目的分析耳内镜下应用耳屏软骨膜对中小鼓膜穿孔进行翻瓣和非翻瓣式Ⅰ型鼓室成形术的疗效。方法将68例(68耳)施行鼓膜修补术的患者根据术式不同分为对照组(耳内镜下翻瓣式Ⅰ型鼓室成形术组)和实验组(耳内镜下非翻瓣式Ⅰ型鼓室成形术组)...目的分析耳内镜下应用耳屏软骨膜对中小鼓膜穿孔进行翻瓣和非翻瓣式Ⅰ型鼓室成形术的疗效。方法将68例(68耳)施行鼓膜修补术的患者根据术式不同分为对照组(耳内镜下翻瓣式Ⅰ型鼓室成形术组)和实验组(耳内镜下非翻瓣式Ⅰ型鼓室成形术组),术后随访6个月以上,比较两组的手术效果、手术时间、术中出血量、视觉模拟评分(VAS)及生活质量。结果实验组术中平均出血量和术后24 h VAS评分均明显低于对照组(P<0.05);实验组平均手术时间明显短于对照组(P<0.05)。两组手术后平均气导听阈和气骨导差均明显下降(P<0.001);术后6月组间比较,两组气导平均听阈及气骨导差比较,差异无统计学意义(P>0.05)。实验组术后ZCMEI-21量表评分在耳部症状、医疗资源使用及总分低于对照组(P<0.05)。结论对中耳条件良好的中小鼓膜穿孔患者应用耳屏软骨膜行耳内镜下非翻瓣式Ⅰ型鼓室成形术可以减少术中出血、优化手术时间、减轻术后疼痛、改善生活质量,值得进一步推广。展开更多
Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatm...Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.展开更多
Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the st...Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the studies on this subject, but few data are available in our context. Objective: This paper aims to study post-blast tympanic perforations in Yaounde, specifically the epidemiological, clinical, and paraclinical aspects. Methodology: We conducted a descriptive cross-sectional study with retrospective and prospective data collection in six Yaounde hospitals over 63 months from January 1, 2018, to March 31, 2023. All patients with at least one post-blast tympanic perforation were included. Socio-demographic, clinical and paraclinical data were collected on a questionnaire and analysed using SPSS 28 software. Results: We included 124 patients. The prevalence of post-blast tympanic perforations was 0.1% of the consultations in the departments. 71 The average age was 28.6 ± 9.1 years, with extremes ranging from 7 to 49 years. The median consultation time was five days. The most frequent injury circumstances were physical aggression (81.45%) and armed conflict (10.5%). The injury mechanisms were slaps (75%), punches (21.74%) and grenades (4.8%). The main symptoms on admission were hearing loss (63.7%), tinnitus (58.1%) and otalgia (57.3%). The tympanic perforations were unilateral in all cases, the anterior-inferior location was more characteristic, and the deafness was conductive in 58.3% of cases, followed by mixed deafness in 23.3% of cases. Conclusion: Post-blast tympanic perforations are rare in consultation. The population is primarily male and from the second decade of life. The main circumstance is aggression.展开更多
目的研究外耳道袖套皮瓣-舌状筋膜瓣技术修复鼓膜大穿孔的应用价值。方法回顾性选取2020年6月至2024年6月在北京大学国际医院施行的袖套-舌形瓣鼓室成形手术患者73例,穿孔面积占鼓膜截面积50%~75%的大穿孔66例,穿孔面积大于鼓膜截面积75...目的研究外耳道袖套皮瓣-舌状筋膜瓣技术修复鼓膜大穿孔的应用价值。方法回顾性选取2020年6月至2024年6月在北京大学国际医院施行的袖套-舌形瓣鼓室成形手术患者73例,穿孔面积占鼓膜截面积50%~75%的大穿孔66例,穿孔面积大于鼓膜截面积75%的特大穿孔7例,观察患者的鼓膜愈合情况与手术前-后听力学指标。结果应用该技术重建鼓膜的愈合率达94.52%(69/73例),术后纯音测听(pure tone audiometry,PTA)较前提高,PTA提升中位数8.75(1.25,16.25)dB;术后气骨导差(air-bone gap,ABG)较术前缩小,ABG缩小中位数7.5(0.63,13.75)dB。鼓膜大穿孔和特大穿孔的愈合率无显著性差异(P=0.338)。结论外耳道袖套皮瓣-舌形筋膜瓣技术兼顾了局部血运、耳道成形、鼓膜形态以及与耳道的解剖关系,显现出良好的鼓膜愈合率和听力学改善,为临床复杂鼓膜的重建提供了一种新选择。展开更多
Objective:To analyze the clinical effect of a simple egg membrane patch bridging method in repairing tympanic membrane perforation.Methods:A total of 93 tympanic membrane perforation patients admitted to the hospital ...Objective:To analyze the clinical effect of a simple egg membrane patch bridging method in repairing tympanic membrane perforation.Methods:A total of 93 tympanic membrane perforation patients admitted to the hospital between September 2022 and October 2023 were selected and divided into two groups according to the random number table method.The control group implemented the conventional treatment(n=46 cases),and the patch group adopted the simple egg membrane patch bridging method(n=47 cases).The healing rate of the tympanic membrane,the air-bone gap,the air conduction hearing threshold,the dry ear rate,and the incidence of complications in both groups were compared before and after treatment.Results:The healing rate of the tympanic membrane in the patch group was significantly higher than that of the control group(95.75%vs.76.09%),with P<0.05;there was no difference in the air-bone gap and air conduction hearing threshold levels between the two groups before treatment(P>0.05),and the hearing indexes of the patch group were significantly lower than those of the control group 3 months after treatment(P<0.05);the dry ear rate in the patch group was significantly higher than that of the control group after treatment(85.11%vs.67.39%),and the total incidence of complications was also significantly lower than that of the control group(6.38%vs.21.74%),with P<0.05.Conclusion:The simple egg membrane patch bridging method is effective in repairing tympanic membrane perforation,which can effectively improve patients’hearing levels and reduce the occurrence of post-treatment complications.Thus,it is worth popularizing and applying in the clinic.展开更多
