Anatomic measurements of the posterior tympanum related to the round window vibroplasty in congenital aural atresia and stenosis patients

Conclusions With the aggravation of the external auditory canal malformation, the size of extra-niche fossa became smaller, providing concrete data and valuable information for the better design, selecting and safer implantation of the transducer in the area of round window niche. Three-dimensional measurements and assessments before surgery might be helpful for a safer surgical approach and implantation of a vibrant soundbridge.

Objectives The aim of this study was to investigate whether differences exist in the morphology of the posterior tympanum related to the round window vibroplasty among congenital aural atresia (CAA), congenital aural stenosis (CAS), and a normal control group, and to analyze its effect on the round window implantation of vibrant soundbridge.

Methods CT images of 10 normal subjects (20 ears), 27 CAS patients (30 ears), and 25 CAA patients (30 ears) were analyzed. The depth and the size of outside fossa of round window niche related to the round window vibroplasty (extra-niche fossa)and the distances between the center of round window niche and extra-niche fossa were calculated based on three-dimensional reconstruction using mimics software. Finally, the data were analyzed statistically.

Results The size of extra-niche fossa in the atresia group was smaller than in the stenosis group (p?p?相似文献   

The immediate effects of a shoulder brace on muscle activity and scapular kinematics in subjects with shoulder impingement syndrome and rounded shoulder posture: A randomized crossover design

BackgroundRound shoulder posture (RSP) is one of the potential risks for shoulder impingement syndrome (SIS) due to alignment deviation of the scapula. Evidence on how the characteristics of a shoulder brace affecting the degree of RSP, shoulder kinematics, and associated muscle activity during movements is limited.Research questionThe purposes of this study were (1) to compare the effects of a shoulder brace on clinical RSP measurements, muscle activities and scapular kinematics during arm movements in subjects with shoulder impingement syndrome (SIS) and RSP; and (2) to compare the effects of two configurations (parallel and diagonal) and two tensions (comfortable and forced tension) of the brace straps on muscle activities and scapular kinematics during arm movements in subjects with SIS and RSP.MethodsTwenty-four participants (12 males; 12 females) with SIS and RSP were randomly assigned into 2 groups (comfortable then forced, and forced then comfortable) with 2 strap configurations in each tension condition. The pectoralis minor index (PMI), acromial distance (AD) and shoulder angle (SA) were used to assess the degree of RSP. Three-dimensional electromagnetic motion analysis and electromyography were used to record the scapular kinematics and muscle activity during arm movements.ResultsAll clinical measurements with the brace were significantly improved (p < 0.05). Under forced tension, muscle activities were higher with the diagonal configuration than with the parallel configuration in the lower trapezius (LT) (1.2–2.3% MVIC, p < 0.05) and serratus anterior (SA) (2.3% MVIC, p = 0.015). For upward rotation and posterior tilting of the scapula, the diagonal configuration was larger than the parallel configuration (1.5°, p = 0.038; 0.4°–0.5°, p < 0.05, respectively).SignificanceDifferent characteristics of the straps of the shoulder brace could alter muscle activity and scapular kinematics at different angles during arm movement. Based on the clinical treatment preference, the application of a shoulder brace with a diagonal configuration and forced tension is suggested for SIS and RSP subjects.     

Round ligament varicosities diagnosed as inguinal hernia during pregnancy: A case report and series from two regional hospitals in Japan

IntroductionRound ligament varicosities (RLV) are not well-known and they are usually caused by pregnancy. Although the groin swelling of RLV mimics an inguinal hernia, it is difficult to distinguish between them through clinical examination alone, and there have been few published reports on this topic, especially from Asia.Case presentationA 37-year-old Japanese woman complained of left groin swelling for 2 weeks at her 28th week of gestation of her first pregnancy. According to a physical examination, she had a soft, painless swelling in the superficial inguinal ring of the left groin. An inguinal hernia was suspected and she was thus scheduled to undergo herniorrhaphy. However, since she had varicosities in the left labia majora, she first underwent color Doppler ultrasonography and a final diagnosis of round ligament varicosities was this made. Her symptoms resolved after delivery of her baby.DiscussionWe herein report 10 cases of RLV in pregnant Japanese women who were initially suspected of having an inguinal hernia. All of them were suspected to suffer from inguinal hernias after a clinical examination by their attending gynecologist. All of them were diagnosed using gray scale and color Doppler ultrasonography, treated with conservative management, and the symptoms resolved in all cases after the delivery.ConclusionThis is the largest report from Asia regarding RLV. To avoid unnecessary surgery in pregnant women, surgeons must be aware of this entity make an accurate diagnosis based of the findings of Doppler ultrasonography.     

