目的:了解新生儿听力筛查异常儿的听力发育变化,并探索新生儿听力普遍筛查的有效模式。方法:应用听觉脑干反应(Aud itory B rainstem Response,ABR)诊断技术对205名新生儿听力筛查异常儿在3个月时进行听力测试,并做高危因素回顾性调查;...目的:了解新生儿听力筛查异常儿的听力发育变化,并探索新生儿听力普遍筛查的有效模式。方法:应用听觉脑干反应(Aud itory B rainstem Response,ABR)诊断技术对205名新生儿听力筛查异常儿在3个月时进行听力测试,并做高危因素回顾性调查;ABR异常者,6个月时做第2次ABR测试。结果:有58名听力障碍儿参加了第2次ABR复诊。该58名听力障碍儿ABR初诊时听力损失耳共计96只,平均听阈值为60.6±12.0 dBnHL;ABR复诊时平均听阈值下降到48.0±11.7dBnHL,差异有极其显著性意义(P<0.001)。其中,25名非高危儿与33名高危儿相比较,他们在ABR初诊、ABR复诊时听力损失耳的平均听阈以及前后听阈下降的平均差值均无显著性意义(P>0.05)。结论:对新生儿听力筛查异常儿在6个月时ABR复诊后再对其中的听力障碍儿推荐配戴助听器等干预措施在目前的中国国情下是经济可行的。展开更多
目的探究听觉诱发电位(auditory evoked potential,AEP)检查P1波峰、P1潜伏期与外中耳畸形患儿术后听觉行为分级(CAP)及言语可懂度分级(SIR)的相关性及对听力改善的评估价值。方法选取我院2017年1月~2019年1月外中耳畸形患儿82例,比较...目的探究听觉诱发电位(auditory evoked potential,AEP)检查P1波峰、P1潜伏期与外中耳畸形患儿术后听觉行为分级(CAP)及言语可懂度分级(SIR)的相关性及对听力改善的评估价值。方法选取我院2017年1月~2019年1月外中耳畸形患儿82例,比较术前、术后12个月P1波峰、P1潜伏期、CAP、SIR分级,分析其相关性,采用有意义听觉整合量表(MAIS)评分评价术后12个月患儿听力康复情况,比较患儿临床资料、P1波峰、P1潜伏期,评价P1波峰、P1潜伏期对听力改善的评估价值。结果术后12个月P1波峰低于术前,P1潜伏期短于术前,CAP、SIR分级高于术前(P<0.05);术前、术后12个月P1波峰、P1潜伏期与CAP、SIR分级均呈负相关(P<0.05);不同MAIS评分患儿术前听力损失程度、术前、术后12个月后CAP、SIR分级、P1波峰比较,差异有统计学意义(P<0.05);P1波峰、P1潜伏期联合评估听力改善的曲线下面积(area under the curve,AUC)最大,为0.872,敏感度、特异度分别为74.19%、85.00%。结论P1波峰、P1潜伏期与外中耳畸形患儿术后CAP、SIR分级均存在负相关性,采用AEP检查P1波峰、P1潜伏期在评估人工耳蜗植入术后听力改善方面具有重要价值。展开更多
Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringiti...Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringitis that require middle ear exploration and mastoidectomy. The aim of this study was to investigate a novel technique of perichondrium/cartilage composite graft for repairing the large TM perforation in the patient of otitis media. Methods Retrospective chart reviews were conducted for 102 patients with large tympanic membrane perforations, who had undergone tympanoplasty from August 2005 to August 2008. Tympanoplasty or tympanomastoidectomy using a perichondrium/cartilage composite graft was analyzed. The tragal or conchal perichondrium/cartilage was used to replace the tympanic membrane in patients. Results Patients aged from 13 to 67 years were followed up in average for 24 months （10-36 months）. Seventy-four ears （72.61%） were used the tragal perichondrium/cartilage as graft material and 27 ears （27.39%） were used the conchal perichondrium/cartilage. Graft take was successful in all patients. Postoperative complications such as wound infection, hematoma, or sensorineural hearing loss were not identified. Nine patients （8.82%） had the partial ossicular replacement prosthesis, 14 patients （13.72%） using the autologous curved incus and 79 patients （77.45%） without prosthesis. Successful closure occurred in 92% of the ears. A total of 85.8% patients achieved a postoperative hearing improvement. Conclusions The graft underlay tympanoplasty using perichondrium/cartilage composite is effective for the majority of patients with large perforation. The hearing was improved even if the mastoidectomy was required in the patients with otitis media with extensive granulation.展开更多
