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
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
听觉系统各组成部分的机械损伤是爆炸后造成听力损失的主要原因,强脉冲声致听觉损害风险准则仍然存在许多争议,例如:指标选择冲量还是超压峰值,正压持续时间是否重要等。本研究基于自由场实爆条件,设计并搭建了大动物爆炸致伤平台,探究...听觉系统各组成部分的机械损伤是爆炸后造成听力损失的主要原因,强脉冲声致听觉损害风险准则仍然存在许多争议,例如:指标选择冲量还是超压峰值,正压持续时间是否重要等。本研究基于自由场实爆条件,设计并搭建了大动物爆炸致伤平台,探究了不同爆炸参数对鼓膜破裂的影响规律,并建立了基于自由场超压峰值和正压持续时间的鼓膜创伤量效关系。通过笔形压力传感器测量自由场超压,通过Friedlander公式拟合超压时程曲线,确定冲击波超压峰值和正压持续时间,并对时域中记录的波形进行归一化能量频谱分析,以确定冲击波在频域上的信号能量分布。对爆炸后的小型猪进行解剖,记录不同爆炸参数下鼓膜创伤程度。以超压峰值和正压持续时间为自变量,对实验数据进行二元逻辑回归分析,并给出鼓膜破裂风险曲线。研究发现,当自由场超压峰值低于170 kPa时,鼓膜无明显损伤;当自由场超压峰值高于237 kPa时,部分鼓膜出现不同程度的破裂和充血。距爆心越近,超压峰值越大,但鼓膜创伤的严重程度并未随之单调增加。在8.0 kg TNT当量的爆炸实验中,鼓膜破裂的严重程度随爆心距的减小呈现先提高再降低的趋势。通过对冲击波载荷特征的分析可知,距爆心越近,正压持续时间越短,高频段能量占比相对更大,小型猪鼓膜破裂的概率可能反而降低,此时仍然出现显著的听力损失和耳蜗损伤。鼓膜作为通过振动传递声信号的黏弹性薄膜结构,其动力学响应可能与载荷频率成分密切相关。除了超压峰值,冲击波波形频谱分布对鼓膜破裂程度影响显著。展开更多
目的探讨鼓膜穿孔导致听力下降的机制。方法通过有限元分析法(finite element analysis,FEA)构建全耳有限元模型并验证;参照实际鼓膜穿孔病例,创建个性化的鼓膜穿孔有限元模型,模拟鼓膜穿孔导致的听力损失;使用基底膜的位移响应与基线...目的探讨鼓膜穿孔导致听力下降的机制。方法通过有限元分析法(finite element analysis,FEA)构建全耳有限元模型并验证;参照实际鼓膜穿孔病例,创建个性化的鼓膜穿孔有限元模型,模拟鼓膜穿孔导致的听力损失;使用基底膜的位移响应与基线的差异来模拟听力损失情况,分析中耳各个组分对听力损失的贡献程度,探讨鼓膜穿孔导致听力下降的机制。结果如果将圆窗膜和中耳腔的耦合去掉,将导致低频约40 dB的听力下降,而高频段基本与基线情况下鼓膜穿孔所导致的听力损失持平;去除鼓膜内侧面和中耳腔气体的耦合,可部分减轻低频听力损失,而高频听力损失加重;切断外耳道气体和中耳腔气体之间的连续性,低频听力损失加重;但是去除圆窗膜和中耳腔之间耦合关系并且去除中耳腔气体和鼓膜内侧面的连接后,原先低频的40 dB听力损失将会恢复到10 dB左右;而去除中耳腔气体和听骨链之间的耦合,对听力损失无明显影响。结论鼓膜穿孔导致听力下降的主要机制是鼓膜穿孔本身所导致的传声效能降低,以及鼓膜内外声压差的降低;圆窗膜处声压的增加可以部分弥补鼓膜穿孔所导致的听力损失。展开更多
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.
文摘听觉系统各组成部分的机械损伤是爆炸后造成听力损失的主要原因,强脉冲声致听觉损害风险准则仍然存在许多争议,例如:指标选择冲量还是超压峰值,正压持续时间是否重要等。本研究基于自由场实爆条件,设计并搭建了大动物爆炸致伤平台,探究了不同爆炸参数对鼓膜破裂的影响规律,并建立了基于自由场超压峰值和正压持续时间的鼓膜创伤量效关系。通过笔形压力传感器测量自由场超压,通过Friedlander公式拟合超压时程曲线,确定冲击波超压峰值和正压持续时间,并对时域中记录的波形进行归一化能量频谱分析,以确定冲击波在频域上的信号能量分布。对爆炸后的小型猪进行解剖,记录不同爆炸参数下鼓膜创伤程度。以超压峰值和正压持续时间为自变量,对实验数据进行二元逻辑回归分析,并给出鼓膜破裂风险曲线。研究发现,当自由场超压峰值低于170 kPa时,鼓膜无明显损伤;当自由场超压峰值高于237 kPa时,部分鼓膜出现不同程度的破裂和充血。距爆心越近,超压峰值越大,但鼓膜创伤的严重程度并未随之单调增加。在8.0 kg TNT当量的爆炸实验中,鼓膜破裂的严重程度随爆心距的减小呈现先提高再降低的趋势。通过对冲击波载荷特征的分析可知,距爆心越近,正压持续时间越短,高频段能量占比相对更大,小型猪鼓膜破裂的概率可能反而降低,此时仍然出现显著的听力损失和耳蜗损伤。鼓膜作为通过振动传递声信号的黏弹性薄膜结构,其动力学响应可能与载荷频率成分密切相关。除了超压峰值,冲击波波形频谱分布对鼓膜破裂程度影响显著。
