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
Introduction: Middle ear volume(MEV) is a clinically relevant parameter across middle ear diseases. MEV values between these techniques have never before been tested for agreement in ears with perforated tympanic memb...Introduction: Middle ear volume(MEV) is a clinically relevant parameter across middle ear diseases. MEV values between these techniques have never before been tested for agreement in ears with perforated tympanic membranes(TMs).Methods: Middle ears were identified from 36 patients ranging 18-89 years of age with TM perforations who underwent tympanometry and temporal bone computed tomography(CT) between 2005 and 2015. MEVs calculated by both tympanometry and three-dimensional volume reconstruction(3DVR) were analyzed for agreement using Bland Altman plots. The differences between tympanometric and 3DVR MEV values for each given middle ear were characterized across MEV quartiles(1= smallest; 4= largest) and across increasing states of middle ear disease using Kruskale Wallis and Wilcoxon testing with Bonferroni correction.Results: Bland Altman plots demonstrated significant disagreement between MEV measurement techniques. Differences between tympanometric(T) and 3DVR MEV values were significantly greater with increasing average(i.e.(Tt3DVR)/2)) MEV per linear regression(p < 0.0001). Significance was demonstrated between fourth and first average MEV quartiles(p= 0.0024), fourth and second quartiles(p= 0.0024), third and first quartiles(p= 0.0048), and third and second quartiles(p= 0.048). Absolute MEV difference was not significantly different across varying states of middle ear disease(p= 0.44).Conclusion: Statistically and clinically significant disagreement was demonstrated between tympanometric and 3DVR MEV values. Studies that vary in MEV estimation techniques may be expected to demonstrate significantly different results. These preliminary results suggest that clinicians should endeavor to seek further confirmation when interpreting high tympanometric MEV values.展开更多
Perforation of tympanic membrane is one of the main reasons for both deafness and dyssaudia.We could improve and restore audition by restoring or replacing the tympanic membrane.So,whether you can make the spurious ty...Perforation of tympanic membrane is one of the main reasons for both deafness and dyssaudia.We could improve and restore audition by restoring or replacing the tympanic membrane.So,whether you can make the spurious tympanic membrane successfully is one of the keys to a successful operation.Utilizing CMM (Coordinate Measuring Machine) measurement equipment, we measured tympanic membrane model precisely and digitally.We also analysed the measured data by point to surface and we have successfully reconstructed the CAD model of the spurious tympanic membrane.Using the model we have got,we schemed out the mold of spurious tympanic membrane.In addition,we utilized MasterCAM compiling CNC (Computerized Numerical Con- trol) code and simulating the course of working.Ultimately,we obtained the mold of spurious tympanic membrane.Our research in this article has great significance to the success of spurious tympanic membrane grafting operation.展开更多
Objective: Infrared Tympanic Thermometer(ITT) is one of the most useful instruments for accurately measuring temperature. The effects of ear pathologies on ITT measurement remain unclear. The purpose of this study is ...Objective: Infrared Tympanic Thermometer(ITT) is one of the most useful instruments for accurately measuring temperature. The effects of ear pathologies on ITT measurement remain unclear. The purpose of this study is to determine if tympanic membrane perforation(TMP) affects ITT measurements in adult patients.Material and methods: A total of 90 adult patients with monaural central TMP were enrolled in this study.Patients were categorized into three subgroups according to perforation size(1-3 mm, 4-7 mm, and 8-10 mm).The tympanic temperatures of the affected and unaffected sites, and subgroups were compared with each other.Results: This study contained 54(60%) males and 36(40%) females ranging from 20 to 58 years of age(mean age: 30.74 ± 9.61 years). The mean tympanic temperature of the side affected with TMP was 36.34 oC ± 0.61 oC.The mean tympanic temperature of the unaffected side with healthy and intact tympanic membrane was 36.33 oC ± 0.6 oC. The Pearson correlation score for the tympanic temperatures and the size of TMP was 0.22 which was not significant(r=-0.12).Conclusion: TMP and perforation size do not affect ITT measurements in adult patients.展开更多
