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.     

中耳癌诊治15例报告

 本文分析了15例中耳癌的临床资料。结果显示：中耳癌的预后差与其病期较晚治疗困难有关。早期诊断和手术加放射疗法的综合治疗可能提高生存率。慢性化脓性中耳炎可能是诱发中耳癌的原因之一，预防中耳炎可能减少中耳癌的发病率。     

中耳胆固醇肉芽肿

目的 探讨中耳胆固醇肉芽肿的病因、发病机制以及治疗方法。方法 回顾性总结分析我院1988年3月～2003年3月经手术和病理证实的70例(耳)中耳胆固醇肉芽肿病人的临床资料。70例(耳)中，术前诊断为胆脂瘤型中耳炎37例，骨疡型中耳炎13例，此二者之中考虑胆固醇肉芽肿者13例；中耳乳突术后感染5例，分泌性中耳炎7例，特发性血鼓室8例，其中考虑可能为胆固醇肉芽肿者2例。所有病人均有不同程度听力下降、耳闭塞感或伴耳鸣，亦可有耳溢液、头痛、头昏及其他症状。70例(耳)均接受手术治疗，依照术前检查，根据病变程度不同而选择不同术式。结果 65例(耳)干耳，随访1年以上无复发。3例(耳)行改良乳突根治加鼓室成形术，术后半年流脓，后改行乳突根治术，术后均干耳；2例(耳)行鼓室探查加鼓窦开放术，术后半年及1年又流脓伴听力下降，后改行改良乳突根治加鼓室成形术，术后干耳。结论 中耳胆固醇肉芽肿的病因主要有：含气腔通气受阻、引流障碍及含气腔出血。中耳胆固醇肉芽肿与特发性血鼓室、分泌性中耳炎及胆脂瘤关系密切。术式的选择应根据病变范围和程度来决定，其原则是彻底清除病变，保持通畅引流。     

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.     

肾阴虚豚鼠模型的建立及对内耳形态学影响的实验研究

目的：观察肾阴虚状态下豚鼠内耳形态学的变化。方法：选用健康豚鼠24只，随机分为A、B、c3组，每组8只。A组每日肌注醋酸强的松龙注射液50mg／kg，同时用生理盐水灌胃，共10天。B组每日肌注醋酸强的松龙剂量同A组，同时用六味地黄汤灌胃，共10天。C组每日肌注生理盐水，同时用生理盐水灌胃，共10天。观察指标为动物的一般状况，cAMP、cGMP和血浆皮质醇含量，并计算出cAMP／cGMP的比值，在光镜下观察毛细胞形态进行计数。结果：各组内毛细胞几乎无坏死。C组耳蜗基底膜第1—4回三排外毛细胞无明显坏死；A、B组第1—3回外毛细胞均不同程度坏死，尤以第1回（底回）最严重，顶回外毛细胞则基本正常，B组外毛细胞坏死程度要比A组轻（P＜0、05）；A、B组1—3回外毛细胞坏死数分别与c组比较有显著性差异（P＜0．01）。结论：肾阴虚状态下豚鼠内耳毛细胞受到损害，滋补肾阴的中药可保护内耳免受这种损害，进一步证明了中医肾与耳关系论述的科学性。     

耳穴降压沟电脉冲刺激治疗高血压病疗效分析

目的:观察耳穴降压沟电脉冲刺激对高血压病的治疗作用.方法:将129例Ⅰ～Ⅲ期高血压病患者采用华佗自动降压仪取耳穴降压沟电脉冲刺激,每次20～30分钟,每天1次.3疗程(21次)后观察血压变化情况.结果:129例患者,显效44例,有效73例,无效12例,总有效率达90.70%.收缩压平均下降(18.64±1.48)mmHg,舒张压平均下降(8.01±0.68)mmHg,收缩压与舒张压治疗前后比较差异均有极显著性意义(P<0.001).结论:耳穴降压沟电脉冲刺激能有效降低高血压病人的收缩压和舒张压.