Rationale:Acute otitis media is a common disease in early childhood,and is usually caused by Streptococcus pneumoniae(S.pneumoniae).Acute mastoiditis is a complication of acute otitis media and can involve not only th...Rationale:Acute otitis media is a common disease in early childhood,and is usually caused by Streptococcus pneumoniae(S.pneumoniae).Acute mastoiditis is a complication of acute otitis media and can involve not only the mucoperiosteum of the middle ear but can also spread to the periosteum by destroying the mastoid bone(acute coalescent mastoiditis).In addition,the infection can extend through the surrounding bones or the emissary veins beyond the mastoid’s air cells,leading to subperiosteal abscesses.Patient’s Concern:A 16-month-old female patient was hospitalized due to the purulent discharge of the left ear and the symptoms of right mastoiditis(swelling and redness of the skin).Diagnosis:Bilateral acute coalescent mastoiditis caused by S.pneumoniae infection.The computer tomography revealed bilateral bone destruction of the mastoid and abscesses found behind the auricle on both sides.Interventions:The patient underwent intravenous antibiotic therapy and surgical treatment.Outcomes:The patient was discharged 14 days after hospitalization with an improved condition.Lessons:Improperly treated acute coalescent mastoiditis can lead to extracranial and intracranial complications,sometimes serious and even life-threatening.Complications are prevalent in children under 2 years,in whom the disease progresses more rapidly and severely.The vaccination with a 13-valent vaccine may not result in sufficient immunity against S.pneumoniae,a predominant pathogen in children affected by acute coalescent mastoiditis.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
目的:应用肌性斜颈兔动物模型,探讨针刀治疗肌性斜颈的作用机制及意义。方法:无水酒精注射制备动物肌性斜颈兔子模型后,选取模型兔子48只,随机分为正常组、模型组、针刀组、按摩组,每组12只。分别给予各组对应治疗,治疗2个月后各组分别...目的:应用肌性斜颈兔动物模型,探讨针刀治疗肌性斜颈的作用机制及意义。方法:无水酒精注射制备动物肌性斜颈兔子模型后,选取模型兔子48只,随机分为正常组、模型组、针刀组、按摩组,每组12只。分别给予各组对应治疗,治疗2个月后各组分别取部分胸锁乳突肌制作标本,免疫组化法观察钙蛋白酶1(calpain-1)、分化抗原决定簇45(CD45)、基质金属蛋白酶2(matrix metalloproteinase-2,MMP-2)、基质金属蛋白酶抑制因子2(tissue inhibitor of metalloproteinases-2,TIMP-2)在各组肌纤维中的表达情况。结果:与正常组比较,其余各组实验动物明显出现颈部活动受限、斜颈、头颈不对称症状,而治疗结束后,针刀组和按摩组实验动物颈部活动受限改善,无明显头颈不对称症状。calpain-1、CD45、TIMP-2的表达,与正常组比较,模型组、按摩组上调(P<0.01);与模型组比较,针刀组、按摩组下调(P<0.01);与针刀组比较,按摩组上调(P<0.01)。MMP-2表达,与正常组比较,模型组下调(P<0.01),与模型组比较,针刀组、按摩组上调(P<0.05)。结论:针刀治疗肌性斜颈效果显著,其作用机制可能与减少calpain-1、CD45、TIMP-2表达,增加MMP-2表达有关。展开更多
目的探讨改良开放和完壁乳突根治鼓室成形术对慢性中耳病变患者平均纯音听阈(pure tone audiometry,PTA及骨导值的影响。方法回顾性纳入河南省中医院2015年1月~2018年1月收治慢性中耳病变患者共176例,其中84例采用改良开放乳突根治鼓室...目的探讨改良开放和完壁乳突根治鼓室成形术对慢性中耳病变患者平均纯音听阈(pure tone audiometry,PTA及骨导值的影响。方法回顾性纳入河南省中医院2015年1月~2018年1月收治慢性中耳病变患者共176例,其中84例采用改良开放乳突根治鼓室成形术治疗设为A组,另92例采用完壁乳突根治鼓室成形术设为B组。比较两组术后复发率、术后干耳率、术后PTA下降值、术后骨导下降值、术后气骨导差下降值、术后听力频率阈下降值及并发症发生情况。结果两组术后PTA下降值、术后骨导下降值及术后气骨导差下降值比较差异无统计学意义(P>0.05);两组术后250、500、1000、2000 Hz听力频率阈下降值比较差异无统计学意义(P>0.05);B组术后4000 Hz听力频率阈下降值显著小于A组(P<0.05)。结论相较于完壁乳突根治鼓室成形术,改良开放乳突根治鼓室成形术治疗慢性中耳病变可获得相近听力改善效果。展开更多
