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[牛肋软骨作为耳科重建材料:解剖学和功能学结果]

[Bovine costal cartilage as material for otologic reconstruction: anatomo-functional results].

作者信息

Bruschini P, Segnini G, Viacava P, Berrettini S, Sellari Franceschini S, Bottoni S, Piragine F

机构信息

Istituto di Clinica Otorinolaringoiatrica, Università di Pisa.

出版信息

Acta Otorhinolaryngol Ital. 1992 Sep-Oct;12(5):443-50.

PMID:1303008
Abstract

The Authors present their experience in using bovine cartilage as otological material reconstruction. Cartilage of the ribs is to collect from selected bred cattle and is first placed in an antibiotic solution for 3 days and then in a 70% ethyl alcohol in which it is stored for 20 days before being utilized. One hundred-nineteen cartilage heterografts have been implanted in the middle ear since January 1989. We report the results of 86 cases which were included in a followed study for at least 12 months. Bovine cartilage was used in 47 canal up techniques, 28 canal down techniques and 11 anatomic and functional rehabilitation of old radical cavities. The result prove most encouraging. In 74 cases we observed good anatomical results characterized by a new, intact eardrum with no sign of inflammation or a cavity lined with normal epithelium. No extrusion was found. Removal of cartilage implanted after a year enabled us observe the high tolerance of the graft and to carry out further histological examination. The histological findings indicated normal and intact cartilagineous matrix, lined with fibrous tissue and mucosa with no evidence of condrocytes. In cases in which the heterografts were utilized for ossiculoplasty, the post-operative air-bone gap was 11.1 dB and the mean hearing gain was 26.3 dB. Moreover, bovine cartilage is easily obtainable and available in pieces of sizes necessary for specific purposes in otologic surgery. Cartilage heterografts might well be a good alternative to autologous and homologous cartilage grafts.

摘要

作者介绍了他们使用牛软骨作为耳科材料进行重建的经验。肋软骨取自经过挑选的良种牛,首先置于抗生素溶液中3天,然后放入70%的乙醇中,在使用前在其中保存20天。自1989年1月以来,已将119块软骨异种移植物植入中耳。我们报告了86例至少随访12个月的研究结果。47例采用耳道上技术、28例采用耳道下技术、11例用于陈旧性根治性中耳腔的解剖和功能重建中使用了牛软骨。结果非常令人鼓舞。在74例中,我们观察到良好的解剖学结果,其特征为新的完整鼓膜,无炎症迹象或内衬正常上皮的腔隙。未发现排斥反应。一年后取出植入的软骨,使我们能够观察到移植物的高耐受性并进行进一步的组织学检查。组织学结果显示软骨基质正常且完整,内衬纤维组织和黏膜,无软骨细胞迹象。在将异种移植物用于听骨成形术的病例中,术后气骨导差为11.1dB,平均听力增益为26.3dB。此外,牛软骨易于获取,并且有耳科手术特定目的所需尺寸的块状材料。软骨异种移植物很可能是自体和同种异体软骨移植物的良好替代品。

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