Objectives To investigate pre-and post-total middle ear reconstruction bacteriological changes in order to facilitate prevention and treatment of surgical infections. Methods Specimens from 128 ears in 124 patients wi...Objectives To investigate pre-and post-total middle ear reconstruction bacteriological changes in order to facilitate prevention and treatment of surgical infections. Methods Specimens from 128 ears in 124 patients with problematic mastoid cavities who underwent revision total middle ear reconstruction were studied. Results Bacteriological tests were positive in 87(68.0%) pre-operative specimens, despite local treatment, and in 74 (57.8%) specimens collected 10 days after operation. Common organism strains in pre-and post-operative specimens were slightly different and included: coagulase-staphylococcus, GRAM+ rods, staphylococcus aureus, pseudomonas aeruginosa and fungi. At the time of patient discharge(15-20 days post-operative), only 3 ears (2.3%) were tested positive which responded well to and became dry after local treatment. At one year, 4 ears (3.1%) showed recurrent otorrhea which again responded to local treatment. Conclusion For infection of problematic mastoid cavities after an open cavity procedure, revision total middle ear reconstruction is effective in controlling infection and promoting a dry ear. Infection prevention and treatment is important considering the relatively high rates of peri-operative local infections.展开更多
Objective： To describe several approaches of ear surgeries for experimental studies in rats. Methods： Anesthetized rats were prepared for demonstration of various ear surgery approaches designed to optimize experime...Objective： To describe several approaches of ear surgeries for experimental studies in rats. Methods： Anesthetized rats were prepared for demonstration of various ear surgery approaches designed to optimize experimental outcomes in studies with specific goals and exposure requirements. The surgical approaches included the posterior tympanum, superior tympanum, inferior tympanum and occipital approaches. Results： The middle ear cavity and inner ear were successfully exposed from different angles via the mentioned surgical approaches. For example, electrode placement for recording of cochlear bioelectric responses was easily achieved through the posterior tympanum or inferior tympanum approach. Alternatively, drug delivery or gene transfection via round window membrane was most easily accomplished using the posterior tympanum approach. Cochlear perfusion of protective or ototoxic drugs was best performed using the inferior tympanum approach. Ossicular chain interruption to induce a prolonged conductive hearing loss was readily achieved using a superior tympanum approach. Lastly, surgical destruction of the endolymphatic sac to induce experimental endolymphatic hydrops was readily performed via an occipital surgical approach.Conclusion： These standardized surgical approaches can be applied in scientific studies of the ear with different purposes covering electro- physiology, conductive hearing loss, intra-cochlear drug perfusion and experimental studies relevant to Meniere＇s disease.展开更多
背景:对于听骨链、肌肉、骨迷路、韧带等结构的影像学显示,常规薄层CT扫描难以达到最理想的效果。目的:评估在中、内耳薄层CT扫描中以HR精密断层重建算法成像的图像质量和辐射剂量。方法:21名志愿者(42耳)进行内耳薄层扫描,对于扫描后...背景:对于听骨链、肌肉、骨迷路、韧带等结构的影像学显示,常规薄层CT扫描难以达到最理想的效果。目的:评估在中、内耳薄层CT扫描中以HR精密断层重建算法成像的图像质量和辐射剂量。方法:21名志愿者(42耳)进行内耳薄层扫描,对于扫描后的图像全部以两种重建算法进行重建,将行0.275 mm HR精密断层重建的设为研究组;行0.55 mm常规薄层重建的设为对照组。利用多平面重建技术对图像进行处理,计算锤骨前韧带、砧骨后韧带、锤骨上韧带和锤骨外侧韧带的显示率,对听骨链、肌肉、骨迷路、韧带等结构的图像显示效果进行主观评分。记录容积CT剂量指数和剂量长度乘积,并计算有效剂量(ED)。研究方案的实施符合锦州医科大学附属第一医院的相关伦理要求。受试者对试验过程完全知情同意。结果与结论:①HR精密断层重建和常规薄层重建的轴位及冠状位图像中所有解剖结构均可见(P>0.05);②在轴位和冠状位的图像中,研究组中内耳部分结构的图像显示质量要明显优于对照组(P<0.05);③中内耳精密断层扫描的有效剂量为(1.19±0.26)mGy;④结果说明,精密断层扫描图像分辨率高,同时能更清晰的观察到中、内耳各结构。展开更多
