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[慢性中耳炎患者治疗不同阶段中耳结构的微循环状态]

[The state of microcirculation in the middle ear structures at different stages of the treatment of the patients presenting with chronic otitis media].

作者信息

Belokopytova E Iu, Fedoseev V I, Pleshkov V A

出版信息

Vestn Otorinolaringol. 2014(3):29-31.

PMID:25246205
Abstract

The present work was designed to study dynamics of blood circulation in the tympanic membrane and tympanic cavity mucosa of 92 patients (105 ears) presenting with otosclerosis, adhesive non-perforative otitis media, and different stages of chronic suppurative otitis media. Normal characteristics of tympanic microcirculation were determined in 22 otologically healthy volunteers (30 ears). Laser Doppler flowmetry with the use of a specially designed probe (the outer diameter: 1.9 mm) was applied. The results of Doppler flowmetry varied in ontologically healthy subjects. The same circulation parameters in the vessels of the microcirculatory bed of the postero-superior quadrant of the tympanic membrane in the patients presenting with chronic suppurative otitis media at the stage of remission, otosclerosis, and adhesive non-perforative otitis media did not significantly differ from those of otologically healthy subjects. The blood flow was shown to increase in the tympanic membrane of the majority of the patients during the postoperative period (within 2nd to 4th weeks after types I-III tympanoplasty); thereafter, it either decreased or returned to the baseline level by weeks 6-8. Four months after the improvement of perfusion parameters of tympanic cavity mucosa and the arrest of exacerbation of mesotympanitis, characteristics of microcirculation in tympanic cavity mucosa were not significantly different from those of the patients with adhesive perforative otitis media. It is concluded that laser Doppler flowmetry may be used as an objective non-invasive technique for the study of microcirculation in the tympanic membrane and tympanic cavity mucosa.

摘要

本研究旨在探讨92例(105耳)患有耳硬化症、粘连性非穿孔性中耳炎以及不同阶段慢性化脓性中耳炎患者的鼓膜及鼓室腔黏膜血液循环动力学。在22名耳科健康志愿者(30耳)中确定了鼓膜微循环的正常特征。使用专门设计的探头(外径:1.9毫米)进行激光多普勒血流测定。在本体健康受试者中,多普勒血流测定结果各不相同。处于缓解期的慢性化脓性中耳炎、耳硬化症和粘连性非穿孔性中耳炎患者鼓膜后上象限微循环床血管中的相同循环参数与耳科健康受试者相比无显著差异。大多数患者在术后期间(I - III型鼓室成形术后第2至4周内)鼓膜血流增加;此后,血流要么减少,要么在第6 - 8周恢复到基线水平。鼓室腔黏膜灌注参数改善且中耳炎症加剧停止四个月后,鼓室腔黏膜微循环特征与粘连性穿孔性中耳炎患者相比无显著差异。结论是,激光多普勒血流测定可作为一种客观的非侵入性技术用于研究鼓膜和鼓室腔黏膜的微循环。

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