The interest for telemedicine has increased since the COVID-19 pandemic because of the risk of infection.Recently,commercial companies started selling digital USB-otoscopes(DUO)that can be connected to a mobile phone....The interest for telemedicine has increased since the COVID-19 pandemic because of the risk of infection.Recently,commercial companies started selling digital USB-otoscopes(DUO)that can be connected to a mobile phone.These DUOs are inexpensive(costing approximately$6e35 each)and make it possible to visualize the whole tympanic membrane.Here,we illustrate the case of a patient who had operative correction of a tympanic membrane retraction,and who self-monitored the tympanic membrane in the course of time.Additionally,we discuss the use of DUOs in otolaryngology telemedicine practice.The use of simple digital USB otoscopes provides a promising method to assess and monitor the tympanic membrane remotely.However,more research is needed to establish the role of DUOs in telemedicine.展开更多
Background: An ear-fitting thermometer probe “NIPRO CE THERMO?” (Nipro Corporation, Osaka, Japan, new CE thermo) for both ears was newly developed in 2017. Since new release, we have never investigated about an accu...Background: An ear-fitting thermometer probe “NIPRO CE THERMO?” (Nipro Corporation, Osaka, Japan, new CE thermo) for both ears was newly developed in 2017. Since new release, we have never investigated about an accuracy of the new CE thermo. In this time, the accuracy of the CE thermo was investigated. Methods: The correlation between the tympanic membrane temperature, measured using the new CE thermo, and the esophageal temperature of 30 patients (right ear: 16 patients, left ear: 14 patients) was measured in the prospective observational study. Results: A good correlation (r = 0.721) and no measurement error (within 1?C in mean ± 2SD) between the two temperatures were observed using Bland-Altman analysis. The correlation and measurement error for each ear yielded the same results. Conclusion: The tympanic membrane temperature, measured using the new CE thermo, showed good correlation with the esophageal temperature and could be used as a central temperature in the perioperative period.展开更多
BACKGROUND Fat embolism syndrome(FES)is a rare disease characterized by pulmonary distress,neurologic symptoms,and petechial rash and seriously threatens human life and health.It is still neglected clinically because ...BACKGROUND Fat embolism syndrome(FES)is a rare disease characterized by pulmonary distress,neurologic symptoms,and petechial rash and seriously threatens human life and health.It is still neglected clinically because of the lack of verifiable diagnostic criteria and atypical clinical symptoms.No studies on FES with pulmonary embolism(PE)and tympanic membrane perforation have been reported to date.Here,we report a rare case of concomitant FES,PE and tympanic membrane perforation after surgery in a patient with a tibiofibular fracture.CASE SUMMARY A 39-year-old man presented with right lower extremity pain due to a car accident while driving a motorbike on the road.X-ray and computed tomography scans revealed a fracture of the right mid-shaft tibia and proximal fibula categorized as a type A2 fracture according to the AO classification.A successful minimally invasive operation was performed 3 d after the injury.Postoperatively,the patient developed sudden symptoms of respiratory distress and hearing loss.Early diagnosis was made,and supportive treatments were used at the early stage of FES.Seven days after surgery,he presented a clear recovery from respiratory symptoms.The outcome of fracture healing was excellent,and his hearing of the left ear was mildly impaired at the last follow-up of 4 mo.CONCLUSION Concomitant FES,PE and tympanic membrane perforation are very rare but represent potentially fatal complications of trauma or orthopedic surgery and present with predominantly pulmonary symptoms.Early diagnosis and treatment can reduce the mortality of FES,and prevention is better than a cure.展开更多
Objective: To report a novel case of Tarceva? treatment for small cell lung carcinoma resulting in tympanic membrane necrosis. Patient: A 49-year-old male with tympanic membrane necrosis and presumed resistant acute o...Objective: To report a novel case of Tarceva? treatment for small cell lung carcinoma resulting in tympanic membrane necrosis. Patient: A 49-year-old male with tympanic membrane necrosis and presumed resistant acute otitis externa and chronic inflammation of the left ear. Patient is status post chemotherapy and radiation diagnosed with non-small cell lung cancer in December 2008 with on-going therapy with Tarceva? for residual disease. Intervention: Tympanoplasty of left ear. Results: Improvement of symptoms of irritation and improvement of hearing and speech reception thresholds. All acid fast bacilli, fungal and bacterial cultures of the intra-op specimen were negative. Conclusions: The possibility that long term Tarceva? therapy could have caused the tympanic membrane necrosis and acute otitis media like symptoms is feasible since Tarceva? is an inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase. Upon activation of EGFRs it undergoes a transition from inactive monomeric form to active homodimer or hertodimer with another member of the ErbB receptor family. This then initiates several signal transduction cascades, leading to DNA synthesis and cell proliferation. Activation of the receptor is important in the innate immune response in human skin. Some of the common side effects include an aceiform skin rash but this is the first reported link between tympanic membrane necrosis and Tarceva?.展开更多