文摘目的分析耳内镜下应用耳屏软骨膜对中小鼓膜穿孔进行翻瓣和非翻瓣式Ⅰ型鼓室成形术的疗效。方法将68例(68耳)施行鼓膜修补术的患者根据术式不同分为对照组(耳内镜下翻瓣式Ⅰ型鼓室成形术组)和实验组(耳内镜下非翻瓣式Ⅰ型鼓室成形术组),术后随访6个月以上,比较两组的手术效果、手术时间、术中出血量、视觉模拟评分(VAS)及生活质量。结果实验组术中平均出血量和术后24 h VAS评分均明显低于对照组(P<0.05);实验组平均手术时间明显短于对照组(P<0.05)。两组手术后平均气导听阈和气骨导差均明显下降(P<0.001);术后6月组间比较,两组气导平均听阈及气骨导差比较,差异无统计学意义(P>0.05)。实验组术后ZCMEI-21量表评分在耳部症状、医疗资源使用及总分低于对照组(P<0.05)。结论对中耳条件良好的中小鼓膜穿孔患者应用耳屏软骨膜行耳内镜下非翻瓣式Ⅰ型鼓室成形术可以减少术中出血、优化手术时间、减轻术后疼痛、改善生活质量,值得进一步推广。
文摘Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.
文摘Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the studies on this subject, but few data are available in our context. Objective: This paper aims to study post-blast tympanic perforations in Yaounde, specifically the epidemiological, clinical, and paraclinical aspects. Methodology: We conducted a descriptive cross-sectional study with retrospective and prospective data collection in six Yaounde hospitals over 63 months from January 1, 2018, to March 31, 2023. All patients with at least one post-blast tympanic perforation were included. Socio-demographic, clinical and paraclinical data were collected on a questionnaire and analysed using SPSS 28 software. Results: We included 124 patients. The prevalence of post-blast tympanic perforations was 0.1% of the consultations in the departments. 71 The average age was 28.6 ± 9.1 years, with extremes ranging from 7 to 49 years. The median consultation time was five days. The most frequent injury circumstances were physical aggression (81.45%) and armed conflict (10.5%). The injury mechanisms were slaps (75%), punches (21.74%) and grenades (4.8%). The main symptoms on admission were hearing loss (63.7%), tinnitus (58.1%) and otalgia (57.3%). The tympanic perforations were unilateral in all cases, the anterior-inferior location was more characteristic, and the deafness was conductive in 58.3% of cases, followed by mixed deafness in 23.3% of cases. Conclusion: Post-blast tympanic perforations are rare in consultation. The population is primarily male and from the second decade of life. The main circumstance is aggression.
文摘目的研究外耳道袖套皮瓣-舌状筋膜瓣技术修复鼓膜大穿孔的应用价值。方法回顾性选取2020年6月至2024年6月在北京大学国际医院施行的袖套-舌形瓣鼓室成形手术患者73例,穿孔面积占鼓膜截面积50%~75%的大穿孔66例,穿孔面积大于鼓膜截面积75%的特大穿孔7例,观察患者的鼓膜愈合情况与手术前-后听力学指标。结果应用该技术重建鼓膜的愈合率达94.52%(69/73例),术后纯音测听(pure tone audiometry,PTA)较前提高,PTA提升中位数8.75(1.25,16.25)dB;术后气骨导差(air-bone gap,ABG)较术前缩小,ABG缩小中位数7.5(0.63,13.75)dB。鼓膜大穿孔和特大穿孔的愈合率无显著性差异(P=0.338)。结论外耳道袖套皮瓣-舌形筋膜瓣技术兼顾了局部血运、耳道成形、鼓膜形态以及与耳道的解剖关系,显现出良好的鼓膜愈合率和听力学改善,为临床复杂鼓膜的重建提供了一种新选择。
文摘Objective:To analyze the clinical effect of a simple egg membrane patch bridging method in repairing tympanic membrane perforation.Methods:A total of 93 tympanic membrane perforation patients admitted to the hospital between September 2022 and October 2023 were selected and divided into two groups according to the random number table method.The control group implemented the conventional treatment(n=46 cases),and the patch group adopted the simple egg membrane patch bridging method(n=47 cases).The healing rate of the tympanic membrane,the air-bone gap,the air conduction hearing threshold,the dry ear rate,and the incidence of complications in both groups were compared before and after treatment.Results:The healing rate of the tympanic membrane in the patch group was significantly higher than that of the control group(95.75%vs.76.09%),with P<0.05;there was no difference in the air-bone gap and air conduction hearing threshold levels between the two groups before treatment(P>0.05),and the hearing indexes of the patch group were significantly lower than those of the control group 3 months after treatment(P<0.05);the dry ear rate in the patch group was significantly higher than that of the control group after treatment(85.11%vs.67.39%),and the total incidence of complications was also significantly lower than that of the control group(6.38%vs.21.74%),with P<0.05.Conclusion:The simple egg membrane patch bridging method is effective in repairing tympanic membrane perforation,which can effectively improve patients’hearing levels and reduce the occurrence of post-treatment complications.Thus,it is worth popularizing and applying in the clinic.