文摘Rationale:Acute otitis media is a common disease in early childhood,and is usually caused by Streptococcus pneumoniae(S.pneumoniae).Acute mastoiditis is a complication of acute otitis media and can involve not only the mucoperiosteum of the middle ear but can also spread to the periosteum by destroying the mastoid bone(acute coalescent mastoiditis).In addition,the infection can extend through the surrounding bones or the emissary veins beyond the mastoid’s air cells,leading to subperiosteal abscesses.Patient’s Concern:A 16-month-old female patient was hospitalized due to the purulent discharge of the left ear and the symptoms of right mastoiditis(swelling and redness of the skin).Diagnosis:Bilateral acute coalescent mastoiditis caused by S.pneumoniae infection.The computer tomography revealed bilateral bone destruction of the mastoid and abscesses found behind the auricle on both sides.Interventions:The patient underwent intravenous antibiotic therapy and surgical treatment.Outcomes:The patient was discharged 14 days after hospitalization with an improved condition.Lessons:Improperly treated acute coalescent mastoiditis can lead to extracranial and intracranial complications,sometimes serious and even life-threatening.Complications are prevalent in children under 2 years,in whom the disease progresses more rapidly and severely.The vaccination with a 13-valent vaccine may not result in sufficient immunity against S.pneumoniae,a predominant pathogen in children affected by acute coalescent mastoiditis.
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.
文摘目的:应用肌性斜颈兔动物模型,探讨针刀治疗肌性斜颈的作用机制及意义。方法:无水酒精注射制备动物肌性斜颈兔子模型后,选取模型兔子48只,随机分为正常组、模型组、针刀组、按摩组,每组12只。分别给予各组对应治疗,治疗2个月后各组分别取部分胸锁乳突肌制作标本,免疫组化法观察钙蛋白酶1(calpain-1)、分化抗原决定簇45(CD45)、基质金属蛋白酶2(matrix metalloproteinase-2,MMP-2)、基质金属蛋白酶抑制因子2(tissue inhibitor of metalloproteinases-2,TIMP-2)在各组肌纤维中的表达情况。结果:与正常组比较,其余各组实验动物明显出现颈部活动受限、斜颈、头颈不对称症状,而治疗结束后,针刀组和按摩组实验动物颈部活动受限改善,无明显头颈不对称症状。calpain-1、CD45、TIMP-2的表达,与正常组比较,模型组、按摩组上调(P<0.01);与模型组比较,针刀组、按摩组下调(P<0.01);与针刀组比较,按摩组上调(P<0.01)。MMP-2表达,与正常组比较,模型组下调(P<0.01),与模型组比较,针刀组、按摩组上调(P<0.05)。结论:针刀治疗肌性斜颈效果显著,其作用机制可能与减少calpain-1、CD45、TIMP-2表达,增加MMP-2表达有关。
文摘目的探讨改良开放和完壁乳突根治鼓室成形术对慢性中耳病变患者平均纯音听阈(pure tone audiometry,PTA及骨导值的影响。方法回顾性纳入河南省中医院2015年1月~2018年1月收治慢性中耳病变患者共176例,其中84例采用改良开放乳突根治鼓室成形术治疗设为A组,另92例采用完壁乳突根治鼓室成形术设为B组。比较两组术后复发率、术后干耳率、术后PTA下降值、术后骨导下降值、术后气骨导差下降值、术后听力频率阈下降值及并发症发生情况。结果两组术后PTA下降值、术后骨导下降值及术后气骨导差下降值比较差异无统计学意义(P>0.05);两组术后250、500、1000、2000 Hz听力频率阈下降值比较差异无统计学意义(P>0.05);B组术后4000 Hz听力频率阈下降值显著小于A组(P<0.05)。结论相较于完壁乳突根治鼓室成形术,改良开放乳突根治鼓室成形术治疗慢性中耳病变可获得相近听力改善效果。