文摘Objectives To investigate pre-and post-total middle ear reconstruction bacteriological changes in order to facilitate prevention and treatment of surgical infections. Methods Specimens from 128 ears in 124 patients with problematic mastoid cavities who underwent revision total middle ear reconstruction were studied. Results Bacteriological tests were positive in 87(68.0%) pre-operative specimens, despite local treatment, and in 74 (57.8%) specimens collected 10 days after operation. Common organism strains in pre-and post-operative specimens were slightly different and included: coagulase-staphylococcus, GRAM+ rods, staphylococcus aureus, pseudomonas aeruginosa and fungi. At the time of patient discharge(15-20 days post-operative), only 3 ears (2.3%) were tested positive which responded well to and became dry after local treatment. At one year, 4 ears (3.1%) showed recurrent otorrhea which again responded to local treatment. Conclusion For infection of problematic mastoid cavities after an open cavity procedure, revision total middle ear reconstruction is effective in controlling infection and promoting a dry ear. Infection prevention and treatment is important considering the relatively high rates of peri-operative local infections.
文摘Objective： To describe several approaches of ear surgeries for experimental studies in rats. Methods： Anesthetized rats were prepared for demonstration of various ear surgery approaches designed to optimize experimental outcomes in studies with specific goals and exposure requirements. The surgical approaches included the posterior tympanum, superior tympanum, inferior tympanum and occipital approaches. Results： The middle ear cavity and inner ear were successfully exposed from different angles via the mentioned surgical approaches. For example, electrode placement for recording of cochlear bioelectric responses was easily achieved through the posterior tympanum or inferior tympanum approach. Alternatively, drug delivery or gene transfection via round window membrane was most easily accomplished using the posterior tympanum approach. Cochlear perfusion of protective or ototoxic drugs was best performed using the inferior tympanum approach. Ossicular chain interruption to induce a prolonged conductive hearing loss was readily achieved using a superior tympanum approach. Lastly, surgical destruction of the endolymphatic sac to induce experimental endolymphatic hydrops was readily performed via an occipital surgical approach.Conclusion： These standardized surgical approaches can be applied in scientific studies of the ear with different purposes covering electro- physiology, conductive hearing loss, intra-cochlear drug perfusion and experimental studies relevant to Meniere＇s disease.
文摘背景:对于听骨链、肌肉、骨迷路、韧带等结构的影像学显示,常规薄层CT扫描难以达到最理想的效果。目的:评估在中、内耳薄层CT扫描中以HR精密断层重建算法成像的图像质量和辐射剂量。方法:21名志愿者(42耳)进行内耳薄层扫描,对于扫描后的图像全部以两种重建算法进行重建,将行0.275 mm HR精密断层重建的设为研究组;行0.55 mm常规薄层重建的设为对照组。利用多平面重建技术对图像进行处理,计算锤骨前韧带、砧骨后韧带、锤骨上韧带和锤骨外侧韧带的显示率,对听骨链、肌肉、骨迷路、韧带等结构的图像显示效果进行主观评分。记录容积CT剂量指数和剂量长度乘积,并计算有效剂量(ED)。研究方案的实施符合锦州医科大学附属第一医院的相关伦理要求。受试者对试验过程完全知情同意。结果与结论:①HR精密断层重建和常规薄层重建的轴位及冠状位图像中所有解剖结构均可见(P>0.05);②在轴位和冠状位的图像中,研究组中内耳部分结构的图像显示质量要明显优于对照组(P<0.05);③中内耳精密断层扫描的有效剂量为(1.19±0.26)mGy;④结果说明,精密断层扫描图像分辨率高,同时能更清晰的观察到中、内耳各结构。
