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OBJECTIVE@#Evaluation of different repair mechanism and influencing factors for Prognosis of tympanic membrane perforations.@*METHOD@#One hundred and twelve female patients of tympanic membrane perforations were randomly divided into two groups: control group (natural repair group) and treatment group (gelatin sponge patch bonded repair group). The perforation healing were dynamically observed in two groups by endoscope.@*RESULT@#The result show that low, medium and high perforations healing rates were 100.00%, 90.48%, 93.33%. The healing time of low, medium and high was (9.0 +/- 2.8) d, (13.0 +/- 2.6) d, (22.0 +/- 4.7) d, the epithelial layer reverse growth in 5 cases. The result show that low, medium and high perforations healing rates were 91.67%, 95.24%, 84.62%. The healing time of low, medium and high was (11.0 +/- 3.7) d, (24.0 +/- 3.8) d, (36.0 +/- 2.1) d, 2 cases were undergone surgeries.@*CONCLUSION@#There are differences in repair mechanism between natural repair and patch bonded repair patch bonded repair can promote granulation hyperplasia, it can help recovering and lessening the patient's conductive hearing loss and occasional tinnitus. granulation hyperplasia and the healing time is closely related. The epithelial layer reverse growth may affect the healing of tympanic membrane perforation.
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Adult , Female , Humans , Middle Aged , Young Adult , Tympanic Membrane Perforation , Therapeutics , Wound HealingABSTRACT
Objective To discuss endoscopic surgical treatment and its effect of intranasal contact point headaches.Methods Twe(n)ty-five patients with intranasal contact point headaches were treated by endoscopic rhinoplasty of nasal cavity,including middle turbinoplasty,functional resection of ostiomeatal complex,endoscopic submucous septoplasty.Achieved organic combination of the above surgery methods according to the different results of the CT scan and endoscope,the surgical procedure waft designed individually.Results All patients were followed up for 9 to 12 months.Recovery was 21 cases(84.00%),efficacy was 3 cases(12.00%),inefficacy was 1 case(4.00%),the rate of fully recovered without serious complication was 96.00%(24/25).Conclusions Intranagal contact point headaches is a sort of the nasal headaches as a result of multi abnormality of nasal cavity structure.Endoscopic rhinoplagty is an effective treatment by means of reconstructing the balance of bilateral nasal cavity and improving its function.
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Objective:To study the influence of endoscopic sinus surgery(ESS)on nasal airway resistance(NAR) of intranasal contact point headaches.Method:The NAR and nasalairflow sensation were measured with anterior rhinomanometry in 20 patients(40sides) before and after the ESS.Result:A telephone follow-up six months after operation,16(85%)cases were cured,3(15%)were improved and 1(5%)had no response and the effective rate was 95%. NAR decreased significantly after the operation. The change ratesin NAR before and after the decongestion were there was a significant difference(P<0.05).Conclusion:The improvement of nasal functions by ESS is due to thealteration of the anatomic structure of the nasal cavity and the amelioration of mucosal edema. The rhinomanometry can be used as a useful clinical tool in determining nasal patency.
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OBJECTIVE@#To analyze the nosazontology of pharyngeal paraesthesia and investigate the treatment.@*METHOD@#Two hundred and twelve misdiagnosed pharyngeal paraesthesia patients were investigated by history inquiry, routine examination, 24-hour esophageal pH monitoring, barium X-ray of the oesophagus, anxieties-athymic private measuring scale, coefficient of variation of the R-R (CVR-R), bioavailable testosterone detection (Bio-T), erection experiment and questionnaire about man climacteric syndrome. The concomitant symptoms and positions of pharyngeal paresthesia were also studied. We adopted individuallized sequential multi-therapy for every patient according to the cause of disease.@*RESULT@#The cause of disease within 212 cases of pharyngeal paraesthesia included 62 psychic trauma, 32 endocrine system disease, 106 upper gastrointestinal disease, circulatory disease, 9 circulatory disease, 3 idiopathic. With individualized treatment, 110 cases had fully recovered, 63 cases excellence and 31 cases utility, and the efficiency rate was 96.23%.@*CONCLUSION@#Pharyngeal paraesthesia can be caused by several factors. Thorough examination and comprehensive analysis should be applied to those incurable patient who has been treated for a long time. Short course of treatment and irrational drug use are the main causes of short-term recurrence and unsatisfactory curative effect.
