细化测量颅内压的无创技术：比较诱发和自发鼓膜位移。

Refining non-invasive techniques to measure intracranial pressure: comparing evoked and spontaneous tympanic membrane displacements.

机构信息

Faculty of Medicine, University of Southampton, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, United Kingdom. Neurological Physics Group, Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, United Kingdom.

出版信息

Physiol Meas. 2018 Feb 28;39(2):025007. doi: 10.1088/1361-6579/aaa9f8.

DOI:10.1088/1361-6579/aaa9f8

PMID:29359706

Abstract

OBJECTIVE

Tympanic membrane displacements (TMDs) are used to non-invasively gauge inner-ear fluid pressure. Inner-ear fluid pressure equalizes with intracranial pressure (ICP) via the cochlear aqueduct and therefore TMDs can indirectly evaluate ICP. We studied the relationship between two TMD modalities, evoked and spontaneous. Evoked TMD is a reflex response to an auditory stimulus and the established stapes-footplate mechanism explains how evoked TMDs change with ICP. Spontaneous TMD refers to a pulsatile TMD waveform expressed in the form of pulse amplitudes (TMD-PAs), the origins of which are poorly understood. We investigated whether both modalities respond similarly to an ICP change, suggesting a common mechanism.

APPROACH

ICP was manipulated in 20 healthy volunteers by a postural change from sitting (lower ICP) to supine (higher ICP). Differences between paired sitting and supine TMD results generated ΔEvoked and ΔSpontaneous values.

MAIN RESULTS

Evoked TMDs became more inward on lying supine while spontaneous TMDs became more outward. There was no evidence of a correlation between ΔEvoked and ΔSpontaneous (Right ears: r = -0.38, p = 0.10, 95% CI -0.75 to 0.21; Left ears: r = 0.34, p = 0.16, 95% CI -0.17 to 0.75).

SIGNIFICANCE

This suggests the stapes-footplate mechanism is not the primary mechanism explaining how spontaneous TMDs respond to changing ICP.

摘要

目的

鼓膜运动（TMD）可用于无创地测量内耳液压力。内耳液压力通过耳蜗导水管与颅内压（ICP）平衡，因此 TMD 可间接评估 ICP。我们研究了两种 TMD 模式（诱发和自发性）之间的关系。诱发 TMD 是对听觉刺激的反射反应，已建立的镫骨足板机制解释了诱发 TMD 如何随 ICP 变化而变化。自发性 TMD 是指以脉冲幅度（TMD-PA）形式表达的脉动 TMD 波形，其起源尚不清楚。我们研究了这两种模式是否对 ICP 变化有相似的反应，这表明存在共同的机制。