有些患者为图方便,会自己购买药物或找偏方治疗耳疾,这不仅贻误诊治,还可引发严重并发症.现为您讲解耳科用药常识. 耳科药也有滴鼻剂 治疗耳科疾病的方法有很多,药物治疗是基本的治疗方法,正确合理使用药物,对疾病的恢复至关重要.

Objective The research aimed at evaluating whether non-invasive endolymphatic MR imaging could be used in aged patients(≥60 years)suffering from Meniere's disease.Methods Under guidance of nasal endoscopy,a diluted gadopentetate dimeglumine injection was administrated through eustachian tube into mid-ear cavity in four patients (≥60 years old) suffered from Meniere's disease.3D-FLAIR MRI scan was performed one day after the administration.Results The administration succeeded through eustachian tube into mid-ear cavity in those four patients.A rise of fluid level on tympanic membrane while administrating a diluted gadopentetated meglumine injection was observed.Imaging of inner ear endolymphatic spaces were visible in vestibule and cochlea in imaging of patient 1.As to patient 2,in cochlea the scala tympani of the first and second turns were enhanced while scala vestibule weren't;Vestibules couldn't be recognized.In images of patient 3,the scala tympani of the three turns in cochlea were enhanced while scala vestibule weren't;Vestibules couldn't be recognized.For Patient 4,in cochlea the scala tympani of the first turn were enhanced while scala vestibule weren't,and the second turn was partially enhanced;and endolymphatic space of vestibule could be distinguished from perilymphatic space.Conclusions This technique could be adopted in investigation of Meniere's disease in elderly patients.MR imaging of endolymphatic spaces in vestibule and cochlea can be visualized,which may partially provide data for diagnosis of Meniere's disease.

Objective To compare the endolymphatic spaces between Meniere's disease (MD) group and normal volunteer group.Methods Patients were performed administration of gadolinium to mid-ear affected by MD via non-invasive method through eustachian tube,and then performed 3D-FLAIR MRI scanning afer one day.After measurement and calculation,the RV and RC (area of endolymphatic space divided by total lymphatic space in vestibule and cochlea,respectively) between the MD group and the normal group were compared.Results The endolymphatic spaces were distinct from perilymphatic spaces in vestibule and cochlea,the average of RV was 0.39,and the standard deviation of RV was 0.07;the average of RC was 0.16,and the standard deviation of RC was 0.05.RV of the MD group had significant difference compared to that of the normal group(t =-6.07,P ＜0.05);RC of the MD group had no significant difference compared to that of the normal group (t =0.783,P ＞ 0.05).According to diagnosis standard raised by Liu F in previous research,the positive ratio of RV was 42.9％,while the positive RC was 9.52％.The two patients during attack period both had positive RVs.Conclusion RV of the MD group had significant difference compared to that of the normal group;RC of the MD group had no significant difference compared to that of the normal group.

目的 了解糖尿病导致听力损害的特征,探讨其发病的相关危险因素. 方法 选择T2DM患者(T2DM组)88例及健康体检者(Con组)56名,检测纯音测听阈值,比较两组听力的差异.结果 T2DM组和Con组听力损害的发生率分别为68.2％和28.6％,两组比较差异有统计学意义(P＜0.01).T2DM组男性听力损害的发生率高于女性(61.7％vs38.3％,P＜0.05),而Con组不同性别间比较,差异无统计学意义(P＞0.05).T2DM组在所测试各个频率听力均有下降,高频听力下降更明显(P＜0.001).T2DM组高频听力损害的发生率为45.4％(40/88),同时合并中低频听力损害发生率为17％(15/88),仅存在中低频听力损害发生率为1.1％(1/88). 结论 T2DM患者听力损害的比例较高,以高频听力损害为主,男性多见.

