Tu Tzong-Yang, Yang An-Hang, Fan Chi-Chen
Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan.
Audiol Neurootol. 2008;13(4):239-46. doi: 10.1159/000115433. Epub 2008 Feb 7.
Obliteration of the mastoid cavities with auricular cartilage is a frequently used method to minimize the open cavity problem in cholesteatoma surgery. However, the method of cartilage preparation and histopathologic changes of the grafted cartilage in patients receiving mastoid obliteration are rarely reported. Hence, the authors developed rabbit tympanic bulla obliteration with auricular cartilage as an animal model and studied the effects of perichondrium preservation on the grafted cartilage.
Auricular cartilage with or without perichondrium was prepared and cut into small pieces to obliterate rabbit tympanic bullae. Four weeks after surgery, the viable chondrocyte ratio indicated by the number of viable chondrocytes divided by the total number of chondrocytes, the microvascular density shown by CD31-labeled vessels, and the chondrogenesis ratio represented by the ratio of the cross-sectional areas of the newly formed cartilage and the originally grafted cartilage were calculated and compared.
The viable chondrocyte ratio was 49.21 +/- 10.17% in the perichondrium-preserved group (n = 12) and 35.46 +/- 3.96% in the perichondrium-removed group (n = 12, p = 0.001). The CD31 microvascular density was significantly higher in the perichondrium-preserved group than in the perichondrium-removed group (167.77 +/- 15.83 vs. 77.17 +/- 19.67 microvessels/mm(2), p < 0.001). The chondrogenesis ratios were 27.58 +/- 12.44% in the perichondrium-preserved group and 0.45 +/- 0.63% in the perichondrium-removed group (p < 0.001).
Obliteration of tympanic bullae with perichondrium-preserved cartilage results in faster restoration of circulation, higher survival of chondrocytes and more cartilage regeneration than with perichondrium-removed cartilage.
用耳软骨填塞乳突腔是胆脂瘤手术中常用的一种方法，可将开放腔问题降至最低。然而，关于接受乳突填塞术患者的软骨制备方法及移植软骨的组织病理学变化鲜有报道。因此，作者建立了以兔鼓室填塞耳软骨的动物模型，并研究保留软骨膜对移植软骨的影响。
制备带或不带软骨膜的耳软骨，切成小块用于填塞兔鼓室。术后4周，计算并比较以存活软骨细胞数除以软骨细胞总数表示的存活软骨细胞比例、CD31标记血管显示的微血管密度以及以新形成软骨与原始移植软骨横截面积之比表示的软骨生成比例。
保留软骨膜组（n = 12）的存活软骨细胞比例为49.21±10.17%，去除软骨膜组（n = 12，p = 0.001）为35.46±3.96%。保留软骨膜组的CD31微血管密度显著高于去除软骨膜组（167.77±15.83对77.17±19.67个微血管/mm²，p < 0.001）。保留软骨膜组的软骨生成比例为27.58±12.44%，去除软骨膜组为0.45±0.63%（p < 0.001）。
与去除软骨膜的软骨相比，用保留软骨膜的软骨填塞鼓室可使循环恢复更快，软骨细胞存活率更高，软骨再生更多。
