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弗洛西尔™(Floseal™)在耳科手术中能安全使用吗?在龙猫动物模型中对耳毒性的评估。

Can floseal™ be applied safely during otologic surgery? Assessment of ototoxicity in a chinchilla animal model.

作者信息

Nhan Carol, Bezdjian Aren, Alarfaj Abdullah, Daniel Sam J

机构信息

McGill Auditory Sciences Laboratory, Department of Otolaryngology, McGill University, McGill University Health Center, 1001 Boulevard Décarie, Montréal, QC, H4A 3 J1, Canada.

McGill Auditory Sciences Laboratory, Department of Experimental Surgery, McGill University, McGill University Health Center, 1001 Boulevard Décarie, Montréal, QC, H4A 3 J1, Canada.

出版信息

J Otolaryngol Head Neck Surg. 2017 Mar 29;46(1):24. doi: 10.1186/s40463-017-0203-5.

Abstract

BACKGROUND

In otologic surgery good visualization is paramount, and patients with bleeding diatheses or who need to be anti-coagulated can present a significant challenge. Here, we determine whether Floseal™, a hemostatic matrix, is ototoxic in a validated animal model.

METHODS

Nine chinchillas housed in the animal care facilities of the Montreal Children's Hospital Research Institute were used for the study. After a myringotomy incision was made in each tympanic membrane, baseline auditory brainstem response measurements were performed at 8, 20, and 25 kHz. In each animal one ear was randomized to receive Floseal™ to the middle ear cavity, whereas the other ear served as the control and received 0.9% sodium chloride. Outcome measures included early (day 7) and late (day 30) auditory brainstem response, clinical evidence of facial nerve or vestibular disturbance and histological evidence of ototoxity.

RESULTS

There was no significant hearing threshold shift on auditory brainstem response across all tested frequencies for both experimental and control ear. No animals receiving Floseal™ developed facial or vestibular nerve dysfunction and there was no histological evidence of ototoxicity.

CONCLUSION

Based on the preliminary ototoxicity assessment on nine chinchillas, transtympanic Floseal™ does not appear to be ototoxic. More studies are warranted to assess the safety and applicability of the product in humans.

摘要

背景

在耳科手术中,良好的视野至关重要,而有出血倾向或需要抗凝的患者可能带来重大挑战。在此,我们在一个经过验证的动物模型中确定止血基质弗洛西尔(Floseal™)是否具有耳毒性。

方法

本研究使用了蒙特利尔儿童医院研究所动物护理设施中饲养的9只龙猫。在每只鼓膜上进行鼓膜切开术后,在8、20和25千赫兹频率下进行基线听觉脑干反应测量。在每只动物中,一只耳朵随机接受向中耳腔注入弗洛西尔(Floseal™),而另一只耳朵作为对照,接受0.9%氯化钠。观察指标包括早期(第7天)和晚期(第30天)听觉脑干反应、面神经或前庭功能障碍的临床证据以及耳毒性的组织学证据。

结果

实验耳和对照耳在所有测试频率下的听觉脑干反应中听力阈值均无显著变化。接受弗洛西尔(Floseal™)的动物均未出现面神经或前庭神经功能障碍,也没有耳毒性的组织学证据。

结论

基于对9只龙猫的初步耳毒性评估,经鼓膜注入弗洛西尔(Floseal™)似乎没有耳毒性。有必要开展更多研究以评估该产品在人体中的安全性和适用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7af3/5371177/79234615c797/40463_2017_203_Fig1_HTML.jpg

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