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Paresthesia , Diagnosis , Therapeutics , Pharyngeal Diseases , Diagnosis , Therapeutics , Pharynx , PathologyABSTRACT
OBJECTIVE@#To study the influence of endoscopic sinus surgery (ESS) on nasal airway resistance (NAR) of intranasal contact point headaches.@*METHOD@#The NAR and nasal airflow sensation were measured with anterior rhinomanometry in 20 patients (40 sides) before and after the ESS.@*RESULT@#A telephone follow-up six months after operation, 16 (85%) cases were cured, 3 (15%) were improved and 1 (5%) had no response and the effective rate was 95%. NAR decreased significantly after the operation. The change rates in NAR before and after the decongestion were (-0.34+/-0.23), (-0.75+/-0.21) and (-0.68+/-0.20), (-0.74+/-0.16) kPa x s/L, respectively, and there was a significant difference (P<0.05).@*CONCLUSION@#The improvement of nasal functions by ESS is due to the alteration of the anatomic structure of the nasal cavity and the amelioration of mucosal edema. The rhinomanometry can be used as a useful clinical tool in determining nasal patency.
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Adult , Female , Humans , Male , Middle Aged , Airway Resistance , Endoscopy , Follow-Up Studies , Headache , Pathology , General Surgery , Nasal Cavity , PathologyABSTRACT
Objective:To analyze the nosazontology of pharyngeal paraesthesia and investigate the treatment. Method: Two hundred and twelve misdiagnosed pharyngeal paraesthesia patients were investigated by history inquiry,routine examination, 24-hour esophageal pH monitoring, barium X-ray of the oesophagus, anxietas-athy-mia private measuring scale, coefficient of variation of the R-R(CVR-R), bioavailable testosterone detection(Bio-T), erection experiment and questionnaire about man climacteric syndrome. The concomitant symptoms and positions of pharyngeal paresthesia were also studied. We adopted individuallied sequential multi-therapy for every patient according to the cause of disease. Result:The cause of disease within 212 cases of pharyngeal paraesthesia included 62 psychictrauma,32 endocrine system disease,106 upper gastrointestinol disease, circulatory disease,9 circulatory disease,3 idiopathic. With individualized treatment, 110 cases had fully recovered, 63 cases excellence and 31 cases utility,and the efficiency rate was 96.23%. Conclusion:Pharyngeal paraesthesia can be caused by several factors. Thorough examination and comprehensive analysis should be applied to those incurable patient who has been treated for a long time. Short course of treatment and irrational drug use are the main causes of short term recurrence and unsatisfactory curative effect.
