Intralabyrinthine schwannomas(ILS)are rare benign tumors,often responsible for hearing loss.MRI is important in establishing the diagnosis.We present the example of a 48-year-old lady who reported a 3-years history of...Intralabyrinthine schwannomas(ILS)are rare benign tumors,often responsible for hearing loss.MRI is important in establishing the diagnosis.We present the example of a 48-year-old lady who reported a 3-years history of right-sided sensorineural deafness.MRI demonstrated a loss of the normal hypersignal of the second turn of the right cochlea compatible with intracochlear schwannoma.展开更多
目的分析一体式蜗内耳蜗电图在人工耳蜗植入(CI)术中的应用情况,讨论其优势及局限,总结该技术的标准化流程。方法收集2023年3月~2025年8月于本团队实施人工耳蜗术中一体式蜗内耳蜗电图的全部临床资料及术中监测数据,对监测成功率、监测...目的分析一体式蜗内耳蜗电图在人工耳蜗植入(CI)术中的应用情况,讨论其优势及局限,总结该技术的标准化流程。方法收集2023年3月~2025年8月于本团队实施人工耳蜗术中一体式蜗内耳蜗电图的全部临床资料及术中监测数据,对监测成功率、监测指标变化规律等进行分析,建立术中监测三阶段分型(植入早期、中期和晚期;上升型、下降型、稳定型、波动型)。结果共有44例(45耳)患者应用该技术(男24,女20),平均年龄27.3±19.2岁,术前低频平均听力为86.6±21.1 dB HL,无明显的耳蜗畸形,均完成全部电极植入。15耳成功在术中引出CM波形,9耳于术毕或术后第2天引出波形,21耳未引出波形(其中9耳术中干扰严重,2耳术中耳机脱落)。在去除术中干扰严重的9耳和术中耳机脱落的2耳后,34耳的术中CM波形引出率与术前低频平均听力之间无统计学意义(n=34,χ^(2)=1.145,P=0.451),且该34耳以及术中成功引出15耳耳蜗微音电位(cochlear microphonics,CM)波形最大幅值与术前低频平均听力无明显相关(n=34,r=-0.015,P=0.931;n=15,r=0.237,P=0.395)。15耳中,植入早期最常见为波动型[7耳(46.7%)],其中4耳依据波形变化采用优化植入干预方案;在中期为稳定型和波动型居多[均为5耳(33.3%)];在晚期,各类型比例相近,且波形下降趋势难以通过干预方案得到恢复。在本院完成术后开机随访且具有术前可测听力的12例(12耳)患者,术后低频听力完全保留率为75%,部分保留率为25%。术毕/术中最高幅值比与术后低频听力阈移呈显著负相关(r=-0.707,P=0.01)。结论术中应用ECochG技术可实时反馈电极植入对内耳的创伤,及时在损伤可逆期内进行微创化调整,有助于术后残余听力的保留。术中标准化流程的建立有助于提升该技术的术中引出率。术中监测三阶段分型的建立有助于电极植入对内耳创伤的机制分析。术中CM波形引出率、引出幅值与术前低频平均听力的关系仍待进一步探讨分析。展开更多
For many years,drug delivery to the inner ear has been a challenge to physicians in the treatment of inner ear disorders.In the past decade,the field of inner ear drug delivery has emerged with the development of new ...For many years,drug delivery to the inner ear has been a challenge to physicians in the treatment of inner ear disorders.In the past decade,the field of inner ear drug delivery has emerged with the development of new biomaterials and drug delivery technologies to improve the effectiveness of inner ear drug therapy.This paper reviews a number of inner ear drug delivery strategies including systemic,intratympanic,and intracochlear delivery.A focus of this review is the recent advances in intratympanic delivery of medications;approaches utilizing novel biomaterials as well as other recent developments are also discussed.Biotechnology-based approaches,such as gene and stem cell therapy methods are also reviewed.Among the various strategies,local drug delivery approaches including intratympanic and intracochlear drug delivery methods that limit systemic exposure are particularly promising.These inner ear drug delivery systems provide a new opportunity to improve the treatment of inner ear disorders.展开更多
文摘Intralabyrinthine schwannomas(ILS)are rare benign tumors,often responsible for hearing loss.MRI is important in establishing the diagnosis.We present the example of a 48-year-old lady who reported a 3-years history of right-sided sensorineural deafness.MRI demonstrated a loss of the normal hypersignal of the second turn of the right cochlea compatible with intracochlear schwannoma.
文摘目的分析一体式蜗内耳蜗电图在人工耳蜗植入(CI)术中的应用情况,讨论其优势及局限,总结该技术的标准化流程。方法收集2023年3月~2025年8月于本团队实施人工耳蜗术中一体式蜗内耳蜗电图的全部临床资料及术中监测数据,对监测成功率、监测指标变化规律等进行分析,建立术中监测三阶段分型(植入早期、中期和晚期;上升型、下降型、稳定型、波动型)。结果共有44例(45耳)患者应用该技术(男24,女20),平均年龄27.3±19.2岁,术前低频平均听力为86.6±21.1 dB HL,无明显的耳蜗畸形,均完成全部电极植入。15耳成功在术中引出CM波形,9耳于术毕或术后第2天引出波形,21耳未引出波形(其中9耳术中干扰严重,2耳术中耳机脱落)。在去除术中干扰严重的9耳和术中耳机脱落的2耳后,34耳的术中CM波形引出率与术前低频平均听力之间无统计学意义(n=34,χ^(2)=1.145,P=0.451),且该34耳以及术中成功引出15耳耳蜗微音电位(cochlear microphonics,CM)波形最大幅值与术前低频平均听力无明显相关(n=34,r=-0.015,P=0.931;n=15,r=0.237,P=0.395)。15耳中,植入早期最常见为波动型[7耳(46.7%)],其中4耳依据波形变化采用优化植入干预方案;在中期为稳定型和波动型居多[均为5耳(33.3%)];在晚期,各类型比例相近,且波形下降趋势难以通过干预方案得到恢复。在本院完成术后开机随访且具有术前可测听力的12例(12耳)患者,术后低频听力完全保留率为75%,部分保留率为25%。术毕/术中最高幅值比与术后低频听力阈移呈显著负相关(r=-0.707,P=0.01)。结论术中应用ECochG技术可实时反馈电极植入对内耳的创伤,及时在损伤可逆期内进行微创化调整,有助于术后残余听力的保留。术中标准化流程的建立有助于提升该技术的术中引出率。术中监测三阶段分型的建立有助于电极植入对内耳创伤的机制分析。术中CM波形引出率、引出幅值与术前低频平均听力的关系仍待进一步探讨分析。
文摘For many years,drug delivery to the inner ear has been a challenge to physicians in the treatment of inner ear disorders.In the past decade,the field of inner ear drug delivery has emerged with the development of new biomaterials and drug delivery technologies to improve the effectiveness of inner ear drug therapy.This paper reviews a number of inner ear drug delivery strategies including systemic,intratympanic,and intracochlear delivery.A focus of this review is the recent advances in intratympanic delivery of medications;approaches utilizing novel biomaterials as well as other recent developments are also discussed.Biotechnology-based approaches,such as gene and stem cell therapy methods are also reviewed.Among the various strategies,local drug delivery approaches including intratympanic and intracochlear drug delivery methods that limit systemic exposure are particularly promising.These inner ear drug delivery systems provide a new opportunity to improve the treatment of inner ear disorders.
