简介：ObjectiveSinceHelms'successfulbilateralcochlearimplantationwithgoodresultsin1996,therehavebeenincreasingnumberofreportsonbilateralcochlearimplantation.Mostseconddevicehavebeenimplantatedwithinoneyearafterthefirst.Consideringeffectsoflongtimeauditorydeprivation,itisnotclearwhetheradelayedsecondcochlearimplantservestoaddadditionalbenefitsandhowitmayinteractwithcentralnervoussystemplasticity.MethodsThreecaseswhoreceiveddelayedsecondcochlearimplantsatPeople'sHospitalofPekingUniversityfrom2002to2005werereviewed.Theintervalbetweenthefirstandsecondimplantswaslongerthan2yearsinallthreepatients.Soundperception,andunilateral/bilateralspeechdiscriminationinquietandnoisewereevaluated.Inaddition,GAPdetectiontestwasconductedinonepatient.ResultsInonecase,havingbothimplantsonprovidedimprovedperformancecomparedtousingonlyoneimplantbothinquietandnoise.Presumablyduetovisualinterferencefromlip-readingorshortintervalbetweensecondimplantandtesting,onepatientshowednoimprovementfromusingthesecondimplanteitherinquietornoise,whilethelastcasedemonstratedadditionalbenefitsfromthesecondimplantonlyinquiet.Inallthreepatients,performanceinrecognizingthefourtonesinMandarinwassuperioroverwordrecognition.ConclusionsConsiderableplasticityinthecerebralauditorycenterispreserved,despitelongacousticdeprivationinsomechildrenwhohavereceivedunilateralcochlearimplant.Delayedsecondimplantscanresultinsignificantimprovementsinsomeofthesechildren.Visualinterferencefromlip-readingmaybeanobstacleduringretraining.ThebetterrecognitionoftonesintheMandarinlanguagemayrepresentadifferentsounddiscriminationmechanismintheauditorysystem,althoughitmayalsoberelatedtothesignalprocessingmechanismsoftheimplantused(MED-ELCOMBI40+).

简介：Auditoryneuropathy(AN)isahearingdisordercharacterizedbyabsenceofauditorybrainstemresponsesdespitepreservationofouterhaircellfunction,andhasattractedattentionsfromresearchersandaudiologistssincereportedbyStarretal[1].ClinicalmanifestationsinANpatientsincludeabnormalauditorybrainstemresponsesnormalotoacousticemissions,lackofacousticreflexeslargecochlearmicrophonics,speechperceptiondeteriora

简介：SomenewresultsofimplantdisorderingonInPbasedMQWstructuresbyim-plantedcompositionaldisorderingarepresented.TheenergyshiftofPLpeakdependsonionspecies,iondose,annealingconditionsandtargettemperature,TheresultsindicatethatthenonactiveionssuchasF^+andNe^+arethebestcandiatesforIICD,theiondosewhichcausedbiggestblueshiftisaround1×10^14cm^-2forroomtemperatureimplantationand5×10^14cm^-2foranelevatedimplantedtemperatureof200℃andtheoptimumannealingconditionisapproximately750℃for30s.AESandTEMcharacterizationsuggeststhationbombardmentbynonelectricallyactiveionssuchasF^+,Ne^+inducedsameamountoflayerinterdiffusionwhichresultsinthebandgapblueshiftduetothecompositionalchanges.

简介：BilateralCochlearimplants(CIs)improvedspeechintelligibility,speechperceptioninbackgroundnoise,andsoundlocalizationinquietandnoisysituations.However,itisunclearwhethertheseadvantagesessentiallyresultinbinauralintegrationofacousticstimulifromeachear.Inthisstudy,weinvestigatedtheeffectivenessofbinauralintegrationbybilateralCIsplacementusingbinauralhearingtestsandsubjectiveauditoryperceptualassessment.A61-year-oldbilateralCIssubjectunderwentthefollowingfourtests:theJapaneseHearinginNoiseTest(HINT-J),thedichoticlisteningtest(DLT),theRapidlyAlternatingSpeechPerception(RASP)test,andsubjectiveauditoryperceptualassessment.TheHINTJscorewassignificantlyhigherforbilateralCIsthanforaunilateralCI.However,DLTandtheRASPtestrevealedcontradictoryresults.Subjectiveauditoryperceptualassessmentrevealedactiveandbrightimpressionsforbilateralhearing,whichwerealsonoisyandstrongcomparedwiththoseforunilateralhearing.TheresultsofthisstudyrevealedthatbilateralCIsimprovedspeechperceptioninbackgroundnoiseandanimprovedauditoryimpression,althoughthebilateralintegrationabilitieswerenotimproved.ThiswasprobablybecausethepatientwasrequiredtocombineinformationfromthetwoearsintoasingleperceptioninDLTandtheRASPtest.Morelongitudinaldatashouldbecollectedandanalyzedinfuturestudiestoevaluatethelong-termeffectsofbilateralCIs.

