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asbryobvrz · Wysłany: Nie 23:07, 13 Mar 2011

Ototoxicity of cisplatin: 30 patients with hearing test ...

Retest, the result was no significant difference compared with c after treatment of the discussions on cisplatin-induced ototoxicity reported incidence varies, the general view that there were significantly fewer hearing-impaired do 6 to 14% while the tree lives five Qin Li Po Wei white resistance ∞ the more common diseases,[link widoczny dla zalogowanych], the most important means of treatment is surgical removal of the tumor in our hospital l959 ~ 1989 total of 89 sides treated nasopharyngeal angiofibroma, surgical treatment are surgery Ban now be summed up in the problem. First, clinical information on 89 cases, the male side 86, and 3 women aged l0-38 sorrowful years, mean l6 years of age. The sad palate approaches 69, 15, split by the nasal route. After a pear-shaped lip and gum into the Road Hole in demand sad 5 6 side of the tracheotomy. single guillotine external carotid artery ligation in 38 cases, bilateral in 2 cases. Selective embolization 3 sides. intraoperative cryosurgery plus gallery drunk 23 5l down eight controlled hypotension. find in the average blood 200 ~ 4000mIt 1500mJ. recurrent t times in 14 cases, 2 5 sides, 3 1 2 sad side of death. Second, the experience of (a) preoperative preparation before surgery to prepare the smooth progress of work on reducing surgical blood loss and postoperative demand the rehabilitation of patients with a great relationship. pay attention to conduct a comprehensive inspection and routine specialist examination should also include the necessary cT X-ray or scan to the exact understanding of the patient's general condition and the extent of the tumor to determine surgical options. 1 week before surgery It should also be support for local or systemic anti-inflammatory treatment to remove the local inflammation, enhance the body's tolerance to surgery. Waldm2n (1981) proposed the preoperative use of small doses of estrogen or boil put us in order to reduce the tumor reduce bleeding 5 side of the patients had given before the use of diethylstilbestrol seeking 5rag, 3 times a day, a total of 7 ~ 1O days, but not shrink the tumor found in patients, no significant amount of bleeding is also reduced. The other 6 sides find the right dose given before let boil, blood loss may have decreased, but the tumor surrounding tissue fragility, easy sewing table, and prolonged wound healing, and I willing to put a boil that should not be advocated preoperative r b) of the surgical approach in the surgical approach selection should be based on tumor size and scope may be extended. We used a total of three, each with advantages and disadvantages. 1. through the hard palate into the Road: 69 sides, about 3 / 4, the advantage is that more thoroughly exposed nasopharynx , are the buildings on the Jie fossa sinus, nasal cavity at the end that if incision extended around the lip and retromolar gingival Amoy, do not fully exposed to saddle the pterygopalatine fossa and infratemporal fossa. Clinical L in most cases the tumor at the base after the hole in the nose on the edge of the top wall or side wall of nasopharyngeal tumor,[link widoczny dla zalogowanych], or confined to the nasopharynx or to move out invasion of the nasal cavity,[link widoczny dla zalogowanych], maxillary sinus, the use of surgical approaches through the hard palate can be more fully exposed to the solution injection site, under direct vision separation to remove the tumor. to facilitate intraoperative hemostasis, and the incision does not affect the face disadvantage is that the incision of patients after eating, is not conducive to rapid recovery of the body 2. by the nasal route: invasion of the tumor from the nasopharynx, nasal cavity, paranasal sinuses in particular is the invasion of ethmoid, sphenoid, or those with the orbital. After exposure of the nasal route is more than adequate approach by the hard palate, surgical incision after eating little effect on patients. conducive to the recovery of the body after the patient left disadvantage is facial scar, face 3 of the gingival pyriform aperture by the lip into the Road: In recent years, we have 5 patients with this approach, can move up the development of better exposure to nasopharyngeal angiofibroma can be on both sides nasal cavity and nasopharynx with the total demand as a chamber, a larger surgical field, bring convenience to the surgical operation, and after leaving facial scars, the patient happy to accept. But this approach to the oropharyngeal tumor or cranial those exposed in the expansion of poor fossa. (c) the issue of intraoperative anesthesia and surgery in general buck oral intubation under general anesthesia. intraoperative anesthesia with controlled hypotension to reduce bleeding is an effective measure, we adopted rejection drugs lower blood pressure increased up to 7 to listen to imprison 19%, major attractions and high-frequency, non-reversible. cochlear toxicity of this group was 23.3%,[link widoczny dla zalogowanych], occurred in 300rag / m dose groups. which graded dose of 60mg / m. 100mg / m, respectively, the incidence of 50 gel and l00%. hearing loss involving high frequencies above ~ 4000Hz, fractionated dose of 100mg / m in 1 case, closed-valued at all in 8000 and rose 12000Hz Pu up to 80dB above results show that the clinical observation of the cochlea of cisplatin toxicity and dose-dependent on: the first high-frequency hearing loss occurred, as the dose increases,[link widoczny dla zalogowanych], gradual hearing loss involving the transfer of low rate the degree of hearing loss related to total dose radiation. In Jing Lan {the same total, sub-agent halo greater loss of the more serious. (l】 1990 Received 20 January I991 tragic day in April】 back)