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[取耳印模引起的并发症]

[Complications Resulting from Taking Ear Impressions].

作者信息

Sugiuchi Tomoko, Kodera Kazuoki, Zusho Hiroyuki, Asano Yoshikazu, Kanesada Keiko, Hayashida Mitsuhiro, Kanaya Koichiro, Tokumaru Takeshi

出版信息

Nihon Jibiinkoka Gakkai Kaiho. 2015 Aug;118(8):1058-67. doi: 10.3950/jibiinkoka.118.1058.

Abstract

In 2012, we carried out a study in a large sample to understand the secondary injuries caused during the taking ear impressions for hearing aids. This study is a follow-up of previous research conducted in 1986 (285 medical institutions) and 1999 (98 medical institutions). We posted a questionnaire survey to the otolaryngology departments of 3,257 medical institutions. The response rate to the questionnaire was 62.9% (2,050 of the 3,257 institutions), and the results indicated that 301 of the 2050 institutions (14.7%) had experience with secondary injuries, with a total of 460 cases reported. In 342 of the 460 cases (74.3%), the secondary injuries occurred at hearing-aid dealerships, followed by 67 cases (14.6%) at affiliated medical institutions, and 51 cases (11.1%) in other locations, including other medical institutions, rehabilitation counseling centers, and educational institutions. The most common type of secondary injury (298 cases, 64.8%) was caused by the presence of foreign bodies in the ear, which in turn was a result of complications occurring during the removal of residual ear impression material. Of these 298 cases, 32 required excision of the foreign bodies and surgical intervention under general anesthesia. The remaining 10 cases exhibited isolated tympanic membrane perforation without foreign body-related complications. Furthermore, 146 cases (31.7%) developed bleeding and otitis externa following removal of the ear impression, and there were reports of cases with bleeding that required long-term outpatient care and treatment. Therefore, since retention of a foreign body in the ear and tympanic membrane perforation can occur even in patients without a history of surgery or prior otologic history, adjustment of hearing aids requires prior otorhinolaryngological examination. Furthermore, because of the risk of secondary injury when taking ear impressions, this procedure must be performed with caution under the guidance of an otolaryngologist.

摘要

2012年,我们进行了一项大样本研究,以了解取助听器耳印模过程中造成的继发性损伤。本研究是对1986年(285家医疗机构)和1999年(98家医疗机构)进行的先前研究的随访。我们向3257家医疗机构的耳鼻喉科发放了问卷调查。问卷的回复率为62.9%(3257家机构中的2050家),结果显示,2050家机构中有301家(14.7%)有继发性损伤经历,共报告460例。在460例中的342例(74.3%)中,继发性损伤发生在助听器经销商处,其次是附属医院的67例(14.6%),其他地点(包括其他医疗机构、康复咨询中心和教育机构)有51例(11.1%)。最常见的继发性损伤类型(298例,64.8%)是耳部异物存留,这又是清除残留耳印模材料过程中发生并发症的结果。在这298例中,32例需要切除异物并在全身麻醉下进行手术干预。其余10例表现为孤立性鼓膜穿孔,无异物相关并发症。此外,146例(31.7%)在取出耳印模后出现出血和外耳道炎,并有出血病例需要长期门诊护理和治疗的报告。因此,由于即使没有手术史或既往耳科病史的患者也可能发生耳部异物存留和鼓膜穿孔,调整助听器需要事先进行耳鼻喉科检查。此外,由于取耳印模时有继发性损伤的风险,此操作必须在耳鼻喉科医生的指导下谨慎进行。

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