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Preparing the surgical area for non-shaved ear surgery: a clinical assessment.

准备非剃毛耳手术的手术区域: 临床评估。

  • 影响因子:1.59
  • DOI:10.12968/jowc.2020.29.1.68
  • 作者列表:"Lee DH","Kim D
  • 发表时间:2020-01-02
Abstract

OBJECTIVE:To review the clinical experience for non-shaved middle ear/mastoid surgery and evaluate the proper method of preparing the postauricular surgical field. METHODS:This retrospective study reviewed medical records of cases where the non-shaved surgical procedure was carried out for middle ear/mastoid diseases. In all cases, middle ear and mastoid surgery was performed by one otologic surgeon without hair shaving to treat chronic perforation of tympanic membrane, as well as chronic suppurative otitis media, with or without mastoiditis during two years. The prevalence of surgical site infection (SSI) and bacterial culture of the surgical field was assessed just before the skin incision. RESULTS:In this review of 106 cases, the SSI rate was 1.6% for the non-shaved ear surgery. Bacterial colonisation was found on the prepared surgical field in 8.5% of cases and these bacteria was different from true pathogens. SSI of the skin incision occurred in two cases, although no bacterial colonisation of the non-shaved surgical field was found. The surgical exposure of postauricular area was enough to do tympanoplasty or tympanomastoidectomy, even though in cases where a hairline was close to postauricular sulcus. CONCLUSION:This study showed that when preparing the non-shaved ear surgery, the surgeons should not have to worry about skin contamination by hair. We suggest that the non-shaved ear surgery would appear to be preferable for the postauricular approach.

摘要

目的: 总结非剃毛中耳乳突手术的临床经验,探讨耳后手术区的合理准备方法。 方法: 这项回顾性研究回顾了对中耳/乳突疾病进行非剃毛手术的病例记录。在所有病例中,中耳和乳突手术由一名没有剃毛的耳科医生在两年内治疗鼓膜慢性穿孔以及慢性化脓性中耳炎,伴有或不伴有乳突炎。在皮肤切口之前评估手术部位感染 (SSI) 的患病率和手术区域的细菌培养。 结果: 在106例病例的回顾中,非剃毛耳手术的SSI率为1.6%。在8.5% 的病例中,在制备的手术区域发现细菌定植,并且这些细菌不同于真正的病原体。在两例中发生皮肤切口的SSI,尽管未发现非剃毛手术区域的细菌定植。耳后区域的手术暴露足以进行鼓室成形术或鼓室切除术,即使在发际线接近耳后沟的情况下。 结论: 这项研究表明,在准备非剃毛耳手术时,外科医生不必担心头发污染皮肤。我们建议未刮耳手术似乎更适合耳后入路。

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影响因子:2.05
发表时间:2020-02-01
DOI:10.1136/archdischild-2018-315866
作者列表:["Butcher E","Dezateux C","Knowles RL"]

METHODS:OBJECTIVE:While several perinatal risk factors for permanent childhood hearing impairment (PCHI) are known, association with gestational length remains unclear. We hypothesised that shorter gestational length predicts higher PCHI risk. DESIGN:19 504 participants from the UK Millennium Cohort Study (born 2000-2002, prior to newborn screening). METHODS:Multivariable discrete-time survival analysis to examine associations between parent-reported PCHI by age 11 years and gestational length, plus other prespecified factors. RESULTS:PCHI affected 2.1 per 1000 children (95% CI 1.5 to 3.0) by age 11; however, gestational length did not predict PCHI risk (HR, 95% CI 1.00, 0.98 to 1.03 per day increase). Risk was increased in those with neonatal illness, with or without admission to neonatal care (6.33, 2.27 to 17.63 and 2.62, 1.15 to 5.97, respectively), of Bangladeshi or Pakistani ethnicity (2.78, 1.06 to 7.31) or born to younger mothers (0.92, 0.87 to 0.97 per year). CONCLUSION:Neonatal illness, rather than gestational length, predicts PCHI risk. Further research should explore associations with ethnicity.

