Intratympanic dexamethasone for refractory sudden deafness / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the clinical efficacy of intratympanic dexamethasone (IT-DEX) for sudden deafness (SD) which were inefficient and contraindicant for systemic steroid.@*METHOD@#Thirty-four patients who were inefficient and contraindicant for systemic steroid were treated by IT-DEX (5 g/L) for 4 times within 12 days. The improvement of audits, tinnitus and stuffy were observed. And the results between the different influencing factor such as age, sex and course of disease were compared by statistical analysis.@*RESULT@#1) For total patients, the effective power of audits, tinnitus and stuffy were 52.9%, 58.8% and 82.4% respectively. And the patients who treated within 2 weeks result in higher effective power of audits and tinnitus than those having been treated for more than 2 weeks, but there was no significant difference between these two groups (P >0.05). 2) For the patients who were inefficient and contraindicant for systemic steroid, the audible effective power of them were 44.4% and 62.5% respectively.@*CONCLUSION@#IT-DEX can treat refractory SD effectively and safely. It is an effective treatment for the patients who were contraindicant for systemic steroid, and it could be used for salvage for the patients who were inefficient for systemic steroid.

Clinical features and management of middle ear adhesion / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the clinical features and therapeutic efficacy of middle ear adhesion.METHODS The clinical data of 40 cases of middle ear adhesion collected during 5 years from 2002 to 2007 were studied retrospectively. RESULTS Part or all of the tympanic membrane of the patients did not move under Siegle otoscopy. The lesions of middle ear adhesion were extensive and invaded all middle ear structures including round and oval windows.The lesions were severe, especially in narrow anatomical spaces such as mesotympanum,hypotympanum and interossicular spaces.Pure tone audiometry showed that average air-bone gap (A-B gap) were (35.34?6.99) dB preoperatively.The average A-B gap were (18.47?5.76) dB 6 months after operation.Follow-up observations and postoperative CT scan showed that tympanic membranes and middle ear cavity recovered well.CONCLUSION There are various degrees of tympanic fibrous adhesion and atelectatic tympanum in middle ear adhesion,especially in mesotympanum, hypotympanum and interossicular spaces.The middle ear adhesion can be treated with operation.The key points for a successful operation include preserving normal tympanum mucosa,opening eustachian tubes, making a bigger middle ear cavity,and performing tympanoplasty with perichondrium-cartilage plates.