Hiraumi Harukazu, Nakagawa Takayuki, Ito Juichi
Department of Otolaryngology, Graduate School of Medicine, Kyoto University, Shogoin, Kyoto, Japan.
Eur Arch Otorhinolaryngol. 2009 Mar;266(3):367-71. doi: 10.1007/s00405-008-0760-3. Epub 2008 Jul 19.
There has been increasing interest in cochlear drug delivery through the round window membrane (RWM). However, placing drugs on the RWM is difficult because of anatomical barriers. We examined the efficacy of a microendoscope for a transtympanic approach to the RWM. We evaluated the visibility of the RWM using four approaches: transtympanic microendoscopic, transtympanic microscopic, transmastoid microendoscopic, and transmastoid microscopic in ten human temporal bones. For the transtympanic approach, we made a fenestration (2 x 1 mm) in the postero-inferior quadrant of the tympanic membrane. For the transmastoid approach, conventional posterior hypotympanotomy was performed. The transtympanic microendoscopic approach enabled visualization of the RWM in all specimens, whereas the transtympanic microscopic approach only permitted visualization in three specimens. Through the transmastoid approach, the RWM was visible in all specimens using either a microendoscope or a microscope. The transtympanic microendoscopic approach can be utilized for cochlear drug delivery through the RWM.
通过圆窗膜（RWM）进行耳蜗给药越来越受到关注。然而，由于解剖学屏障，将药物放置在RWM上很困难。我们研究了微型内窥镜经鼓膜途径到达RWM的效果。我们在10个人类颞骨中使用四种方法评估RWM的可视性：经鼓膜微型内窥镜检查、经鼓膜显微镜检查、经乳突微型内窥镜检查和经乳突显微镜检查。对于经鼓膜途径，我们在鼓膜后下象限做一个开窗（2×1毫米）。对于经乳突途径，进行传统的后鼓室切开术。经鼓膜微型内窥镜检查方法能够在所有标本中观察到RWM，而经鼓膜显微镜检查方法仅在三个标本中观察到。通过经乳突途径，使用微型内窥镜或显微镜在所有标本中都能看到RWM。经鼓膜微型内窥镜检查方法可用于通过RWM进行耳蜗给药。
