Roth Adam A, Tang Pei-Ciao, Ye Michael J, Mohammad Khalid S, Nelson Rick F
Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Laryngoscope. 2018 Jan;128(1):E40-E46. doi: 10.1002/lary.26779. Epub 2017 Jul 12.
To determine if 2Flute (Stryker Corporation, Kalamazoo, MI) otologic burs improve the size, cellular content, and bone healing of autologous cortical bone grafts harvested during canal wall reconstruction (CWR) tympanomastoidectomy with mastoid obliteration.
Institutional review board-approved prospective cohort study.
Human autologous cortical bone chips were harvested using various burs (4 and 6 mm diameter; multiflute, and 2Flute [Stryker Corporation]) from patients undergoing CWR tympanomastoidectomy for the treatment of chronic otitis media with cholesteatoma. Bone chip size, cell counts, cellular gene expression, and new bone formation were quantified.
Bone chips were significantly larger when harvested with 2Flute (Stryker Corporation) bur compared to multiflute burs at both 6 mm diameter (113 ± 14 μm vs. 66 ± 8 μm ; P < 0.05) and 4 mm diameter (70 ± 8 μm vs. 50 ± 3 μm ; P < 0.05). After 2 weeks in culture, cell numbers were significantly higher when harvested with 2Flute (Stryker Corporation) bur compared to multiflute burs at both 6 mm diameter (48.7 ± 3 vs. 31.8 ± 3 cells/μg bone; P < 0.05) and 4 mm diameter (27.6 ± 1.2 vs. 8.8 ± 1.2 cells/μg bone; P < 0.05). Bone-derived cells express osteoblast markers (alkaline phosphatase, osteocalcin). Cultured cells are able to form new bone in culture, and bone formation is facilitated by the presence of bone chips.
Use of 2Flute (Stryker Corporation) otologic burs for human autologous cortical bone harvest results in more viable bone fragments, with larger bone chips and more osteoblasts. Future studies are needed to determine if this leads to improved bone healing.
NA. Laryngoscope, 128:E41-E46, 2018.
确定2刃（史赛克公司，密歇根州卡拉马祖）耳科磨钻能否改善在开放式乳突根治伴乳突腔填塞鼓室乳突联合切除术期间获取的自体皮质骨移植块的大小、细胞含量和骨愈合情况。
经机构审查委员会批准的前瞻性队列研究。
从因胆脂瘤型慢性中耳炎接受开放式乳突根治伴乳突腔填塞鼓室乳突联合切除术的患者中，使用各种磨钻（直径4和6毫米；多刃和2刃[史赛克公司]）获取人自体皮质骨碎片。对骨碎片大小、细胞计数、细胞基因表达和新骨形成进行定量分析。
与多刃磨钻相比，使用2刃（史赛克公司）磨钻获取的骨碎片在直径6毫米时（113±14微米对66±8微米；P<0.05）和直径4毫米时（70±8微米对50±3微米；P<0.05）均明显更大。培养2周后，与多刃磨钻相比，使用2刃（史赛克公司）磨钻获取的骨碎片在直径6毫米时（48.7±3对31.8±3个细胞/微克骨；P<0.05）和直径4毫米时（27.6±1.2对8.8±1.2个细胞/微克骨；P<0.05）细胞数量明显更多。骨源性细胞表达成骨细胞标志物（碱性磷酸酶、骨钙素）。培养的细胞能够在培养物中形成新骨，并且骨碎片的存在促进了骨形成。
使用2刃（史赛克公司）耳科磨钻获取人自体皮质骨可产生更具活力的骨碎片，骨碎片更大且成骨细胞更多。需要进一步研究以确定这是否会改善骨愈合。
无。《喉镜》，2018年，第128卷：E41-E46。
