Morawski Krzysztof, Telischi Fred F, Merchant Faisal, Abiy Lidet W, Lisowska Grazyna, Namyslowski Grzegorz
Ear, Nose, and Throat Department, Silesian Medical Academy, Zabrze, Poland.
Laryngoscope. 2003 Sep;113(9):1615-22. doi: 10.1097/00005537-200309000-00039.
The aim of this study was to observe the effects of mannitol, administered topically at the round window (RW), on cochlear blood flow (CBF) and distortion-product otoacoustic emission (DPOAE) after repeated episodes of cochlear ischemia.
Ten young rabbits were used for this study. Reversible ischemic episodes within the cochlea were induced by directly compressing the internal auditory artery (IAA). CBF was measured using a laser-Doppler (LD) probe positioned at the RW niche. DPOAEs were measured at 4, 8, and 12 kHz geometric mean frequency (GMF) using 60 dB sound pressure level (SPL) primary tone stimuli. In five test ears, mannitol was administered topically at the RW for 30 minutes before the IAA compressions. In five control ears, the IAA compressions were undertaken without application of RW medication. Each ear underwent three 5 minute IAA compressions with a 60 minute rest period between compressions.
In the control animals, it was observed that a progressive reduction in DPOAE level followed each successive IAA compression at all three test frequencies. The reduction in DPOAE amplitudes was consistently greater at the higher test frequencies. In the test rabbits, the RW administration of mannitol resulted in significantly less reduction in DPOAE level measures after repeated IAA compressions. For example, 30 minutes after reperfusion at 12 kHz GMF, DPOAE levels in the control ears were reduced by 1.5, 6.0, and 16 dB, compared with 1.5, 4.0, and 6.0 dB in the mannitol test ears.
Mannitol appears to exert a protective effect on cochlear function after periods of ischemia. The RW appears to be an efficacious route for topical administration of mannitol into the inner ear.
本研究旨在观察在圆窗(RW)局部应用甘露醇对耳蜗缺血反复发作后耳蜗血流(CBF)和畸变产物耳声发射(DPOAE)的影响。
本研究使用了10只幼兔。通过直接压迫内听动脉(IAA)诱导耳蜗内可逆性缺血发作。使用置于RW龛的激光多普勒(LD)探头测量CBF。使用60分贝声压级(SPL)的初级音调刺激在4、8和12千赫几何平均频率(GMF)下测量DPOAE。在5只测试耳中,在压迫IAA前30分钟在RW局部应用甘露醇。在5只对照耳中,在不应用RW药物的情况下进行IAA压迫。每只耳朵进行3次5分钟的IAA压迫,每次压迫之间有60分钟的休息期。
在对照动物中观察到,在所有三个测试频率下,每次连续的IAA压迫后DPOAE水平都逐渐降低。在较高的测试频率下,DPOAE振幅的降低始终更大。在测试兔中,在RW应用甘露醇导致反复IAA压迫后DPOAE水平测量值的降低明显较少。例如,在12千赫GMF再灌注30分钟后,对照耳的DPOAE水平降低了1.5、6.0和16分贝,而甘露醇测试耳分别为1.5、4.0和6.0分贝。
甘露醇似乎在缺血期后对耳蜗功能发挥保护作用。RW似乎是将甘露醇局部应用于内耳的有效途径。