文摘目的探究听觉诱发电位(auditory evoked potential,AEP)检查P1波峰、P1潜伏期与外中耳畸形患儿术后听觉行为分级(CAP)及言语可懂度分级(SIR)的相关性及对听力改善的评估价值。方法选取我院2017年1月~2019年1月外中耳畸形患儿82例,比较术前、术后12个月P1波峰、P1潜伏期、CAP、SIR分级,分析其相关性,采用有意义听觉整合量表(MAIS)评分评价术后12个月患儿听力康复情况,比较患儿临床资料、P1波峰、P1潜伏期,评价P1波峰、P1潜伏期对听力改善的评估价值。结果术后12个月P1波峰低于术前,P1潜伏期短于术前,CAP、SIR分级高于术前(P<0.05);术前、术后12个月P1波峰、P1潜伏期与CAP、SIR分级均呈负相关(P<0.05);不同MAIS评分患儿术前听力损失程度、术前、术后12个月后CAP、SIR分级、P1波峰比较,差异有统计学意义(P<0.05);P1波峰、P1潜伏期联合评估听力改善的曲线下面积(area under the curve,AUC)最大,为0.872,敏感度、特异度分别为74.19%、85.00%。结论P1波峰、P1潜伏期与外中耳畸形患儿术后CAP、SIR分级均存在负相关性,采用AEP检查P1波峰、P1潜伏期在评估人工耳蜗植入术后听力改善方面具有重要价值。
文摘Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringitis that require middle ear exploration and mastoidectomy. The aim of this study was to investigate a novel technique of perichondrium/cartilage composite graft for repairing the large TM perforation in the patient of otitis media. Methods Retrospective chart reviews were conducted for 102 patients with large tympanic membrane perforations, who had undergone tympanoplasty from August 2005 to August 2008. Tympanoplasty or tympanomastoidectomy using a perichondrium/cartilage composite graft was analyzed. The tragal or conchal perichondrium/cartilage was used to replace the tympanic membrane in patients. Results Patients aged from 13 to 67 years were followed up in average for 24 months （10-36 months）. Seventy-four ears （72.61%） were used the tragal perichondrium/cartilage as graft material and 27 ears （27.39%） were used the conchal perichondrium/cartilage. Graft take was successful in all patients. Postoperative complications such as wound infection, hematoma, or sensorineural hearing loss were not identified. Nine patients （8.82%） had the partial ossicular replacement prosthesis, 14 patients （13.72%） using the autologous curved incus and 79 patients （77.45%） without prosthesis. Successful closure occurred in 92% of the ears. A total of 85.8% patients achieved a postoperative hearing improvement. Conclusions The graft underlay tympanoplasty using perichondrium/cartilage composite is effective for the majority of patients with large perforation. The hearing was improved even if the mastoidectomy was required in the patients with otitis media with extensive granulation.
文摘目的 了解某汽车零部件制造企业的工人听力健康现状,探讨听力损失的可能影响因素。方法检测个体接触噪声强度;测量个人声衰减值(personal attenuation rating,PAR);开展双耳6个频段(0.5~6.0 kHz)的气导纯音听阈测试;并使用问卷开展作业人员噪声接触情况和护听器使用情况调查。采用χ^(2)检验分析不同特征分组人群的听力损失发生率,构建logistic回归模型分析听力损失的影响因素。结果共调查某汽车零部件制造企业的281名噪声作业工人,个体接触噪声强度(normalization of equivalent continuous A-weighted sound pressure level to a nominal 8h working day,L_(EX,8h))范围为80.1~94.5 dB(A)。分析不同使用情况分组的工人之间的基线PAR,发现有无接受培训、是否知道正确佩戴方法、日常是否正确佩戴的工人的基线PAR比较,差异无统计学意义(P>0.05)。基线PAR未通过测试有35人,未通过率为12.4%。高频听阈提高检出55人,检出率为19.6%。男性工人年龄≥30岁、工龄≥10年、佩戴护听器后的噪声接触水平≥80 dB(A)的工人高频听阈提高发生较高(χ^(2)=3.064、17.103、2.933,P<0.1);工龄≥10年发生高频听阈提高的风险是工龄<10年者的4.224倍(OR=4.224,95%CI:1.920~9.297,P<0.01)。结论工龄是汽车零部件制造业工人听力健康的影响因素,部分工人佩戴护听器的防护效果不佳,部分工人高估了自己使用护听器的能力,企业应进一步加强培训。
