Introduction: Middle ear surgery is increasingly performed in our department. Our goal was to take stock of this activity in the ENT department of the Donka National Hospital. Equipment and Methods: It was a descripti...Introduction: Middle ear surgery is increasingly performed in our department. Our goal was to take stock of this activity in the ENT department of the Donka National Hospital. Equipment and Methods: It was a descriptive and retrospective study;it involved 71 patients’ records operated from January 1, 2018 to December 31, 2023. We included the files of patients who had a middle ear surgery including the post-operative report and follow-up. Incomplete or illegible records were excluded. The parameters studied were epidemiological, otoscopic, tomodensitometric, surgical indications, surgical techniques and results. Results: We recorded 71 middle ear surgeries out of 548 ENT surgeries, the prevalence was 12.96%. The average age was 23 years (type-deviation = 17, 29 years) with extremes of 3 to 75 years. According to the preoperative audiometry, the deafness was medium (48.8%), mild (36.9%) and severe (14.3%). The operative indications were among others: perforation of the tympanic sequellar (52.5%), chronic otomastoiditis (23.8%), cholesteatoma (15%) and seromuqueous otitis (8.7%). We performed 70 tympanoplasties (90.9%), 50 mastoidectomies (64.9%) and 7 trans-tympanic aerators (9.1%). One month after surgery, the neotympanum was constituted in 86%, and the hearing gain was between 11 and 15 dB in 18.3% of cases. Conclusion: Middle ear surgery was infrequent. Young subjects are the most concerned. Tympanoplasty and mastoidectomy are the main surgical techniques. The anatomical and functional results are appreciable.展开更多
Background: The ear and face are indispensable and distinctive features for hearing and identification. Objectives: This study was designed to generate anthropometric data of the ear and facial indices of females of E...Background: The ear and face are indispensable and distinctive features for hearing and identification. Objectives: This study was designed to generate anthropometric data of the ear and facial indices of females of Efik and Ibibio children in Cross River and Akwa Ibom States, show morphological and aesthetic differences and ethnicity. Methods: A total of 600 female children (300 Efiks and 300 Ibibios) aged 2 to 10 years that met the inclusion criteria were chosen from selected primary schools in Calabar Municipality, Calabar South of Cross River State and from Uyo, Itu of Akwa Ibom State, Nigeria. Standardized measurements of face length, face width, ear length, and ear width were taken with a spreading caliper;the facial (proscopic) and ear (auricular) indices were determined. Results: Efik subjects presented a mean face length of 8.36 ± 0.06 cm, face width of 11.04 ± 0.04 cm, ear length of 4.92 ± 0.02 cm, and ear width of 3.06 ± 0.01 cm. Ibibio subjects had mean values for face length, face width, ear length, and ear width as 8.17 ± 0.05 cm, 10.75 ± 0.05 cm, 4.77 ± 0.03 cm, and 2.94 ± 0.02 cm respectively. The mean facial index and ear index for Efik subjects were 75.68 ± 0.31 and 62.16 ± 0.27 respectively;while the mean facial and ear indices for Ibibio subjects were 74.79 ± 0.36 and 61.80 ± 0.34 respectively. Statistical analysis demonstrated significant differences in face length, ear length, ear width and facial index, with the Efik subjects having higher values than Ibibio subjects (p Conclusion: The results showed hypereuryproscopic face as the prevalent face type among females of both ethnic groups, therefore can be of importance in sex, ethnic, and racial differentiation, and in clinical practice, aesthetics and forensic medicine.展开更多
