Yuksel Sancak, Douglas Swarts J, Banks Juliane, Doyle William J
Department of Otorhinolaryngology-Head and Neck Surgery, University of Texas Medical School at Houston, 6431 Fannin Street, MSB 5.036, Houston, TX 77030, USA.
Eur Arch Otorhinolaryngol. 2011 Feb;268(2):203-6. doi: 10.1007/s00405-010-1368-y. Epub 2010 Sep 1.
Past in vivo studies in humans showed that the tympanic membrane (TM) is permeable to physiological gases. Animal studies show that transTM CO(2) conductance is increased by TM pathology. The objective of the study was to determine if transTM CO(2) exchange in humans is affected by atrophic and sclerotic pathologies. The study used an ear canal (EC) probe (ECP) constructed from a custom-fitted acrylic body, a glass capillary tube enclosing an oil meniscus to maintain ambient ECP + EC pressure and a silica glass microtube linked to a mass spectrometer (MS) for measuring gas composition that was hermetically sealed within the ear canal of the test ear. ECP + EC volume was measured and gas samples taken at 10 min intervals for 1 h. The fractional CO(2) pressure measured in the ECP + EC for each sample was regressed on time and the slope of the function multiplied by the ECP + EC volume and divided by the estimated transTM CO(2) gradient at the start of the experiment to yield transTM CO(2) conductance (microL/min/Pa). Data were complete for 15 normal, 13 sclerotic and 9 atrophic TMs. The average (+std) transTM CO(2) conductances were 1.76 × 10(-4) + 7.27 × 10(-5), 2.26 × 10(-4) + 1.5 × 10(-4) and 2.36 × 10(-4) + 1.14 × 10(-4) microL/min/Pa/TM for the normal, sclerotic and atrophic TMs, respectively. A pairwise comparison of data for the normal and atrophic TMs under the directional hypothesis of a greater CO(2) exchange rate for thinner TMs approached statistical significance (P = 0.07). A similar pairwise comparison for the sclerotic and normal TMs did not approach statistical significance (P = 0.28). The effect of TM pathologies on CO(2) conductance was limited.
过去针对人类的体内研究表明,鼓膜(TM)对生理气体具有通透性。动物研究显示,TM病变会增加经TM的CO₂传导率。本研究的目的是确定人类经TM的CO₂交换是否受萎缩性和硬化性病变影响。该研究使用了一种耳道(EC)探头(ECP),它由定制的丙烯酸主体、一根包围油弯月面以维持ECP + EC环境压力的玻璃毛细管以及一根与质谱仪(MS)相连用于测量气体成分的石英玻璃微管组成,该微管密封在受试耳的耳道内。测量ECP + EC体积,并每隔10分钟采集一次气体样本,共采集1小时。将每个样本在ECP + EC中测得的CO₂分压随时间进行回归分析,该函数的斜率乘以ECP + EC体积,再除以实验开始时估计的经TM的CO₂梯度,以得出经TM的CO₂传导率(微升/分钟/帕斯卡)。15例正常TM、13例硬化性TM和9例萎缩性TM的数据完整。正常、硬化性和萎缩性TM的平均(±标准差)经TM的CO₂传导率分别为1.76×10⁻⁴ + 7.27×10⁻⁵、2.26×10⁻⁴ + 1.5×10⁻⁴和2.36×10⁻⁴ + 1.14×10⁻⁴微升/分钟/帕斯卡/TM。在较薄TM具有更高CO₂交换率的定向假设下,对正常和萎缩性TM的数据进行成对比较接近统计学显著性(P = 0.07)。对硬化性和正常TM进行的类似成对比较未接近统计学显著性(P = 0.28)。TM病变对CO₂传导率的影响有限。