Sokołowski Jacek, Niemczyk Kazimierz, Bartoszewicz Robert, Morawski Krzysztof, Bruzgielewicz Antoni
Katedra i Klinika Otolaryngologii Warszawskiego Uniwersytetu Medycznego K. Niemczyk.
Otolaryngol Pol. 2009 Sep-Oct;63(5):432-6. doi: 10.1016/S0030-6657(09)70156-8.
Evaluation of usefulness new non-contact method--Laser Doppler vibrometry (LDV) in measurements of movability of ossicular chain during second look operation was aim of the study. We would like answer to questions: 1. Is LDV helpful in intraoperative conditions? 2. Which measurements points have the largest practical value? 3. Which measured parameters could be used to determination of effectiveness ossicular chain reconstruction?
In experiment there were taken 3 fresh temporal bones kept in 0,9% NaCl. In first stage were executed: antromastoidectomy with wide tympanotomy. The ossicular chain movability investigation was conducted on: back branch of stapes, front branch of stapes, round window, umbo of eardrum. Laser Doppler Vibrometer was used to measurement ossicular chain's movability. ER-2 loudspeakers were generated wave: 1000 Hz, 2000 Hz, 4000Hz. In second stage were executed: Malleus-Stapes Assembly (MSA) ossicular chain's reconstruction and repeated investigation in measured points.
The most convenient points to measurement were respectively: back branch of stapes, front branch of stapes, umbo of eardrum. In two cases round window was placed in deep niche and was partly covered by facial nerve. MSA performance didn't influence accessibility of measuring points. Theresholds of measured point's movability was useful to evaluation of reconstruction.
Back branch of stapes, front branch of stapes and umbo of eardrum are useful to intraoperatve measurements ossicular chain movability. Delimitation thresholds of ossicular chain movability can help in reconstruction's evaluation. After next experiments LDV can be use in practice-intraoperative.
本研究旨在评估一种新的非接触式方法——激光多普勒振动测量法(LDV)在二次探查手术中测量听骨链活动度的实用性。我们希望回答以下问题:1. LDV在术中条件下是否有帮助?2. 哪些测量点具有最大的实用价值?3. 哪些测量参数可用于确定听骨链重建的效果?
实验采用3块保存在0.9%氯化钠溶液中的新鲜颞骨。第一阶段进行:乳突根治术并扩大鼓室切开术。在以下部位进行听骨链活动度研究:镫骨后支、镫骨前支、圆窗、鼓膜脐。使用激光多普勒振动计测量听骨链的活动度。ER-2扬声器产生1000Hz、2000Hz、4000Hz的波。第二阶段进行:锤骨-镫骨连接(MSA)听骨链重建,并在测量点重复进行研究。
最便于测量的点分别是:镫骨后支、镫骨前支、鼓膜脐。有两例圆窗位于深部隐窝,部分被面神经覆盖。MSA手术操作不影响测量点的可达性。测量点活动度的阈值有助于评估重建效果。
镫骨后支、镫骨前支和鼓膜脐对术中测量听骨链活动度有用。听骨链活动度的界定阈值有助于评估重建效果。经过进一步实验后,LDV可在术中实际应用。