Malignant tumors originating from the middle ear are rare. The literature identifies chronic inflammation and Human Papillomavirus (HPV) infection as the most common risk factors. A CT scan to assess bony invasion and...Malignant tumors originating from the middle ear are rare. The literature identifies chronic inflammation and Human Papillomavirus (HPV) infection as the most common risk factors. A CT scan to assess bony invasion and an MRI to evaluate soft tissue involvement, depth of invasion, and perineural invasion, followed by a biopsy, are indispensable for diagnosis and treatment. There is no standard treatment for squamous cell carcinoma of the middle ear, however, most reported cases are treated with surgical resection followed by postoperative radiotherapy. Given the challenges of achieving complete surgical excision, radiotherapy plays a crucial role in controlling middle ear cancers, as demonstrated in our case. We present a case of squamous cell carcinoma of the middle ear in a 63-year-old female with a history of chronic suppurative otitis media. The patient underwent a right subtotal petrosectomy without lymph node dissection followed by concurrent chemoradiotherapy. At the one-year follow visit, no recurrence or metastasis was detected.展开更多
In advanced otological surgeries, powered instruments form an indispensable part. The risk of deterioration to hearing in the operated ear is a commonly discussed issue, however, there remains a possibility of affecti...In advanced otological surgeries, powered instruments form an indispensable part. The risk of deterioration to hearing in the operated ear is a commonly discussed issue, however, there remains a possibility of affecting the hearing in the contralateral ear due to transcranial vibration. So in this study we aimed to assess the possibility of the non-operated ear being affected by the noise generated during ear surgeries and whether it is temporary or permanent in nature. Methodology: This study included 63 patients diagnosed with unilateral disease who underwent mastoid surgery. Preoperatively all the patients were subjected to Pure tone audiometry (PTA), Transient evoked otoacoustic emission (TEOAE) and Distortion product otoacoustic emission (DPOAE). Patients were operated using both cutting and diamond burrs of ranging from sizes 1 - 6 mm. Total drilling time was recorded. Results: Post-operative hearing evaluation was done at 1 week, 4 weeks and 12 weeks. The sound emitted by various burrs was recorded by Sound Level Meter. Out of the total 58 patients that followed up, 46 showed change in at least one of the hearing parameters. Patients showing changes had a higher drilling time as compared to those with no changes. Of these, the changes associated with the total drilling time and with cutting burr time were found to be significant. The hearing changes seen on PTA, TEOAE and DPOAE were transient in nature with only one patient having a persistent decreased high frequency threshold at the end of 12 weeks. It was also found that cutting burrs produce more sound as compared to diamond burrs and a larger size burr of a type produces more sound than a smaller one of its type. Conclusion: The drilling of mastoid bone during ear surgeries can transiently impair the hearing in the contralateral ear which is of great significance in patients with only one hearing ear.展开更多
This case is a 49-year-old female patient who presented with suspected eustachian tube dysfunction symptoms that were refractory to medical treatment. She presented with conductive hearing loss and aural fullness on t...This case is a 49-year-old female patient who presented with suspected eustachian tube dysfunction symptoms that were refractory to medical treatment. She presented with conductive hearing loss and aural fullness on the left. A physical exam revealed an epitympanic fleshy mass in the middle ear with effusion. Imaging with MRI and CT showed opacification of the epitympanum with surrounding bony demineralization bilaterally left greater than right and significant thinning versus dehiscence of the tegmen mastoideum and tympani on the left with only thinning of the tegmen on the right. An MR temporal bone with and without contrast, demonstrated enhancement of the left middle ear extending to the tegmen and corresponding enhancement of the dura along the floor of the left middle cranial fossa as well as extending along foramen ovale into the infratemporal fossa. There was to a lesser degree similar appearance on the right. A biopsy of the middle ear mass on the left revealed meningioma. This case highlights the need to widen your differential with common symptoms when they are refractory to treatment.展开更多
