效明显高于对照组（P〈0．001）,且无不良副反应发生。结论中耳变压疗法能够明显减轻儿童中耳负压,改善听力,操作上安全,简便,值得在临床上推广应用。     

Middle-Ear Disease in Indians of the Mount Currie Reservation, British Columbia

Complete otological examinations, including audiograms, were carried out on 504 British Columbia Indians of the Mount Currie Reservation. Of these, 79 were found to have evidence of current middle ear pathology, while 226 were known to have had previous disease. Among 364 subjects who could be formally tested, 112 had a 15-decibel or greater hearing loss in the speech frequencies. Among these Indians, middle-ear disease began early in life and recurrences were frequent. The prevalence of aural disease was related to poor social conditions, family history and presence of nasal discharge. No other relationships could be demonstrated, and there was no evident benefit from adenotonsillectomy. No secretory otitis or otosclerosis and almost no sensorineural high-tone hearing loss were discovered.     

Retrospective review of grommet insertions for otitis media with effusion in children in Singapore

Otitis media with effusion is one of the most common childhood infections, and grommet insertions are done for chronic otitis media which have failed medical therapy. The aims of this study were 1) to determine the patient profile of children needing grommet insertion and 2) to determine if grommet insertion is safe and effective. A retrospective review of 105 children with myringotomy and grommet insertions for chronic otitis media with effusion between 2006 and 2008 was performed. Seventy two percent of patients were younger than 6 years old. Male to female ratio was 4:3. Twelve percent of patients were syndromic. In children with otitis media with effusion, hearing and academic performance improved after grommet insertion. Allergic rhinitis and cleft palate are risk factors for chronic middle ear effusion.     

Ear wax and otitis media in children

A study was designed to find the prevalence of ear wax in children aged 3 to 10 years and to test the belief that large amounts of wax are unlikely to be seen when otitis media is present. Roughly a quarter of the children had appreciable amounts of wax, and there was a gradual decline in prevalence with age. The amount of ear wax appeared to decrease when otitis media was present. The results did not support removing wax when assessing children's ears in general practice.     

门诊儿童中耳炎疾病调查情况分析

目的了解本地区儿童慢性中耳炎的发病情况,以提高儿童慢性中耳炎的诊断和治疗水平。方法回顾分析我院听力门诊就医的儿童患中耳炎疾病的临床资料。结果儿童中耳炎疾病占门诊耳科就诊总人数的40％,2—6岁年龄组患中耳炎的发病率占78．1％。结论低龄儿童因中耳生理解剖和机体免疫发育的特殊性,易发生中耳功能异常,诊治儿童耳部病变时,防止误诊误治。     

5364名学龄儿童耳科常见病的患病率调查

1985年9～10月,我们对仙游县5364名学龄儿童进行耳科常见病的患病率调查,着重指出中耳炎的患病率是:(1)急性化脓性中耳炎20例,占总调查人数的0.37％;(2)慢性化脓性中耳炎111例,占总调查人数的2.07％;(3)非化脓性中耳炎81例,占总调查人数的1.51％。提示至今中耳炎患病率仍高,须及时防治。     

Screening and management of adult hearing loss in primary care: scientific review