关键词: 耳聋 流行病学
翻译标题与摘要 下载文献
影响因子:1.09
发表时间:2020-01-01
DOI:10.1016/j.bjorl.2018.10.007
作者列表:["Öçal R","Akın Öçal FC","Güllüev M","Alataş N"]

METHODS:INTRODUCTION:Sudden hearing loss is a significant otologic emergency. Previous studies have revealed a coexistence of sudden hearing loss with chronic inflammation. The predictive importance of C-reactive protein/albumin values as a prognostic factor has been shown in various inflammatory and tumoral conditions. OBJECTIVES:The aim of this study was to determine whether the C-reactive protein/albumin ratio in sudden hearing loss can be used for prognostic purposes and whether there is a relationship between the neutrophil/lymphocyte ratio and the C-reactive protein/albumin ratio. METHODS:A retrospective examination was made of 40 patients diagnosed with idiopathic sudden hearing loss and a control group of 45 healthy subjects. The pure tone averages of all the patients were determined on first presentation and repeated at 3 months after the treatment. The patients were separated into 2 groups according to the response to treatment. The neutrophil/lynphocyte ratio and the C-reactive protein/albumin ratios were calculated from the laboratory tests. RESULTS:The patients included 16 females and 24 males with a mean age of 44.1±14.2 years and the control group was composed of 23 females and 22 males with a mean age of 42.2±13.8 years. The mean C-reactive protein/albumin ratio was 0.95±0.47 in the patient group and 0.74±0.13 in the control group. The difference was statistically significant (p=0.009). The mean C-reactive protein/albumin ratio was 0.79±0.12 in the response to treatment group and 1.27±0.72 in the non-response group, with no significant difference determined between the groups (p=0.418). The mean neutrophil/lymphocyte ratio was 3.52±3.00 in the response to treatment group and 4.90±4.60 in the non-response group, with no statistically significant difference determined between the groups (p=0.261). CONCLUSION:C-reactive/albumin ratio was significantly higher in patients with sudden hearing loss than in the control group. Although C-reactive protein/albumin ratio was found to be lower in sudden hearing loss patients who responded to treatment compared to those who did not, the difference between two groups was not statistically significant.

影响因子:1.09
发表时间:2020-01-01
DOI:10.1016/j.bjorl.2018.10.006
作者列表:["Scarabello EM","Lamônica DAC","Morettin-Zupelari M","Tanamati LF","Campos PD","Alvarenga KF","Moret ALM"]

METHODS:INTRODUCTION:The cochlear implant is an effective device for children with severe and/or profound prelingual hearing loss, since it provides considerable improvement in oral language acquisition through the auditory pathway. The use of a cochlear implant contributes to the development of auditory perception, favoring the acquisition of the linguistic processes related to communication skills, which might have a positive effect on other areas of development. OBJECTIVE:The aim of this study was to verify the performance of children using cochlear implants for expressive and receptive oral language. METHODS:This was a prospective cross-sectional study that used the following tests: Child language test in the phonology, vocabulary, fluency and pragmatics areas, and the Peabody picture vocabulary test. Thirty children participated in this study, of both genders, aged between 36 and 72 months, with severe and/or profound bilateral sensorineural hearing loss, without other impairments and users of unilateral cochlear implant with full electrode insertion for a minimum of 12 months. RESULTS:The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language. Even though when compared to the normative language acquisition process, the results showed that these children had patterns of linguistic skills that are below their chronological age; the results indicate that these children are developing expressive and receptive oral language skills, and this is the outcome that should be taken into account in this study. CONCLUSION:The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language skills, but not in all the studied semantic categories.

耳部疾病方向

包括耳部的炎症、耳聋、肿瘤等,发病机制广,且严重性聋可使人处于半残废状态。

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