实验性外淋巴瘘对内耳形态学的影响  

Influence of Experimental Perilymphatic Fistula on the Inner Ear Morphology

作　　者：吴立连[1] 梁建伟[1] 曾英[1] 吕红[1] 王显红[1] 董民声[2] 

机构地区：[1]咸宁医学院附属第一医院耳鼻咽喉科,咸宁437100 [2]河南医科大学附属第一医院耳鼻咽喉科,郑州450000

出　　处：《咸宁医学院学报》2000年第2期110-112,共3页Journal of Xianning Medical College

摘　　要：目的 :建立动物模型观察实验性外淋巴瘘 (EPLF)对内耳形态学的影响 ,为临床治疗外淋巴瘘提供实验性依据。方法 :2 4只豚鼠随机分成 6组 ,每组 4只 ,右耳为对照耳。用微型注射器刺破左耳圆窗膜 (RWM ) ,并抽出 2～ 4 μl外淋巴液造成EPLF ,分别于造瘘后 1、2、4、7、1 4和 2 8天处死 ,光镜和电镜下观察内耳形态变化。结果 :穿孔的RWM大部分 ( 83 % )易于愈合。RWM破裂后 2～ 4天穿孔处组织连接 ,7～ 1 4天基本愈合。扫描电镜观察造瘘后 4天有毛细胞损伤 ,瘘口未愈合耳的耳蜗底回毛细胞明显减少。结论 :EPLF转归有二 ,单一RWM穿孔趋向自然修复愈合 ,其组织形态学变化可逆 ;未愈合者或病程大于 1 4天者 ,内耳形态学存在组织病理学改变 ,病理改变以及病程可作为手术干预的客观指标。Objective The influence of experimental perilymphatic fistula (EPLF) on inner ear morphology was investigated to establish an experimental model which could offer a warranty for cinical treatment.Methods 24 guinea pigs were randomly divided into 6 groups of 4 animals each (right ear as a control).EPLF was produced by pricking in the left round window membrane (RWM) of the guinea pig and by suctioning 2～4μl of perilymph fluid with a fine needle,than,the animals were killed on 1,2,4,7,14 and 28 days later,respectively.Morphologic changes of the cochlea were observed under a light and scanning electronic microscope.Results Most of the RWM ruptured were easily healed.The RWM perforation had already closed after 2～4 days and largely healed at 7～14 days.Loss of hair cell was immediately occured with causing fistula.Hair cells in the cochlea’s basal turn were significantly decreased,particularly under that perforation still unlealed.Conclusion The pathologically morphologic variation exist in inner ear following EPLF.It can be regarded as a objective indication of surgery and a theoretical basis in clinical treatment when the duration of the window membrane ruptured is more than 7～14days.

关 键 词：外淋巴瘘 内耳形态学 扫描电镜 EPLE 突发性耳聋 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]