小鼠自然老化过程中耳蜗的糖代谢障碍

应用定量组织化学技术分析了ＣＢＡ和Ｃ５７ＢＬ小鼠耳蜗中糖元代谢的改变，发现１８个月和３６个月龄ＣＢＡ小鼠的毛细胞和血管纹中，糖元含量比６周龄ＣＢＡ正常小鼠明显增高，说明在自然老化ＣＢＡ小鼠耳蜗中存在糖元储积现象。     

Bilateral stapedotomy in patients with otosclerosis: a disability-orientated evaluation of the benefit of second ear surgery

This study reports the evaluation of the results of 80 stapedotomies in patients with bilateral otosclerosis. All pre- and postoperative audiological data, together with all relevant information of the operations, were stored in a database and analysed retrospectively. A new approach has been developed in order to evaluate the benefit of second ear stapes surgery in a more disability-orientated way using the AMA-criteria in the Guides to the Evaluation of Permanent Impairment. In all patients the percentage of Binaural Hearing Impairment (BHI) and the percentage of Impairment of the Whole Person (IWP) were determined according to the AMA-criteria. In patients who had both operations at the Academic Medical Centre it was found after the first operation that there was an important decrease in the BHI-percentage (from 26% to 10%) as well as for the IWP-percentage (from 9% to 4%). In addition, the percentages dropped significantly after the second operation (from 11% to 7% and from 4% to 2%, respectively). During follow-up there were no serious complications. It is concluded that bilateral stapedotomy is a safe procedure with good results.     

Eureka-project: ‘totally implantable artificial larynx’: progress report

Objective. The European Eureka project ‘Artificial larynx’ aims at realizing an implantable artificial larynx, consisting of artificial vocal folds, artificial epiglottis, tissue connector for tracheal fixation and valve mechanism to switch between breathing and speaking. The last part has been realized. Because its functioning is identical to a tracheostomal valve, it was tested as such. Materials and methods. The device consists of two valves: a speech valve, that will be open during normal breathing and closed by strong expiration and a cough valve that opens during coughing and closes automatically during inhalation. Magnets keep the valves in the breathing position. The magnetic force can be varied. Several prototypes have been tested in vitro and in situ. Results. The prototypes showed good in vitro behaviour. The range of adjustability of speech and cough was wide enough, flow resistance acceptable. This was confirmed by preliminary in vivo experiments. Patients were enthusiastic; hands-free speaking and coughing is possible. Conclusion. Numerous problems have to be solved to produce an artificial larynx. Each solution generated up till now, however, can already be applied to improve the existing rehabilitation process of laryngectomized patients.     

Ocular torsion induced by static visual stimulation and static whole body roll

Objective. This study was aimed to improve the reliability of clinical statolith testing by quantifying the influence of visual orientation and stimulation on the statolith-ocular reflex. Materials and methods. Ocular torsion was induced in 12 healthy adults by visual stimulation and by static whole body roll with and without simultaneous visual orientation. Visual stimulation was achieved by a horizontal grating oscillating sinusoidally in a frontal plane. Visual orientation during whole body roll was established by mounting an illuminated horizontal grating either on a tilting device (head-fixed) or on the wall in the frontal plane (earth-fixed). Results. No eye torsion was observed in static visual tilts of the grating. Dynamic visual stimulation elicited substantial eye torsion. Static whole body roll in the dark induced static ocular counter-rolling. Visual orientation either head- or earth-fixed did not affect the amplitude or gain of the body roll induced ocular counter-rolling. Conclusion. Dynamic visually induced torsional eye movements can be used to test the ability of the oculomotor system to generate torsional eye movements prior to quantifying the statolith-ocular reflex. Simultaneously visual information does not affect the gain of the static statolith-ocular reflex.     

内耳畸形与耳蜗骨化患者的耳蜗植入

目的探讨先天性内耳畸形与耳蜗骨化患者耳蜗植入术的有关问题.方法对我院2002年10月～2004年2月间行耳蜗植入术的8例内耳畸形和2例耳蜗骨化的患者进行回顾性分析.结果4例大前庭水管综合征患者术中有外淋巴液搏动;3例Mondini畸形和1例共同腔畸形患者术中出现井喷;1例耳蜗部分骨化患者术中误将电极插入内听道后纠正;另一例耳蜗部分骨化患者植人短电极.1例Mondini畸形患者术后发生少量脑脊液耳鼻漏,保守治疗3月后痊愈,其余患者无并发症.所有患者均成功开机.结论对于内耳畸形或耳蜗骨化的患者,耳蜗植入术前详细的影像学评估,对术中困难的充分估计和正确、规范处理是手术成功的基本条件.     

耳穴压籽促进儿童生长发育

目的：促进儿童生长发育。方法：治疗组,耳穴压籽,对照组,服用长治市制药厂生产的小儿健脾丸。结果：治疗组,107．7±6．7cm,对照组,106．3±3．7cm,经统计学处理：具有高度显著性（P〈0．01）。结论：治疗组明显优于对照组。     

279例耳闷胀感的病因分析

目的 探讨产生耳闷胀感的部位和原因。方法 收集耳闷胀感为主诉的279例362耳,对患耳的临床表现、鼓室导抗图、纯音测听和咽鼓管功能进行分析。结果 362耳中鼓室导抗图A型203耳、B型111耳、C型33耳以及鼓膜穿孔15耳。纯音测听表现为传导性聋、感音神经性聋、混合性聋以及正常者分别是83耳、8l耳、105耳和93耳。在362耳中,咽鼓管功能异常208耳,在A型鼓室导抗图203耳中,咽鼓管功能异常67耳。结论 产生耳闷胀感的病变部位包括外、中、内耳和面神经的病变,其中以分泌性中耳炎、各种原因引起的感音神经性聋和“咽鼓管狭窄症”为多。     

鼻咽癌初诊患者中耳功能的相关多因素量化分析

目的：探索量化和客观评价鼻咽癌初诊患者的中耳功能的方法,采用多因素及量化的方法分析其影响因素。方法：对320例（320耳）鼻咽癌初诊患者行电耳镜、声导抗检测、纯音听阈测试、鼻咽部及中耳CT或MRI扫描、咽鼓管功能检查、电子鼻咽镜检查,量化评估中耳功能;采用SPSS13．0进行单因素及多因素分析。结果：T分期、临床分期、肿物部位、扩散类型、形态、咽鼓管功能及咽口形态、影像学侵犯范围（鼻腔、颅底、咽隐窝、咽旁间隙、腭帆张肌、腭帆提肌）是影响鼻咽癌初诊患者的中耳功能单因素,而性别、年龄、病理类型、N分期、M分期对鼻咽癌初诊患者中耳功能无影响;多因素分析显示：T分期、肿物部位、咽鼓管功能、腭帆张肌侵犯、颅底侵犯是影响鼻咽癌初诊患者中耳功能的独立因素。结论：鼻咽癌初诊患者的中耳功能受T分期、肿物部位、咽鼓管功能、腭帆张肌侵犯、颅底侵犯等相关因素影响,本研究探讨的中耳量化标准能较为客观地评估鼻咽癌初诊患者的中耳功能。     

耳内镜下显微手术结合药物填塞治疗外耳道胆脂瘤疗效观察

外耳道胆脂瘤（external auditory canal chol—esteatoma,EACC）是由于各种原因引发外耳道发生鳞状上皮增生脱屑,形成的胶质碎片聚集,角化上皮包裹所致的一种慢性炎性疾病。发病率为1‰^（1）。易与外耳道阻塞性角化病、外耳道耵聍及胆脂瘤型中耳炎相混淆,常常漏诊或误诊。