Permeability of the round window membrane

Summary Cefmetazole sodium, a cephamycin antibiotic, was shown to pass through the round window membrane into the inner ear of the guinea pig. The concentration of the drug in the inner ear fluid indicated that a larger amount of the drug reached the inner ear through the round window membrane than when administered intraperitoneally.This study was supported by a Research Grant for Specific Diseases from the Ministry of Health and Welfare's Acute Profound Deafness Research Committee of Japan     

糖尿病足的治疗与新进展

糖尿病足是糖尿病的严重并发症,血管狭窄闭塞、神经病变和感染是主要的临床表现,本文复习了近年来的20余篇文献,主要从以下6个方面对糖尿病足的治疗进展进行总结。①糖尿病足的基础治疗;②血管狭窄闭塞和血栓的治疗,其中骨髓干细胞移植治疗糖尿病足取得了进展;③神经病变的治疗;④糖尿病足溃疡的处理;⑤抗菌素的使用原则;⑥祖国传统医学在糖尿病足治疗中的应用。糖尿病足的治疗是个系统工程,单一的方法难以治愈,并且早发现早治疗,可以起到事半功倍的效果。     

鼓室灌注地塞米松治疗难治性突发性感音神经性聋临床分析

目的观察和比较鼓膜穿刺、鼓膜置管和圆窗置管微泵灌注地塞米松3种方法治疗难治性突发性感音神经性聋的疗效。方法55例常规方法治疗无效的突聋患者作为研究对象,其中圆窗置管微泵灌注用药治疗21例(置管组),每次2.5mg/0.5ml,维持1小时,每天两次,连续给药7天,总剂量35mg;鼓膜穿刺注药23例(穿刺组),首次剂量为2.5mg,此后,每2天重复注药1次(每次2.5mg),共4次,总剂量10mg;鼓膜切开置管滴药11例(滴药组),首次剂量为0.5%地塞米松0.5ml,经通气管滴入鼓室,每天重复滴药2次(每次2.5mg),共7天,总剂量32.5mg。同期常规方法治疗无效的32例突聋患者,且拒绝鼓室用药者随访作为对照(对照组),比较各组听力恢复及并发症情况。4组治疗前听力无显著差异(P>0.05)。结果治疗完成后1月纯音测听检查:置管组、穿刺组和滴药组平均PTA分别提高9dB、8.6dB和1.7dB,前2组明显高于对照组1.4dB(P<0.05),置管组8例(38.1%)听力改善约15～56dB,无效13例;穿刺组8例(34.8%)听力改善约16～54dB,无效15例;滴药组1例(9.1%)听力改善约26dB,无效10例;对照组3例(9.4%)听力改善约15～36dB,无效29例。结论鼓室灌注地塞米松治疗难治性突聋方法安全有效,为用常规方法治疗无效的突聋患者,提供了再次治疗的机会。     

联苯双脂滴丸制备工艺的研究

目的　对滴丸剂型的制备工艺进行研究。方法与结果　通过对联苯双脂滴丸制备过程的试验 ,确定了联苯双脂滴丸的重量、处方组成与制备工艺 ,讨论了影响滴丸成形、丸的圆整度和丸重差异的因素。结论　该制备工艺适用于滴丸剂型的工业化生产。     

人工耳蜗植入术的应用解剖学研究

目的探讨后鼓室入路人工耳蜗植入术的有关解剖,为人工耳蜗植入手术提供解剖学基础。方法取成人颞骨标本60侧(左、右各30侧),在放大6倍的手术显微镜下进行观察和测量,结果进行统计学处理。结果圆窗龛(窝)的形态大体分为2种类型:近圆形(52%)和近半圆形(48%)。圆窗龛下壁有一窦腔者占86.7%。岬下脚出现率为11.7%,岬小桥出现率为33.3%。颈静脉窝高位,窝顶达圆窗龛上缘者占11.7%,均未影响圆窗龛的形态。外耳道上棘至锥隆起、鼓索隆起、圆窗龛前唇(缘)、面神经管锥曲的距离分别是(18.02±1.21)mm、(15.22±1.32)mm、(20.09±1.20)mm、(14.96±2.03)mm。鼓索隆起至面神经管锥曲、锥隆起的距离分别是(3.33±0.42)mm、(3.79±0.56)mm。锥隆起向后至面神经管的距离平均为(3.58±0.47)mm。结论后鼓室进路即是通过面神经隐窝的进路,面神经隐窝大小各异,鼓索隆起至面神经管锥曲和至锥隆起的距离,可作为面神经隐窝的宽度。人工耳蜗植入术经面神经隐窝入路较理想,距圆窗龛较近,有利于电极插入。该入路靠近面神经管,手术操作时应注意保护面神经。圆窗龛前唇遮盖圆窗膜,手术时必须磨去前唇暴露圆窗膜。