Kwok Pingling, Gleich Otto, Spruss Thilo, Strutz Jürgen
ENT-Department.
Central Animal Facilities, University Regensburg, Regensburg, Germany.
Otol Neurotol. 2019 Jun;40(5):e532-e541. doi: 10.1097/MAO.0000000000002205.
The choice of the material for plugging a dehiscence of the superior semicircular canal is based on the ease of use and the success of the procedure to permanently relieve symptoms without adverse side effects.
Dehiscence of the superior semicircular canal can lead to autophony, conductive hearing loss, and vertigo. Surgical treatment by plugging the canal is a highly effective treatment of the symptoms in many patients, although, the procedure can be associated with some degree of hearing loss in more than or equal to 25% of the patients. The available data indicate that adverse effects may be more frequently observed with bone wax as compared with other materials.
In the present study we compare the tissue reactions induced by plugging the superior semicircular canal with autologous bone pate/bone chips, muscle, fat, artificial bone wax, and teflon in the gerbil model in an attempt to identify the material leading to successful plugging with the least adverse tissue reactions.
Our data show that successful plugging was achieved in 100% of the ears by bone pate/bone chips, teflon, and bone wax while the success rate was significantly lower (<50%) following muscle and fat. The proportion of adverse tissue reactions was significantly more pronounced using bone wax as compared with teflon and bone pate/bone chips.
The use of teflon or autologous bone as a material for plugging a dehiscent superior semicircular canal should be favored over bone wax, muscle, and fat.
用于封堵上半规管裂孔的材料选择基于使用的便利性以及该手术能永久缓解症状且无不良副作用的成功率。
上半规管裂孔可导致自听增强、传导性听力损失和眩晕。通过封堵该半规管进行手术治疗对许多患者的症状是一种非常有效的治疗方法，尽管在≥25%的患者中该手术可能会伴有一定程度的听力损失。现有数据表明，与其他材料相比，使用骨蜡时可能更频繁地观察到不良反应。
在本研究中，我们在沙鼠模型中比较了用上颌骨骨块/骨屑、肌肉、脂肪、人工骨蜡和聚四氟乙烯封堵上半规管所引起的组织反应，试图确定能以最少的不良组织反应成功封堵的材料。
我们的数据显示，使用骨块/骨屑、聚四氟乙烯和骨蜡时，100%的耳实现了成功封堵，而使用肌肉和脂肪时成功率显著较低（<50%）。与聚四氟乙烯和骨块/骨屑相比，使用骨蜡时不良组织反应的比例明显更高。
与骨蜡、肌肉和脂肪相比，应优先使用聚四氟乙烯或自体骨作为封堵上半规管裂孔的材料。
