先天性外中耳畸形(18)——功能耳再造研究进展与展望

先天性外中耳畸形是头面部最常见的出生缺陷,包括耳郭形态畸形和结构畸形[1 ].耳郭结构畸形是引起听力缺陷和容貌损害的五官严重畸形,国内每年新增该类病例近万名,为先天性结构畸形救助项目的重点;临床主要表现为耳郭畸形、外耳道闭锁或狭窄、中耳畸形等,容貌的缺陷和听觉功能的障碍使患者自幼社会适应和早期言语发育困难[2 ].单纯...     

胃食管反流相关性咽喉部肉芽肿20例

我科近年收治20例胃食管反流相关性咽喉部肉芽肿病例,报告如下。     

鳃裂畸形的诊治

鳃裂畸形属先天性疾病,是胚胎发育过程中鳃沟与咽囊发生异常穿破或未完全闭合而形成,可表现为颈侧部的囊肿、瘘管或窦道。临床上较少见,容易误诊,治疗不当易复发。我们近期收治2例鳃裂畸形患者,通过复习相关文献,分析总结如下。1临床资料病例1。患者,女性,8岁,因"出生后发现     

下食管括约肌和上食管括约肌在咽喉反流中的作用

目前认为,咽喉反流和胃食管反流是两种疾病,但是两者在发病机制上有一定的相似处,本文就下食管括约肌和上食管括约肌在咽喉反流发生中的作用进行综述。     

鼻内镜下治疗鼻咽囊肿13例

我科收治鼻咽囊肿患者13例,均采用鼻内镜下手术进行切除,报告如下。资料与方法1.1资料2003年6月至2009年1月,我科收治的鼻咽囊肿患者13例,其中男性8例、女性5例;年龄1岁9个月至67岁,     

国际耳力学动态

耳力学是生物力学在听觉医学的一个分支,包括中耳力学和内耳力学,主要探索机械力的作用对中内耳传音的影响,其研究热潮的兴起源于20世纪70年代一些公开发表的研究报道,如基底膜调谐的灵敏性、非线性、耳蜗主动特性、耳声发射（OAE）现象等,这些研究内容后来逐渐被我们熟知。1980年＂主动＂耳蜗概念的问世,促使科学家们认为对听觉中的一些新发现、新理论有必要进行一次国际性的研讨,1983年国际性高端会议——“听觉力学”（mechanics of hearing, MOH）研讨会应运而生,十多年后集中反映中耳研究进展的“中耳力学研究与耳科学”（Middle-Ear Mechanics in Research and Otology, MEMRO）会议也随之诞生。目前国内从事该领域研究的学者很少,因此有必要向国内学界介绍这些国际会议概况与进展。     

住院患者与医院环境耐甲氧西林金黄色葡萄球菌耐药性分析

[目的]了解耐甲氧西林金黄色葡萄球菌（MRSA）在医院内的流行及耐药特征,为预防和控制MRSA引起的院内感染提供科学依据。[方法]以上海某区一家综合性二级医院临床患者标本中分离的78株金黄色葡萄球菌（SA）和同时期该医院诊疗环境中分离的53株sA共131株sA为研究对象,分别用头孢西丁药敏纸片法和PCR法检测MRSA,K-B法检测该131株sA对15种抗菌药物的敏感性。[结果]131株SA中,MRSA构成比为55．73％（73／131）。其中,临床分离株和环境分离株中的MRSA构成比分别为52．56％（41／78）和60．38％（32／53）,两者相比差异无统计学意义（JP〉0．05）。临床MRSA株主要分布于痰液及伤口分泌物;环境MRSA株主要分布于床头柜、监护仪以及医护人员手。抗菌药物敏感性实验显示,MRSA对β-内酰胺类药物耐药率100％,对糖肽类药物、利奈唑胺、利福平高度敏感,对其他抗菌药物均呈多重耐药。[结论]MRSA在医院内有较高流行度,而且呈多重耐药性。应加强抗生素的合理使用,及时进行MRSA院内感染目标性监测,切实做好MRSA感染患者的消毒隔离工作。     

以呼吸道症状为突出表现的胃食管反流病临床分析

目的探讨由胃食管反流引起的呼吸道表现,即胃食管气道反流(GEAR)的临床特点,分析易误诊原因,总结经验,提高诊疗水平。方法对45例以呼吸道症状为突出表现的胃食管反流病(GERD)患者进行回顾性分析。结果该组呼吸道症状主要表现为咳嗽、咯痰、咽部异物感、憋气及喘息等,曾被误诊为慢性支气管炎、慢性咽炎及哮喘等,均经胃镜检查和(或)食管24 h p H监测诊断为GERD,且所有病例均经奥美拉唑和莫沙必利治疗,大部分患者症状缓解。结论以呼吸系统症状为突出表现的GERD,往往无烧心、反酸、反胃的典型症状,因此临床上极易误诊,对于这类患者应予以足够重视。     

小儿喉软化症的诊断与治疗

1942年Jackson首先描述了一组吸气时声门上组织向内塌陷的临床病理生理现象,提出喉软化症(laryngomalacia)的命名。半个多世纪的研究逐渐揭示了这一组疾病的临床特征及其可能的病理生理机制和病因。本病是一种婴幼儿常见的疾病,偶可     

突发性极重度聋与全聋的预后特点及差异

Objective To clarify the different prognostic characteristics between profound sudden sensorineural hearing loss (SSNHL) and total SSNHL. Methods The patients with SSNHL who visited Eye Ear Nose and Throat Hospital from June 2007 to September 2008 were reviewed retrospectively. All the 204 patients, with pure tone average (PTA) threshold more than 90 dB, were enrolled and divided into two groups, including total SSNHL and profound SSNHL groups. The relationship between recovery rate and prognostic factors including the age, complications, time period between onset and therapy was analyzed.Results There were 57 cases of total SSNHL and 147 cases of profound SSNHL in this series. Tinnitus was complained in more than 90% of the patients in both groups, which was higher than that of dizziness and ear fullness. Dizziness was present in 64. 9% (37/57) patient with total SSNHL group and 45.6% (67/147)patients with profound SSNHL, which had significant difference between the two groups (x2 = 5.72,P =0. 017). The PTA threshold improvement in total SSNHL group and profound SSNHL group was (36. 4 ±19.3) dB and (40. 2 ±21.3) dB respectively, which was no significant difference between the two groups (t = 1. 165 ,P =0. 245). The cured patients were all those received therapy within 1 week following the onset of SSNHL, which was of 2. 6% (1/38) patients in the total SSNHL group and 14. 3% (14/98) patients in the profound SSNHL group(P =0. 045). Furthermore, 3.5% (2/57) patients in total SSNHL group as well as 29. 9% (44/147) patients in profound SSNHL group obtained a good result with PTA threshold ≤50 dB after therapy(x2 = 15.92,P = 0. 001 ). In addition, the favorable prognosis was related with the onsettherapy time point( P = 0. 001 ), but not related to the patients' age. Conclusion Profound SSNHL and total SSNHL though both with PTA threshold > 90 dB had significant differences recovery rate and need to be studied separately.