Objective:Tympanoplasty aims to eradicate lesions and restore middle ear function in chronic otitis media.This study was conducted to compare the surgical and functional outcomes of endoscopic tympanoplasty(ET)and mic...Objective:Tympanoplasty aims to eradicate lesions and restore middle ear function in chronic otitis media.This study was conducted to compare the surgical and functional outcomes of endoscopic tympanoplasty(ET)and microscopic tympanoplasty(MT)in anterior tympanic membrane perforation.Methods:The clinical data of 42 patients undergoing tympanoplasty with anterior quadrants tympanic membrane perforation between January 2018 and July 2019 were retrospectively analyzed.Patients were classified into the ET group(n?22)or the MT group(n?20).Patients’demographics,clinical characteristics,surgical and functional outcomes were assessed between the two groups.Results:External auditory canal widening was not necessary in the ET group and was performed in 55.0%of patients in the MT group.The operation time of the ET group was significantly shorter than that of the MT group(61.23±11.48 min vs.78.65±11.79 min,p=0.034).The pain scale score of the ET group at 24 hours after surgery was significantly lower than that of the MT group(0.86±0.64 vs.2.40±1.14,p=0.029).The grafting success rate was 95.5%(21/22)in the ET group and 95.0%(19/20)in the MT group.In the ET group,the pre-and postoperative air-bone gap were 35.60±8.43 dB and 18.79±5.80 dB,respectively,which was a significant improvement(p=0.016).The respective values in the MT group(33.33±7.88 dB and 19.58±6.24 dB)also represented a significant improvement(p=0.004).Conclusion:ET is more beneficial for patients with anterior tympanic membrane perforations,which helps minimize the surgical trauma and reduces operation time and postoperative pain.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
A rat model of chronic tympanic membrane perforation was developed to be used in the search of new materials for the sealing of these perforations. A longitudinal study was carried out in rats subjected to incisional ...A rat model of chronic tympanic membrane perforation was developed to be used in the search of new materials for the sealing of these perforations. A longitudinal study was carried out in rats subjected to incisional myr-ingotomy followed by the application of mitomycin C alone or with dexamethasone. Rats were checked at days 3, 7,1 0,1 4 and weekly thereafter until perforation closure, for up to 6 months. The addition of dexamethasone is a key component in order to obtain a chronic opening. Myringotomies treated w ith saline had a mean healing time of 8.5 days. At 8 weeks, between 62.5% and 77.7% of tympanic membranes treated w ith mitomycin C and dexamethasone remained perforated and at 6 months this number fell to 21.4%. This technique is able to maintain most tympanic membrane perforations patent for at least 8 weeks. This rat model is adequate for its use in preclinical or translational research.展开更多
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.
文摘Introduction: Middle ear volume(MEV) is a clinically relevant parameter across middle ear diseases. MEV values between these techniques have never before been tested for agreement in ears with perforated tympanic membranes(TMs).Methods: Middle ears were identified from 36 patients ranging 18-89 years of age with TM perforations who underwent tympanometry and temporal bone computed tomography(CT) between 2005 and 2015. MEVs calculated by both tympanometry and three-dimensional volume reconstruction(3DVR) were analyzed for agreement using Bland Altman plots. The differences between tympanometric and 3DVR MEV values for each given middle ear were characterized across MEV quartiles(1= smallest; 4= largest) and across increasing states of middle ear disease using Kruskale Wallis and Wilcoxon testing with Bonferroni correction.Results: Bland Altman plots demonstrated significant disagreement between MEV measurement techniques. Differences between tympanometric(T) and 3DVR MEV values were significantly greater with increasing average(i.e.(Tt3DVR)/2)) MEV per linear regression(p < 0.0001). Significance was demonstrated between fourth and first average MEV quartiles(p= 0.0024), fourth and second quartiles(p= 0.0024), third and first quartiles(p= 0.0048), and third and second quartiles(p= 0.048). Absolute MEV difference was not significantly different across varying states of middle ear disease(p= 0.44).Conclusion: Statistically and clinically significant disagreement was demonstrated between tympanometric and 3DVR MEV values. Studies that vary in MEV estimation techniques may be expected to demonstrate significantly different results. These preliminary results suggest that clinicians should endeavor to seek further confirmation when interpreting high tympanometric MEV values.
