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通过闭塞内淋巴管进行手术诱导内淋巴积水。

Surgical induction of endolymphatic hydrops by obliteration of the endolymphatic duct.

作者信息

Megerian Cliff A, Heddon Chris, Melki Sami, Momin Suhael, Paulsey Janis, Obokhare Joy, Alagramam Kumar

机构信息

Otolaryngology - Head and Neck Surgery, Case Western Reserve University, USA.

出版信息

J Vis Exp. 2010 Jan 22(35):1728. doi: 10.3791/1728.

Abstract

Surgical induction of endolymphatic hydrops (ELH) in the guinea pig by obliteration and obstruction of the endolymphatic duct is a well-accepted animal model of the condition and an important correlate for human Meniere's disease. In 1965, Robert Kimura and Harold Schuknecht first described an intradural approach for obstruction of the endolymphatic duct (Kimura 1965). Although effective, this technique, which requires penetration of the brain's protective covering, incurred an undesirable level of morbidity and mortality in the animal subjects. Consequently, Andrews and Bohmer developed an extradural approach, which predictably produces fewer of the complications associated with central nervous system (CNS) penetration.(Andrews and Bohmer 1989) The extradural approach described here first requires a midline incision in the region of the occiput to expose the underlying muscular layer. We operate only on the right side. After appropriate retraction of the overlying tissue, a horizontal incision is made into the musculature of the right occiput to expose the right temporo-occipital suture line. The bone immediately inferio-lateral the suture line (Fig 1) is then drilled with an otologic drill until the sigmoid sinus becomes visible. Medial retraction of the sigmoid sinus reveals the operculum of the endolymphatic duct, which houses the endolymphatic sac. Drilling medial to the operculum into the area of the endolymphatic sac reveals the endolymphatic duct, which is then packed with bone wax to produce obstruction and ultimately ELH. In the following weeks, the animal will demonstrate the progressive, fluctuating hearing loss and histologic evidence of ELH.

摘要

通过闭塞和阻塞内淋巴管在豚鼠中手术诱导内淋巴积水(ELH)是该病症公认的动物模型,也是人类梅尼埃病的重要相关模型。1965年,罗伯特·木村和哈罗德·舒克内希特首次描述了一种用于阻塞内淋巴管的硬膜内入路(木村,1965年)。尽管这种技术有效,但它需要穿透大脑的保护覆盖层,在动物实验对象中导致了不理想的发病率和死亡率。因此,安德鲁斯和博默开发了一种硬膜外入路,预计该入路产生的与中枢神经系统(CNS)穿透相关的并发症较少。(安德鲁斯和博默,1989年)这里描述的硬膜外入路首先需要在枕部区域做一个中线切口,以暴露下面的肌肉层。我们只在右侧进行手术。在适当牵拉覆盖组织后,在右枕部的肌肉组织上做一个水平切口,以暴露右颞枕缝线。然后用耳科钻在缝线下方立即向外侧钻孔,直到乙状窦可见。将乙状窦向内侧牵拉可暴露内淋巴管的盖,盖内有内淋巴囊。在盖内侧向内淋巴囊区域钻孔可暴露内淋巴管,然后用骨蜡填充以造成阻塞并最终导致内淋巴积水。在接下来的几周里,动物将表现出进行性、波动性听力损失以及内淋巴积水的组织学证据。

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