OBJECTIVE:To investigate the clinical characteristics and the effect of drug treatment for sudden hearing loss with vertigo or dizziness.METHODS:In a prospective, randomized, single blinded randomized multicenter clinical study, patients with sudden deafness, ranging in age from 18 to 65 years old, with a duration less than 2 weeks, and with no any medical treatments were collected. In accordance with the hearing curve, those patients were divided into four types, i.e., low and intermediate frequency descent type; high frequency descent type; fall flat type; and total deafness type. Each type was treated by four different treatment options, according to the unified design of the random table, and randomly selected one of the options for treatment. The efficacy of the patients with sudden deafness with vertigo and dizziness was analyzed statistically after the follow-up for 4 weeks. SPSS 13.0 software was used to analyze the data.RESULTS:In August 2007 to October 2011, 33 hospitals in the country included 1 024 patients with sudden deafness in line with the inclusion criteria, of whom 296 (28.91%) were accompanied by vertigo/dizziness symptoms, 126 were males and 170 were females, with an average age of (41.2 ± 13.5) years old. types of the different audiometric curves of sudden deafness, the occurrence of complete deafness with vertigo/dizziness was the highest (44.93%), followed by flat down type (25.87%), high frequency descent type (21.28%) and low intermediate frequency descent type (18.54%). After the standard treatment, the vertigo and dizziness symptoms of the sudden deafness patients could disappear, and the hearing in each group was obviously improved. The hearing curative effect on patients accompanied by vertigo/dizziness of low frequency and intermediate frequency descent type was the best, and the total efficiency can reach up to 94.74%, with the cure rate of 68.42%; followed by flat type, in which the total effective rate was 80.76%, with the recovery rate of 22.12%; and the effects on patients in high frequency descent type and total deafness type effect were relatively poor, in which the total effective rates were 70.00% (recovery rate of 10.00%) and 65.32% (recovery rate of 5.65%), respectively. The total effective rate of patients with sudden deafness associated with halo had no statistical significance (P > 0.05), in comparison to that of patients without halo; but, the cure rate of patients with no vertigo/dizziness of total deafness and the high frequency decreased patients with sudden deafness was significantly higher than that of vertigo/dizziness patients, with a statistical difference (P < 0.05).CONCLUSIONS:The patients with sudden deafness in each type have a certain proportion of vertigo/dizziness, especially the deaf type. The possibility of hearing complete recovery in patients with vertigo/dizziness was significantly lower than that without vertigo/dizziness.

CONCLUSIONS:This study is the first to demonstrate noninvasive evaluation of the effect of endolymphatic sac decompression (ESD) in Ménière's disease using magnetic resonance imaging (MRI).OBJECTIVE:To evaluate the effect of ESD for the treatment of Ménière's disease by applying noninvasive intratympanic gadolinium (Gd) perfusion through the eustachian tube and three-dimensional fluid-attenuated inversion MRI (3D-FLAIR MRI).METHODS:This was a prospective study. 3D-FLAIR MRI was performed with a 3 Tesla unit 24 h after intratympanic administration of Gd through the eustachian tube in five patients with intractable Ménière's disease before and 3 months after ESD, with a 2-year follow-up on the effect of ESD.RESULTS:Gd was present in the perilymph of the inner ear in all the patients, which clearly displayed the endolymphatic space on 3D-FLAIR MRI with a visible borderline between the perilymph and the endolymph. According to the normal values for the endolymphatic space, four of five patients had a ratio of more than 26% in the cochlea, and three of five patients had a ratio of more than 41% in the vestibule preoperatively. All the patients had a ratio of less than 26% in the cochlea and 41% in the vestibule postoperatively. ESD was effective in reducing the incidence and severity of vertigo attacks with significant improvement in 60% of patients.