文摘Perforation of tympanic membrane is one of the main reasons for both deafness and dyssaudia.We could improve and restore audition by restoring or replacing the tympanic membrane.So,whether you can make the spurious tympanic membrane successfully is one of the keys to a successful operation.Utilizing CMM (Coordinate Measuring Machine) measurement equipment, we measured tympanic membrane model precisely and digitally.We also analysed the measured data by point to surface and we have successfully reconstructed the CAD model of the spurious tympanic membrane.Using the model we have got,we schemed out the mold of spurious tympanic membrane.In addition,we utilized MasterCAM compiling CNC (Computerized Numerical Con- trol) code and simulating the course of working.Ultimately,we obtained the mold of spurious tympanic membrane.Our research in this article has great significance to the success of spurious tympanic membrane grafting operation.
文摘Objective: Infrared Tympanic Thermometer(ITT) is one of the most useful instruments for accurately measuring temperature. The effects of ear pathologies on ITT measurement remain unclear. The purpose of this study is to determine if tympanic membrane perforation(TMP) affects ITT measurements in adult patients.Material and methods: A total of 90 adult patients with monaural central TMP were enrolled in this study.Patients were categorized into three subgroups according to perforation size(1-3 mm, 4-7 mm, and 8-10 mm).The tympanic temperatures of the affected and unaffected sites, and subgroups were compared with each other.Results: This study contained 54(60%) males and 36(40%) females ranging from 20 to 58 years of age(mean age: 30.74 ± 9.61 years). The mean tympanic temperature of the side affected with TMP was 36.34 oC ± 0.61 oC.The mean tympanic temperature of the unaffected side with healthy and intact tympanic membrane was 36.33 oC ± 0.6 oC. The Pearson correlation score for the tympanic temperatures and the size of TMP was 0.22 which was not significant(r=-0.12).Conclusion: TMP and perforation size do not affect ITT measurements in adult patients.
文摘The interest for telemedicine has increased since the COVID-19 pandemic because of the risk of infection.Recently,commercial companies started selling digital USB-otoscopes(DUO)that can be connected to a mobile phone.These DUOs are inexpensive(costing approximately$6e35 each)and make it possible to visualize the whole tympanic membrane.Here,we illustrate the case of a patient who had operative correction of a tympanic membrane retraction,and who self-monitored the tympanic membrane in the course of time.Additionally,we discuss the use of DUOs in otolaryngology telemedicine practice.The use of simple digital USB otoscopes provides a promising method to assess and monitor the tympanic membrane remotely.However,more research is needed to establish the role of DUOs in telemedicine.
文摘Background: An ear-fitting thermometer probe “NIPRO CE THERMO?” (Nipro Corporation, Osaka, Japan, new CE thermo) for both ears was newly developed in 2017. Since new release, we have never investigated about an accuracy of the new CE thermo. In this time, the accuracy of the CE thermo was investigated. Methods: The correlation between the tympanic membrane temperature, measured using the new CE thermo, and the esophageal temperature of 30 patients (right ear: 16 patients, left ear: 14 patients) was measured in the prospective observational study. Results: A good correlation (r = 0.721) and no measurement error (within 1?C in mean ± 2SD) between the two temperatures were observed using Bland-Altman analysis. The correlation and measurement error for each ear yielded the same results. Conclusion: The tympanic membrane temperature, measured using the new CE thermo, showed good correlation with the esophageal temperature and could be used as a central temperature in the perioperative period.
基金The Subject Leadership Project of Shanghai Pudong New Area,No.PWRd2016-06the Featured Clinical Discipline Project of Shanghai Pudong,No.PWYts2018-03.
文摘BACKGROUND Fat embolism syndrome(FES)is a rare disease characterized by pulmonary distress,neurologic symptoms,and petechial rash and seriously threatens human life and health.It is still neglected clinically because of the lack of verifiable diagnostic criteria and atypical clinical symptoms.No studies on FES with pulmonary embolism(PE)and tympanic membrane perforation have been reported to date.Here,we report a rare case of concomitant FES,PE and tympanic membrane perforation after surgery in a patient with a tibiofibular fracture.CASE SUMMARY A 39-year-old man presented with right lower extremity pain due to a car accident while driving a motorbike on the road.X-ray and computed tomography scans revealed a fracture of the right mid-shaft tibia and proximal fibula categorized as a type A2 fracture according to the AO classification.A successful minimally invasive operation was performed 3 d after the injury.Postoperatively,the patient developed sudden symptoms of respiratory distress and hearing loss.Early diagnosis was made,and supportive treatments were used at the early stage of FES.Seven days after surgery,he presented a clear recovery from respiratory symptoms.The outcome of fracture healing was excellent,and his hearing of the left ear was mildly impaired at the last follow-up of 4 mo.CONCLUSION Concomitant FES,PE and tympanic membrane perforation are very rare but represent potentially fatal complications of trauma or orthopedic surgery and present with predominantly pulmonary symptoms.Early diagnosis and treatment can reduce the mortality of FES,and prevention is better than a cure.