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OBJECTIVE@#To investigate the epidemic features and risk factors of voice diseases of 5758 business dealers.@*METHOD@#Questionnaire survey was conducted among 5785 business dealers of four markets in Yiwu city by random cluster sampling from March to July, 2006. They were also examined by indirect laryngoscopy. The incidence of voice disease was calculated and the risk factors were evaluated in four markets.@*RESULT@#The incidence of voice disease was 39.3%, 18.8%, 28.4% and 58.1% in garment market, crafts market, stock market, and vegetable market, respectively. The average incidence was 30.4% in four markets. The difference of incidence among four markets was statistically significant (P < 0.01). The difference of incidence between female and male was statistically significant in any market. Chronic laryngitis and polyp of vocal cord were found to be the major pathological manifestations in men, while Chronic laryngitis and vocal nodules were found to be the major pathological manifestations in women. In addition, laryngeal carcinoma was confirmed in 8 cases. Market noise, pollution, unhealthy habits of business trade and excessive voice were the high risk factors. The female and the business dealers aged from 30 to 50 were the high risk people.@*CONCLUSION@#Varied relevant measures should be taken to prevent and control voice disease in different subgroups of population. People should be examined thoroughly as soon as they got voice problem. Improvement of market environment and timely intervention may reduce the prevalence rate of voice disease.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , China , Incidence , Laryngeal Diseases , Epidemiology , Noise, Occupational , Prevalence , Risk Factors , Smoking , Surveys and Questionnaires , Voice Disorders , EpidemiologyABSTRACT
Objective Clinical studies of Chronic Nasosinusitis by endoscopic intranasal sinus surgery under head mirror.Methods 43 cases were operatived by endoscopic intranasal sinus surgery under head mirror.Results 29 cases were cured and 14 cases effectived, Efficiency 100.00%. 17 uncinate process residue, There were no severe complications.Conclusion Endoscopic intranasal sinus surgery under head mirror for chron icsinu sit is and nasal polyps can solveo stiom eatalcomplex anom alism more effectively and raise the cure rates of sinusitis (type Ⅰ、Ⅱ) than conventional technique in surgery.This choice will reduce the cost of the patients than Endoscopic sinus surgery, but must be provided with the knowledge in nasal and paranasal sinus, grapple the gist of endoscopic intranasal sinus, strict Surgical indication at the same time.
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Objective Analysis the concomitance symptom and region of refractoriness paraesthesia pharynges.Methods Investigated 219 misdiagnosed pharyngeal paraesthesia patients with their history,routine examination,24 hours pH value determined of esophagus,esophago-barium visualization,anxietas-athymia private measuring scale,erectexperiment,coefficient of variation of the R-R(CVR-R) and man climacteric syndrome 10 questionnaire.according to the cause of disease we adopted Sequence therapy and individualized combined treatment for every patient.Results In the cases of219,169 were cured,29 were effective,with total effective rate of 90.41 %.21(9.59%) cases were not cured.Eighty three(37.90 %) of them with the type of a mental scar had a 89.16%(74/83).Among 42(19.18 %) cases of climacteric syndrome and menst rual disordertype,41 cases were cured with a 97.62 % effective rate.Eleven(5.02 %) cases of the type of functionaldisturbance of independence nerve were whole cured.Ninteen(8.68 %) of them with the type of reflux esophagitis had 89.47 %(17) effective rate.Sixty four(29.22%) cases of the type of Laryngopharyngeal reflux had 85.94%(55) effective rate.There were 94 menstrual disorder,73 sleep disorders,29 dreaminess,32 hypodynamia,71 heart disorders,11 chest distress,63 digestive tract symptom with heartburn、stomac discomfort etc.73 were breastbone of midline cervix and position permanent ;91 were not constant and migrationed.Conclusions There were obvious relation between the following symptom and the spot ofparaesthesia pharynges and their causa morbi,To clinical diagnosis the causa morbi of paraesthesia pharynges and treatment have the extremely important guiding sense for carefull inquirying the following symptom and spot of paraesthesia pharynges.
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Objective To investigate the morphological changes in wound margin during the repair of traumatic tympanic membrane perforation patched by gelatin sponge with the aid of an endoscope in evaluating the prognosis. Methods Twenty-three female patients with traumatic tympanic membrane perforation within 6 hours were patched repaired with therapeutic gelatin sponge patches. Changes in the wound margin of traumatic tympanic membrane and the morphology of healed tympanic membrane were observed with endoscope. Results Among the 23 cases, infection occurred in 2 cases, and 5 were lost for follow-up. In the other 16 cases, the healing time in 11 cases was between 6 days and 20 days. On the first day after treatment, granulation and exudation increased around the wound margin. Hyperaemia was observed in both tympanic annulus and the handle of malleus. On the second day, granulation tissue increased further, and epithelization was observed on the third to sixth day. Hyperplasia of epithelial layer was accompanied by the formation of fibrosis of traumatic tympanic membrane. The initial healed tympanic membrane was thicker than normal and then thinned gradually in the following 3 days to 1 week. The threshold of pure tone audiometry in speech frequency was improved by 25?10dB. In 3 cases of these 16 patients, the healing time was 26-74 days with no hyperplasia of granulation tissue. In the other 2 cases of these 16 patients, the wound margin was surrounded by crust and failed to heal in 3 weeks. Conclusion Granulation hyplasia and increase in exudation can improve the repair of traumatic tympanic membrane by patching of a therapeutic gelatin sponge and shorten the healing time. When the wound margin was surrounded by crust hinders the repair of traumatic tympanic membrane.