简介：AbstractWith cochlear implantation (CI) being the standard of care for profoundly deaf cases, more and more patients with low frequency residual hearing are currently being treated with CI. In view of preserving the residual hearing, the ultimate aim of both the surgeons and the CI companies is to achieve zero-degree of electrode insertion trauma. Variations in the size and shape of cochlea, cross-sectional dimensions of ST, electrode insertion techniques with and without metal stylet rod and the experience level of the operating surgeons, all play a role in the electrode array related insertion trauma. An effective electrode design must include flexible array to accommodate the cochlear shape variation, electrode with variety of array lengths to support the concept of cochlear size specific electrode array and finally smaller cross-sectional dimensions of electrode array in matching the cross-sectional dimensions of ST. As per published reports, FLEX electrode array design offers minimal degree of electrode insertion trauma along with the possibility of patient specific electrode array length matching their cochlear size. Looking at the cross-sectional dimensions of FLEX electrode array along with its volume, it appear to be highly safe to the cochlea by not taking too much volume inside the ST. To offer additional support, otological pre-planning software tool like OTOPLAN is now clinically available in measuring the cochlear size in finding the best electrode array match along with the possibilities of anatomy based post-operative speech processor fitting.

简介：Cochlearimplantationisauniquemethodtore-constructauditionforpatientswithseveretoprofoundhearingloss.Withincreasingclinicalapplicationofthistechnique,itsrehabilitativeeffectsinpatientshasbecomeanimportanttopicofhearingandspeechrehabilitationresearch.Thisarticleisanoverviewofhearingandspeechrehabilitativetraining,rehabilitativeefficacyevaluationandfactorsaffectingrehabilitationefficacyfollowingcochlearimplantation.

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简介：MedicalforgedCoCrMoalloywastreatedbyplasmanitridingprocess.Themicrostructureswerecharacterizedby3Dprofiler,SEMandXRD.Thetribologicalpropertieswereinvestigatedunderlubricationof25%bovineserumsolution.Resultsshowthatplasmanitridingisapromisingprocesstoproducethick,hard,andmorewearresistantlayersonthesurfaceofCoCrMoalloy.AllnitridedsamplesshowedanimportantincreaseinthesurfacehardnessduetotheformationofharderCrNandCr2Nphaseswithcompactnano-crystallinestructures.ThetypicalhardnessvaluesofHV0.05increasedalmosttwotimesthanuntreatedone.Underbovineserumlubrication,atlownitridingtemperaturetheCoefficientofFriction（COF）ofnitridedsamplewaslowerthanthatofuntreatedsample,butathighnitridingtemperaturetheCOFwasalmostthesameastheuntreatedone.Comparedwiththeuntreatedsample,thenitridedsamplesshowedlowerwearratesandhigherwearresistanceunderdifferentnitridingtemperatures.TheadhesivewearisthemainmechanismforuntreatedCoCrMoalloyandthewearmechanismsofnitridedonesarethefatiguewearandslightadhesivewear.ItisconcludedthattheimprovementofwearresistanceisascribedtothehardnitrideformationofCrNandCr2Nphasesatthenitridedsurfaces.

简介：Electricallyevokedcompoundactionpotential(eCAP)amplitudeselicitedatsuprathresholdlevelswereassessedasameasureoftheeffectivenessofcochlearimplant(CI)stimulation.Twenty-oneindividualsparticipated;onewasexcludedduetofacialstimulationduringeCAPtesting.Foreachparticipant,eCAPswereelicitedwithstimulationfromsevenelectrodesneartheupperlimitoftheindividual'selectricaldynamicrange.Areduced-channelCIprogramwascreatedusingthosesamesevenelectrodes,andparticipantsperformedavoweldiscriminationtask.Consistentwithpreviousreports,eCAPamplitudesvariedacrosstestedelectrodes;theprofileswereuniquetoeachindividual.In6subjects(30%),eCAPamplitudevariabilitywaspartiallyexplainedbytheimpedanceoftherecordingelectrode.Theremainingamplitudevariabilitywithinsubjects,andthevariabilityobservedacrosssubjectscouldnotbeexplainedbyrecordingelectrodeimpedance.Thisimpliesthatotherunderlyingfactors,suchasvariationsinneuralstatusacrossthearray,areresponsible.Across-sitemeaneCAPamplitudewassignificantlycorrelatedwithvoweldiscriminationscores(r2?0.56).AsingleeCAPamplitudemeasuredfromthemiddleofthearraywasalsosignificantlycorrelatedwithvoweldiscrimination,butthecorrelationwasweaker(r2?0.37),thoughnotstatisticallydifferentfromtheacrosssitemean.NormalizingeacheCAPamplitudebyitsassociatedrecordingelectrodeimpedancedidnotimprovethecorrelationwithvoweldiscrimination(r2?0.52).FurtherworkisneededtoassesswhethercombiningeCAPamplitudewithothermeasuresoftheelectrode-neuralinterfaceand/orwithmorecentralmeasuresofauditoryfunctionprovidesamorecompletepictureofauditoryfunctioninCIrecipients.

