慢性电刺激泪液分泌：泪腺与前筛神经。
Chronic Electrical Stimulation for Tear Secretion: Lacrimal vs. anterior ethmoid nerve.
机构信息
Department of Ophthalmology, Stanford University, Stanford, CA, USA.
Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA.
出版信息
Ocul Surf. 2019 Oct;17(4):822-827. doi: 10.1016/j.jtos.2019.08.012. Epub 2019 Aug 30.
PURPOSE
To evaluate and compare the effect of lacrimal nerve stimulation (LNS) and anterior ethmoid nerve stimulation (AENS) on aqueous tear secretion, and tissue condition following chronic implantation.
METHODS
A neurostimulator was implanted in rabbits adjacent to the (1) lacrimal nerve, and (2) anterior ethmoid nerve. Tear volume was measured with Schirmer test strips after stimulation (2.3-2.8 mA pulses at 30 Hz for 3-5 min), and scores were compared to sham stimulation. Lacrimal gland and nasal septal tissue were evaluated histologically after chronic stimulation (2 weeks-7 months).
RESULTS
LNS increases tear volume by 32% above sham (p < 0.05, n = 5), compared with 133% for AENS (p ≤ 0.01, n = 6). AENS also significantly increases tear secretion in the fellow, non-stimulated eye (p ≤ 0.01, n = 6), as expected from the tearing reflex pathway. Histologically, chronic LNS is well tolerated by surrounding tissues while chronic AENS results in nasal mucosal fibrosis and implant extrusion within 3 weeks.
CONCLUSIONS
AENS is significantly more effective than LNS at enhancing aqueous tear secretion, including the fellow eye. The lacrimal implant is well tolerated, while the nasal implant requires further design optimization to improve tolerability.
目的
评估和比较泪神经刺激（LNS）和前筛前神经刺激（AENS）对慢性植入后水样泪液分泌和组织状况的影响。
方法
将神经刺激器植入兔子的（1）泪神经和（2）前筛前神经附近。刺激后（30Hz 脉冲 2.3-2.8mA，持续 3-5min）用 Schirmer 试纸测量泪液量，并与假刺激评分进行比较。慢性刺激（2 周-7 个月）后，对泪腺和鼻中隔组织进行组织学评估。
结果
LNS 使泪液量增加 32%，明显高于假刺激（p<0.05，n=5），而 AENS 增加 133%（p≤0.01，n=6）。AENS 还显著增加了对侧未刺激眼的泪液分泌（p≤0.01，n=6），这与流泪反射途径相符。组织学上，慢性 LNS 周围组织耐受良好，而慢性 AENS 在 3 周内导致鼻黏膜纤维化和植入物挤出。
结论
AENS 比 LNS 更有效地增强水样泪液分泌，包括对侧眼。泪腺植入物具有良好的耐受性，而鼻植入物需要进一步的设计优化以提高耐受性。
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