在完备的多维扩散过程的市场模型(模型系数是依赖于时间的广义 Black-Scholes 市场模型)假设下,考虑了连续时间均值-风险型证券投资组合策略选择问题.用终端财富的在险收益(earnings at risk,EaR)作为风险度量标准,分别在允许卖空和不...在完备的多维扩散过程的市场模型(模型系数是依赖于时间的广义 Black-Scholes 市场模型)假设下,考虑了连续时间均值-风险型证券投资组合策略选择问题.用终端财富的在险收益(earnings at risk,EaR)作为风险度量标准,分别在允许卖空和不允许卖空两种情况下,获得了均值-EaR 型投资组合策略选择问题的最优解和有效边界的显式表达式.展开更多
目的对结直肠癌外科患者治疗过程中,快速康复(enhanced recovery after surgery,ERAS)计划的应用价值进行分析。方法选择2020年7月1日—2022年3月1日常德市第一人民医院普通外科结直肠癌患者150例,按随机数字表法分为研究组与对照组,每...目的对结直肠癌外科患者治疗过程中,快速康复(enhanced recovery after surgery,ERAS)计划的应用价值进行分析。方法选择2020年7月1日—2022年3月1日常德市第一人民医院普通外科结直肠癌患者150例,按随机数字表法分为研究组与对照组,每组各75例,分别对患者进行传统开腹手术+EARS计划与传统开腹手术治疗,分析两组并发症、炎症因子水平、首次下床活动时间、进食时间、术后住院天数、排气时间、排便时间、满意度。结果研究组术后住院天数、排便、首次下床活动、进食、排气时间等指标均短于对照组,差异有统计学意义(P<0.05)。治疗有效率比较,研究组高于对照组,差异有统计学意义(P<0.05)。对照组并发症发生率高于研究组,差异有统计学意义(P<0.05)。研究组炎症因子水平均低于对照组,差异有统计学意义(P<0.05)。结论EARS计划推广价值较高,可以抑制炎症因子水平,提升治疗效果,预后效果显著。展开更多
文摘Introduction: Middle ear surgery is increasingly performed in our department. Our goal was to take stock of this activity in the ENT department of the Donka National Hospital. Equipment and Methods: It was a descriptive and retrospective study;it involved 71 patients’ records operated from January 1, 2018 to December 31, 2023. We included the files of patients who had a middle ear surgery including the post-operative report and follow-up. Incomplete or illegible records were excluded. The parameters studied were epidemiological, otoscopic, tomodensitometric, surgical indications, surgical techniques and results. Results: We recorded 71 middle ear surgeries out of 548 ENT surgeries, the prevalence was 12.96%. The average age was 23 years (type-deviation = 17, 29 years) with extremes of 3 to 75 years. According to the preoperative audiometry, the deafness was medium (48.8%), mild (36.9%) and severe (14.3%). The operative indications were among others: perforation of the tympanic sequellar (52.5%), chronic otomastoiditis (23.8%), cholesteatoma (15%) and seromuqueous otitis (8.7%). We performed 70 tympanoplasties (90.9%), 50 mastoidectomies (64.9%) and 7 trans-tympanic aerators (9.1%). One month after surgery, the neotympanum was constituted in 86%, and the hearing gain was between 11 and 15 dB in 18.3% of cases. Conclusion: Middle ear surgery was infrequent. Young subjects are the most concerned. Tympanoplasty and mastoidectomy are the main surgical techniques. The anatomical and functional results are appreciable.
文摘Background: The ear and face are indispensable and distinctive features for hearing and identification. Objectives: This study was designed to generate anthropometric data of the ear and facial indices of females of Efik and Ibibio children in Cross River and Akwa Ibom States, show morphological and aesthetic differences and ethnicity. Methods: A total of 600 female children (300 Efiks and 300 Ibibios) aged 2 to 10 years that met the inclusion criteria were chosen from selected primary schools in Calabar Municipality, Calabar South of Cross River State and from Uyo, Itu of Akwa Ibom State, Nigeria. Standardized measurements of face length, face width, ear length, and ear width were taken with a spreading caliper;the facial (proscopic) and ear (auricular) indices were determined. Results: Efik subjects presented a mean face length of 8.36 ± 0.06 cm, face width of 11.04 ± 0.04 cm, ear length of 4.92 ± 0.02 cm, and ear width of 3.06 ± 0.01 cm. Ibibio subjects had mean values for face length, face width, ear length, and ear width as 8.17 ± 0.05 cm, 10.75 ± 0.05 cm, 4.77 ± 0.03 cm, and 2.94 ± 0.02 cm respectively. The mean facial index and ear index for Efik subjects were 75.68 ± 0.31 and 62.16 ± 0.27 respectively;while the mean facial and ear indices for Ibibio subjects were 74.79 ± 0.36 and 61.80 ± 0.34 respectively. Statistical analysis demonstrated significant differences in face length, ear length, ear width and facial index, with the Efik subjects having higher values than Ibibio subjects (p Conclusion: The results showed hypereuryproscopic face as the prevalent face type among females of both ethnic groups, therefore can be of importance in sex, ethnic, and racial differentiation, and in clinical practice, aesthetics and forensic medicine.