CONTEXT: Hearing loss is the third most prevalent chronic condition in older adults and has important effects on their physical and mental health. Despite these effects, most older patients are not assessed or treated for hearing loss. OBJECTIVE: To review the evidence on screening and management of hearing loss of older adults in the primary care setting. DATA SOURCES AND STUDY SELECTION: We performed a search from 1985 to 2001 using MEDLINE, HealthSTAR, EMBASE, Ageline, and the National Guideline Clearinghouse for articles and practice guidelines about screening and management of hearing loss in older adults, as well as reviewed references in these articles and those suggested by experts in hearing impairment. DATA EXTRACTION: We reviewed articles for the most clinically important information, emphasizing randomized clinical trials, where available, and identified 1595 articles. DATA SYNTHESIS: Screening tests that reliably detect hearing loss are use of an audioscope, a hand-held combination otoscope and audiometer, and a self-administered questionnaire, the Hearing Handicap Inventory for the Elderly-Screening version. The value of routine screening for improving patient outcomes has not been evaluated in a randomized clinical trial. Screening is endorsed by most professional organizations, including the US Preventive Services Task Force. While most hearing loss in older adults is sensorineural and due to presbycusis, cerumen impaction and chronic otitis media may be present in up to 30% of elderly patients with hearing loss and can be treated by the primary care clinician. In randomized trials, hearing aids have been demonstrated to improve outcomes for patients with sensorineural hearing loss. Nonadherence to use of hearing aids is high. Prompt recognition of potentially reversible causes of hearing loss, such as sudden sensorineural hearing loss, is important to maximize the possibility of functional recovery. CONCLUSION: While untested in a clinical trial, older adults can be screened for hearing loss using simple methods, and effective treatments exist and are available for many forms of hearing loss.     

分泌性中耳炎的纯音听阈和鼓室导抗图分析

目的 探讨分泌性中耳炎的纯音听阈和鼓室导抗图的临床特征和机理。方法 分析37例（61耳）分泌性中耳炎的临床资料。结果 37例（61耳）纯音听阈测试中22耳（36％）为轻度传导性听力下降,32耳（52％）为中度传导性听力下降,多为平坦型或轻度上升型曲线。鼓室导抗图测试中B型14耳（23％）,C型47耳（77％）。结论 分泌性中耳炎是以鼓室积液及传导性听力下降为主要特征中耳非化脓性炎症。纯音听阈和鼓室导抗图测试是诊断分泌中耳炎的重要手段。     

化脓性中耳炎的内耳功能分析

目的：研究化脓性中耳炎的内耳功能状态。方法：收集１１１例化脓性中耳炎患者（１６３耳），测其骨导听阈，并以单侧患者中的４０位的健耳为对照；对３０名患者进行听性脑干反应（ＡＢＲ）和眼震电图（ＥＮＧ）检查。结果：化脓性中耳炎各组骨导听阈均值明显高于对照组，且与中耳炎的类型和病程相关。ＡＢＲ和ＥＮＧ检查亦有异常改变。结论：化脓性中耳炎确可引起感音神经性聋（ＳＮＨＬ），且中耳病变越重，病程越长，听力下降越明显。少部分患者外周前庭功能可受累     

中耳传音机构炎性病损及其听力状态

本文分析鼓室成形术125耳的病变与听力状态。105 耳鼓膜大穿孔听骨受累者占62％,鼓室硬化病变占 12.8％。鼓膜大穿孔而听骨链完整者气导平均损失 47.1dB,若听骨链中断则损失达60.8dB;鼓膜中等穿孔而听骨链完整者损失41.9dB,若听骨链中断则损失达53.9dB。16例鼓室硬化症平均损失 60.4dB。本研究有助于认识中耳病变与听力损失的关系及分析临床听力图。     

慢性化脓性中耳炎与感音神经性耳聋关系的临床分析

目的探讨慢性化脓性中耳炎（CSOM）与感音神经性耳聋（SNHL）之间的相关性。方法回顾性分析单侧CSOM手术治疗64例患者的骨导阈值改变,分析0．5、1．0、2．0、4．0kHz患耳与健耳骨导阈值的差异,单因素方差分析听骨链破坏对语频骨导阈值的影响。结果患耳与健耳各频率骨导闽值之间差异有统计学意义（P〈0．05）;听骨链受损组平均骨导阈值在2kHz与4kHz处〉听骨链正常组（P〈0．05）。结论CSOM可引起感音神经性耳聋,高频骨导听阈较低频更易受到影响。听骨链损害与骨导听力下降有关,其共振作用的减弱或消失即可影响骨导听力的下降。