文摘Objective: To report a novel case of Tarceva? treatment for small cell lung carcinoma resulting in tympanic membrane necrosis. Patient: A 49-year-old male with tympanic membrane necrosis and presumed resistant acute otitis externa and chronic inflammation of the left ear. Patient is status post chemotherapy and radiation diagnosed with non-small cell lung cancer in December 2008 with on-going therapy with Tarceva? for residual disease. Intervention: Tympanoplasty of left ear. Results: Improvement of symptoms of irritation and improvement of hearing and speech reception thresholds. All acid fast bacilli, fungal and bacterial cultures of the intra-op specimen were negative. Conclusions: The possibility that long term Tarceva? therapy could have caused the tympanic membrane necrosis and acute otitis media like symptoms is feasible since Tarceva? is an inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase. Upon activation of EGFRs it undergoes a transition from inactive monomeric form to active homodimer or hertodimer with another member of the ErbB receptor family. This then initiates several signal transduction cascades, leading to DNA synthesis and cell proliferation. Activation of the receptor is important in the innate immune response in human skin. Some of the common side effects include an aceiform skin rash but this is the first reported link between tympanic membrane necrosis and Tarceva?.
文摘Objective:Tympanoplasty aims to eradicate lesions and restore middle ear function in chronic otitis media.This study was conducted to compare the surgical and functional outcomes of endoscopic tympanoplasty(ET)and microscopic tympanoplasty(MT)in anterior tympanic membrane perforation.Methods:The clinical data of 42 patients undergoing tympanoplasty with anterior quadrants tympanic membrane perforation between January 2018 and July 2019 were retrospectively analyzed.Patients were classified into the ET group(n?22)or the MT group(n?20).Patients’demographics,clinical characteristics,surgical and functional outcomes were assessed between the two groups.Results:External auditory canal widening was not necessary in the ET group and was performed in 55.0%of patients in the MT group.The operation time of the ET group was significantly shorter than that of the MT group(61.23±11.48 min vs.78.65±11.79 min,p=0.034).The pain scale score of the ET group at 24 hours after surgery was significantly lower than that of the MT group(0.86±0.64 vs.2.40±1.14,p=0.029).The grafting success rate was 95.5%(21/22)in the ET group and 95.0%(19/20)in the MT group.In the ET group,the pre-and postoperative air-bone gap were 35.60±8.43 dB and 18.79±5.80 dB,respectively,which was a significant improvement(p=0.016).The respective values in the MT group(33.33±7.88 dB and 19.58±6.24 dB)also represented a significant improvement(p=0.004).Conclusion:ET is more beneficial for patients with anterior tympanic membrane perforations,which helps minimize the surgical trauma and reduces operation time and postoperative pain.
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。
基金supported by funding from the Instituto de Salud Carlos Ⅲ Spanish Net of Cell Therapy (Ter Cel), RETICS subprogram of the I+D+I 2013–2016 Spanish National Plan, projects "RD12/0019/ 0001", "RD12/0019/0023" and "RD16/0011/0001" funded by ISCⅢ and co-founded by ERDF
文摘A rat model of chronic tympanic membrane perforation was developed to be used in the search of new materials for the sealing of these perforations. A longitudinal study was carried out in rats subjected to incisional myr-ingotomy followed by the application of mitomycin C alone or with dexamethasone. Rats were checked at days 3, 7,1 0,1 4 and weekly thereafter until perforation closure, for up to 6 months. The addition of dexamethasone is a key component in order to obtain a chronic opening. Myringotomies treated w ith saline had a mean healing time of 8.5 days. At 8 weeks, between 62.5% and 77.7% of tympanic membranes treated w ith mitomycin C and dexamethasone remained perforated and at 6 months this number fell to 21.4%. This technique is able to maintain most tympanic membrane perforations patent for at least 8 weeks. This rat model is adequate for its use in preclinical or translational research.
