Objective The purpose of this paper is to study the variations of the bone conduction hearing in the patients with chronic suppurative otitis media complicated by bone conduction deterioration after tympanoplasty and to analyze the relative factors. Methods In 54 cases (61 ears) of decreased bone conduction thresholds associat-ed with chronic suppurative otitis media, reviewed retrospectively were the data before the operation and during the follow-ups from 3 to 27 months. The bone conduction thresholds at 0. 5,1, 2 and 4 kHz were studied in relation to the courses of disease, the complications of cholesteatoma, the operation procedures and the reconstructions of os-sicular chains before and after surgeries. Results Before operation the most obvious hearing loss of bone conduction was found at 4 kHz in 61 ears, while after operation the average bone conduction hearing at the 4 frequencies was improved at different degrees with the most at 2 k Hz. Thirty-two of 61 cases (52.50%) were found to have their hearing improved at least by more than 10 dE at two frequencies without any deterioration at the 4 frequencies. Con-clusion The factors of the duration of disease and complications of cholesteatoma are obviously not related to the improvement of hearing after operation. A patient with reconstruction of ossicular chain is markedly superior to one without the reconstruction in improvement of hearing. When the auditory ossicular chains and functions of the oval and/or round windows are damaged, the bone conduction hearing can be affected accordingly. However the hearing of some cases will be improved after tympanoplasty. Also, the possible improvement is also related to different sur-geries in treating patients with middle ear infections.

OBJECTIVE: To evaluate the efficacy of microsurgical treatment of preauricular fistula (IPF). METHOD: The clinical data of 102 ears with IPF underwent microsurgical treatment were reviewed retrospectively. RESULT: One hundred ears (98.04%) recovered from the microsurgical treatment without recurrence. CONCLUSION Microsurgical technique is simple, safe and valuable in treating IPF, particularly when it comes to the patients with post operational recurrence, repeated infection or too much scar tissue.
Adult ; Ear, External ; Female ; Fistula ; congenital ; surgery ; Humans ; Male ; Microscopy ; Retrospective Studies

OBJECTIVE: To study the clinical effect of Treatment of blow-out fracture of medial orbital wall with nasoseptal cartilage under nasal endoscope. METHOD: Under a nasal endoscope, the fracture and the prolapsed orbital contents were reduced to the orbit, and then an autogenous nasoseptal cartilage was grafted into the orbital defect. The variations in the visual acuity, diplopia, enophthalmos degree and eyeball position were detected preoperatively and postoperatively. RESULT: During the follow up of three months to four years after operation, all the 28 cases showed neither loss nor distinct descent of visual acuity. The postoperative mean enophthalmos degree (1.5 +/- 0.6) mm was lower than the preoperation one(3.6 +/- 1.1) mm (P<0.05). Diplopia disappeared completely of 25 cases during 3 month after operation,while it appeared in the primary position of 2 cases. The eye movement was normal of 26 cases after operation t, and the abduction was slightly limited of 2 cases, but which was better than be for). Any displacement of filling material, infection, rejection reaction were not found of all the 28 cases. CONCLUSION The medial orbital blow out fracture with nasal endoscope has many advantages, such as short operative route, clear surgical visual field, simple performance, light injury and no scars, and the effect of which will be really certain in the operative practice.
Adult ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Orbital Fractures ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVE To observe the efficacy and safety of hydromorphone in patient-controlled intravenous analgesia(PCIA)after uvulopalatopharyngoplasty.METHODS A total of 90 patients who received uvulopalatopharyngoplasty in Central Theater General Hospital from January 2022 to June 2023 were selected and divided into three groups(n=30 in each group)by using random number table method.Control group was given sufentanil 2.0 μg/kg,group A was given hydromorphone 0.20 mg/kg and group B was given hydromorphone 0.30 mg/kg.The analgesic parameters of three groups were background infusion rate of 1.2 ml/h,PCA amount of 2 ml,and lock-up time of 10 min.VAS score and Ramsay sedation score at 2 h,6 h,12 h,24 h and 48 h after surgery were recorded,as well as the number of compressions within 48 h after surgery,and the incidence of adverse reactions were analyzed.RESULTS There were no significant differences in intraoperative blood loss,operation time and intraoperative urine volume among the three groups(P>0.05).VAS score in group A and group B at 2 h(2.0±0.3,2.2±0.4),6 h(1.8±0.4,1.9±0.4),12 h(1.8±0.4,1.7±0.4),24 h(1.6±0.3,1.5±0.4)and 48 h(1.1±0.3,1.2±0.4)were significantly lower than those in control group(2.8±0.5,2.3±0.5,2.1±0.4,2.0±0.5,1.7±0.5)(P<0.05),but there was no significant difference between group A and group B(P>0.05).The Ramsay score of group A and group B at 2 h,6 h,12 h,24 h,and 48 h after operation was significantly lower than that of the control group(P<0.05).There was no significant difference in Ramsay score between group A and group B(P>0.05).The total number of compressions and effective number of compressions in group A and group B at 12 h,24 h and 48 h after surgery were lower than those in control group(P<0.05),but there was no significant difference between group A and group B(P>0.05).The incidence of total adverse reactions in group B was higher than that in group A and control group(P<0.05).There was no significant difference in the incidence of total adverse reactions between group A and control group(P<0.05).CONCLUSION Hydromorphone can effectively be used for postoperative self-controlled analgesia in patients with uvulopalatopharyngoplasty,and the efficacy is better than sufentanil,but the dose of 0.20 mg/kg hydromorphone has better safety than that of 0.3 mg/kg hydromorphone.