文摘Malignant tumors originating from the middle ear are rare. The literature identifies chronic inflammation and Human Papillomavirus (HPV) infection as the most common risk factors. A CT scan to assess bony invasion and an MRI to evaluate soft tissue involvement, depth of invasion, and perineural invasion, followed by a biopsy, are indispensable for diagnosis and treatment. There is no standard treatment for squamous cell carcinoma of the middle ear, however, most reported cases are treated with surgical resection followed by postoperative radiotherapy. Given the challenges of achieving complete surgical excision, radiotherapy plays a crucial role in controlling middle ear cancers, as demonstrated in our case. We present a case of squamous cell carcinoma of the middle ear in a 63-year-old female with a history of chronic suppurative otitis media. The patient underwent a right subtotal petrosectomy without lymph node dissection followed by concurrent chemoradiotherapy. At the one-year follow visit, no recurrence or metastasis was detected.
文摘In advanced otological surgeries, powered instruments form an indispensable part. The risk of deterioration to hearing in the operated ear is a commonly discussed issue, however, there remains a possibility of affecting the hearing in the contralateral ear due to transcranial vibration. So in this study we aimed to assess the possibility of the non-operated ear being affected by the noise generated during ear surgeries and whether it is temporary or permanent in nature. Methodology: This study included 63 patients diagnosed with unilateral disease who underwent mastoid surgery. Preoperatively all the patients were subjected to Pure tone audiometry (PTA), Transient evoked otoacoustic emission (TEOAE) and Distortion product otoacoustic emission (DPOAE). Patients were operated using both cutting and diamond burrs of ranging from sizes 1 - 6 mm. Total drilling time was recorded. Results: Post-operative hearing evaluation was done at 1 week, 4 weeks and 12 weeks. The sound emitted by various burrs was recorded by Sound Level Meter. Out of the total 58 patients that followed up, 46 showed change in at least one of the hearing parameters. Patients showing changes had a higher drilling time as compared to those with no changes. Of these, the changes associated with the total drilling time and with cutting burr time were found to be significant. The hearing changes seen on PTA, TEOAE and DPOAE were transient in nature with only one patient having a persistent decreased high frequency threshold at the end of 12 weeks. It was also found that cutting burrs produce more sound as compared to diamond burrs and a larger size burr of a type produces more sound than a smaller one of its type. Conclusion: The drilling of mastoid bone during ear surgeries can transiently impair the hearing in the contralateral ear which is of great significance in patients with only one hearing ear.
文摘This case is a 49-year-old female patient who presented with suspected eustachian tube dysfunction symptoms that were refractory to medical treatment. She presented with conductive hearing loss and aural fullness on the left. A physical exam revealed an epitympanic fleshy mass in the middle ear with effusion. Imaging with MRI and CT showed opacification of the epitympanum with surrounding bony demineralization bilaterally left greater than right and significant thinning versus dehiscence of the tegmen mastoideum and tympani on the left with only thinning of the tegmen on the right. An MR temporal bone with and without contrast, demonstrated enhancement of the left middle ear extending to the tegmen and corresponding enhancement of the dura along the floor of the left middle cranial fossa as well as extending along foramen ovale into the infratemporal fossa. There was to a lesser degree similar appearance on the right. A biopsy of the middle ear mass on the left revealed meningioma. This case highlights the need to widen your differential with common symptoms when they are refractory to treatment.
文摘目的对结直肠癌外科患者治疗过程中,快速康复(enhanced recovery after surgery,ERAS)计划的应用价值进行分析。方法选择2020年7月1日—2022年3月1日常德市第一人民医院普通外科结直肠癌患者150例,按随机数字表法分为研究组与对照组,每组各75例,分别对患者进行传统开腹手术+EARS计划与传统开腹手术治疗,分析两组并发症、炎症因子水平、首次下床活动时间、进食时间、术后住院天数、排气时间、排便时间、满意度。结果研究组术后住院天数、排便、首次下床活动、进食、排气时间等指标均短于对照组,差异有统计学意义(P<0.05)。治疗有效率比较,研究组高于对照组,差异有统计学意义(P<0.05)。对照组并发症发生率高于研究组,差异有统计学意义(P<0.05)。研究组炎症因子水平均低于对照组,差异有统计学意义(P<0.05)。结论EARS计划推广价值较高,可以抑制炎症因子水平,提升治疗效果,预后效果显著。
