Sokołowski Jacek, Lachowska Magdalena, Bartoszewicz Robert, Niemczyk Kazimierz
Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland.
Clin Exp Otorhinolaryngol. 2016 Jun;9(2):98-103. doi: 10.21053/ceo.2015.00542. Epub 2016 Apr 19.
Despite the increasing number of research concerning the applications of the Laser Doppler Vibrometry (LDV) in medicine, its usefulness is still under discussion. The aim of this study is to present a methodology developed in our Department for the LDV intraoperative assessment of ossicular chain reconstruction.
Ten patients who underwent "second look" tympanoplasty were involved in the study. The measurements of the acoustic conductivity of the middle ear were performed using the LDV system. Tone bursts with carrier frequencies of 500, 1,000, 2,000, and 4,000 Hz set in motion the ossicular chain. The study was divided into four experiments that examined the intra- and interindividual reproducibility, the utility of the posterior tympanotomy, the impact of changes in the laser beam angle, and the influence of reflective tape presence on measurements.
There were no statistically significant differences between the two measurements performed in the same patient. However, interindividual differences were significant. In all cases, posterior tympanotomy proved to be useful for LDV measurements of the ossicular prosthesis vibrations. In most cases, changing the laser beam angle decreased signal amplitude about 1.5% (not significant change). The reflective tape was necessary to achieve adequate reflection of the laser beam.
LDV showed to be a valuable noncontact intraoperative tool for measurements of the middle ear conductive system mobility with a very good intraindividual repeatability. Neither a small change in the angle of the laser beam nor performing the measurements through posterior tympanotomy showed a significant influence on the results. Reflective tape was necessary to obtain good quality responses in LDV measurements.
尽管关于激光多普勒振动测量法(LDV)在医学领域应用的研究数量不断增加,但其实用性仍在讨论之中。本研究的目的是介绍我们科室开发的一种用于在术中通过LDV评估听骨链重建的方法。
10例行“二次探查”鼓室成形术的患者参与了本研究。使用LDV系统对中耳的声导率进行测量。载波频率为500、1000、2000和4000Hz的短纯音使听骨链运动。该研究分为四个实验,分别检测个体内和个体间的可重复性、后鼓室切开术的效用、激光束角度变化的影响以及反射带的存在对测量的影响。
在同一患者身上进行的两次测量之间无统计学显著差异。然而,个体间差异显著。在所有病例中,后鼓室切开术被证明对通过LDV测量听骨假体振动是有用的。在大多数情况下,改变激光束角度会使信号幅度降低约1.5%(变化不显著)。反射带对于实现激光束的充分反射是必要的。
LDV是一种有价值的非接触式术中工具,可用于测量中耳传导系统的活动度,个体内重复性非常好。激光束角度的微小变化以及通过后鼓室切开术进行测量均未对结果产生显著影响。反射带对于在LDV测量中获得高质量反应是必要的。