CONCLUSIONS:The comparison of noninvasive standard evaluation of endolymphatic hydrops in Meniere's disease and the endolymphatic space in healthy volunteers using magnetic resonance imaging (MRI) evaluation should be carried out first.OBJECTIVE:To compare the standard evaluation of endolymphatic hydrops in Meniere's disease and the endolymphatic space in healthy volunteers in the cochlea and the vestibule in the same age group by applying noninvasive intratympanic gadolinium (Gd) perfusion through the eustachian tube and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI).METHODS:This was a prospective study. 3D-FLAIR MRI was performed with a 3 Tesla (3 T) unit 24 h after intratympanic administration of Gd through the eustachian tube in 6 patients with medically active and intractable Meniere's disease and 20 healthy volunteers. Pure tone test and tympanometry were performed 24 h before Gd was administered, and 24 h and 1 month after Gd administration.RESULTS:Gd was present in the perilymph of the inner ear, which clearly displayed the endolymphatic space on 3D-FLAIR MRI with a visible borderline between the perilymph and the endolymph. In 45-55-year-old healthy volunteers, the normal value for the endolymphatic space in the cochlea ranged between 8% and 26%, and that in the vestibule was between 20% and 41%. According to the normal value for the endolymphatic space, four of six patients had a ratio of more than 26% in the cochlea; moreover, four of six patients had a ratio of more than 41% in the vestibule. All the patients had a ratio of more than the normal value in the cochlea and/or the vestibule. No significant changes in pure tone test and tympanometry were noted.

<正>感冒后听力会减弱,此时听MP3如果把音量开得很大,这种声刺激,会损伤耳朵中的毛细胞,造成暂时性的听力损伤,有些人则会出现噪声性耳聋。对于一些敏感人群,甚至会造成听力永久性损伤。

OBJECTIVE To explore condition of pri-mary organ culture of the utricular maculae of the guineapigs inner ear in vitro and establish an experimentalmodel for further research. METHODS The utricularmaculae of the guinea pigs were primarily cultured withtissue culture method in vitro. RESULTS The grow ofthe outgrowth zone of the utricular maculae presentedfibroblasts cell during 10 days. Existing of the support-ing cells and hair cells in sensory epithelium were foundby means of paraffin embedded sections on 10th day.Hair cells were damaged and supporting cells were livedin culture medium with gentamicin for 48 hours bymeans of plastic embedded mount and semi-thinsectioning. CONCLUSION Primary organ culture ofthe utricular maculae of the guinea pig inner ear in vitrois feasible. This organ culture method provide an ex-perimental model for further research on utricularmaculae.

目的在离体状态下对豚鼠前庭椭圆囊器官进行培养,观察庆大霉素损伤毛细胞后细胞的增殖情况.方法采用白色健康豚鼠36只,体重300-450克,随机分为4组:(1)正常对照组;(2)正常加BrdU(5-溴基脱氧尿核苷BrdU)组;(3)庆大霉素组;(4)庆大霉素加BrdU组.应用体外组织培养、5-溴基脱氧尿核苷(BrdU,3μg/ml)掺入及免疫组织化学染色和Epon树酯包埋半薄切片等方法,在不同时间(2、3、5、15天)光镜观察庆大霉素(2.0mM)损伤后毛细胞及支持细胞增殖情况.结果用庆大霉素48小时后,可见到椭圆囊感觉上皮中的毛细胞溶解破坏.加入BrdU继续培养,BrdU免疫组织化学染色显示了第5和15天被BrdU标记的阳性细胞核,阳性细胞核多位于椭圆囊感觉上皮中基底层,从细胞的形态和分布位置上看为支持细胞;感觉上皮的表层,也可观察到BrdU反应阳性的上皮细胞,细胞核较圆,形态和位置类似毛细胞.结论提示损伤后的椭圆囊感觉上皮支持细胞可以进行细胞的有丝分裂,支持细胞可能是修复毛细胞的前体细胞.

梅尼埃病(Meniere disease, MD)病因不明.近来国内外越来越多的实验及临床研究表明MD与免疫反应有关.为了了解MD的发病与免疫机制的关系,检测了MD患者的血清中3类体液免疫参数的变化.