简介：Aim:ToverifywhetherpartialintraoperativeTenon'scapsuleresection(PTCR)withadjunctiveMitomycinCiseffectiveindevelopingthin,avascularblebsineyesundergoingAhmedglaucomavalveinsertionandtoassesstheefficacyandsafetyofthisprocedure.Methods:ThisstudywasconductedinfourLatinAmericacountries(Argentina,Brazil,ColombiaandPeru).AhmedglaucomavalveimplantinsertionwithPTCR(groupA)andwithoutPCTR(groupB)wasperformedinneovascular

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简介：AbstractObjective:To review current literature and experience with Gore-Tex® implant extrusion following medialization thyroplasty, as well as to report the unique case of Gore-Tex® implant extrusion following revision medialization thyroplasty.Methods:Review of existing literature and description of personal experience with unique case of Gore-Tex® implant extrusion following revision medialization thyroplasty.Results:Review of existing literature found no prior reported cases of Gore-Tex® implant extrusion following revision medialization thyroplasty. Risk factors for implant extrusion include the pressure of the implant on insertion and the inability to secure the implant. Cases of implant extrusion can be managed operatively via an endoscopic or via an external open approach.Conclusion:This is the first reported case of Gore-Tex® implant extrusion following revision medialization thyroplasty. Careful consideration should be given in revision medialization thyroplasty as additional implant material may cause increased pressure, a risk factor for implant extrusion.

简介：第二等的绿内障的长期的结果在回顾的学习包括了的一系列中国patients.METHODSThe与Ahmed绿内障阀门(AGV)由于眼色素层炎对待培植的AIMTo报告从经历了AGV培植的有uveitic绿内障的56个病人的67只眼睛。治疗的成功被定义为完成压力(IOP)从基线IOP在6和21公里Hg之间铺平与或没有另外的反绿内障药或最少20%减小的intraocular的病人。主要结果大小包括了IOP，在1点的绿内障药的数字，3，6，12，24，36，48并且在外科以后的60mo，外科的复杂并发症，最后的改正最好的视觉尖酸(BCVA)，吗视觉地(VF)和网膜的神经纤维层(RNFL).RESULTSThe平均数后续是53.3灡?潬桲硥獩？？

简介：AbstractBackground:The purpose of this study was to analyze cases of AO31-A2 intertrochanteric fractures (ITFs) and to identify the relationship between the loss of the posteromedial support and implant failure.Methods:Three hundred ninety-four patients who underwent operative treatment for ITF from January 2003 to December 2017 were enrolled. Focusing on posteromedial support, the A2 ITFs were divided into two groups, namely, those with (Group A, n = 153) or without (Group B, n = 241) posteromedial support post-operatively, and the failure rates were compared. Based on the final outcomes (failed or not), we allocated all of the patients into two groups: failed (Group C, n = 66) and normal (Group D, n = 328). We separately analyzed each dataset to identify the factors that exhibited statistically significant differences between the groups. In addition, a logistic regression was conducted to identify whether the loss of posteromedial support of A2 ITFs was an independent risk factor for fixation failure. The basic factors were age, sex, American Society of Anesthesiologists (ASA) score, side of affected limb, fixation method (intramedullary or extramedullary), time from injury to operation, blood loss, operative time and length of stay.Results:The failure rate of group B (58, 24.07%) was significantly higher than that of group A (8, 5.23%) (χ2 = 23.814, P < 0.001). Regarding Groups C and D, the comparisons of the fixation method (P = 0.005), operative time (P = 0.001), blood loss (P = 0.002) and length of stay (P= 0.033) showed that the differences were significant. The logistic regression revealed that the loss of posteromedial support was an independent risk factor for implant failure (OR = 5.986, 95% CI: 2.667–13.432) (P < 0.001).Conclusions:For AO31-A2 ITFs, the loss of posteromedial support was an independent risk factor for fixation failure. Therefore, posteromedial wall reconstruction might be necessary for the effective treatment of A2 fractures that lose posteromedial support.

简介：Opticalcouplingbehaviorandassociatedeffectsintwo-dimensionalimplant-definedcoherentlycoupledverticalcavitysurface-emittinglaser(VCSEL)arraysarestudiedviabothexperimentsandtheoreticalcalculations.Experimentsshowthatopticalcouplingbetweenarrayelementscanenhancethearray’soutputpower.Additionally,opticalcouplingvialeakyopticalfieldscanprovideextraopticalgainforthearrayelements,whichcanthenreducethethresholdsoftheseelements.Elementscanevenbepumpedwithoutcurrentinjectiontoemitlightbyreceivingastrongleakyopticalfieldfromotherarrayelements.Opticalcouplingcanalsocauseunusualphenomena:thecentralelementsinlarge-areacoherentlycoupledVCSELarraysthatlasepriortotheouterelementswhenthearraysarebiased,ortheaverageinjectioncurrentrequiredforeachelementtolase,whichismuchlowerthanthethresholdforasingleVCSEL.Theoreticalcalculationsareperformedtoexplaintheexperimentalresults.