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Objective To establish a method for recognizing nasal bleeding sites and hemorrhagic foci of hidden epistaxis.Methods The bleeding sites and hemorrhagic foci,as well as the used surgical techniques and the curative effects were studied retrospectively in 122 patients with spistaxis from Jan.2005 to Oct.2007,in whom the bleeding sites and hemorrhagic foci were not found by routine nasoscope examination.Under nasal endoscopic monitoring,electric heat cauterization(EHC),microwave coagulation(MC) and micro-traumatic nasal packing(MTNP) were applied respectively to treat the hidden epistaxis.Results The hemorrhagic foci were found in the following sites:Olfactory cleft 48 cases(39.3%),superior wall of inferior nasal meatus 20 cases(16.4%),posteroinferior wall of middle nasal meatus 6 cases(4.9%) and so on.Epistaxis was well controlled in 113 of 122 cases(92.6%),in whom the hemorrhagic foci were found by endoscope,by laser soldering,MC and EHC.Packing with mini gel foam was used in 9 cases,for whom the hemorrhagic foci were not found.No complications occurred during a 1-2 months of follow up after treatment.Of the 122 cases,106 cases(86.9%) stopped bleeding by treatment once and 16 cases(13.1%) stopped by treatment twice.Conclusion The lateral or posterior area of middle and inferior nasal meatus,and olfactory cleft area are the frequent sites of hidden epistaxis.Examination with endoscopy,combined with the findings on the middle and inferior turbinate and the features of blood flow in different sites,will be important on recognizing the hidden epistaxis and locating the hemorrhagic foci.
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Objective To investigate the pathogenesis,diagnosis and therapy of intranasal contact point headache.Method The clinical data of 73 patients with contact point headache between the septum and the lateral nasal wall were retrospectively reviewed and the anatomical abnormality of nasal carity was determined by CT scanning of the sinuses and endoscopy.All the patients underwent surgical intervention for correcting the abnormal anatomical conditions of nasal cavity.Results The headache disappeared in 67 of the 73 patients after topical anesthesia,and in the 6 remainders after maxillary sinus puncture.Among the anatomic variations in all the cases,endoscopy revealed that 31 sides there was hypertrophy of ethmoidal bulla,hypertrophy and medial deriation of processus uncinatus in 59 cases,abnormality of middle turbinate in 91 sides,and upper nasal septal deviation in 51 cases.Among the 73 cases,there was confact of two or mose sites of mucosa of the abnormalities in 57 cases.The headache disappeared in 64 patients(87.7%) one week after operation,and it was reduced in 9 cases(12.3%).12-month follow-up showed recovery in 59 cases(80.8%),in 12 cases(16.4%) it was partially relieved,and in 2 cases(2.7%) there was no effect.Conclusions Abnormal nasal septa,enlarged turbinates and other anatomic abnormalities are the most common findings in contact point headache.Pressure due to mucosal contact between the septum and lateral nasal wall mucosa,and maxillary sinus orifice occlusion are the major causes of contact point headaches.Endoscopy,CT scanning,and topical anesthesia are ideal in diagnosis of intranasal contact point headache.
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0.05),but significant difference existed between two groups at 6 and 12 months after treatment(P