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[声传导系统重建中镫骨足板静态应力的实验研究]

[Experimental studies of static stress on the footplate in the reconstruction of the sound conduction system].

作者信息

Pau H W, Hüttenbrink K B

机构信息

Hals-Nasen-Ohren-Klinik, Universität Bonn.

出版信息

Laryngol Rhinol Otol (Stuttg). 1988 Jul;67(7):331-4.

PMID:3210862
Abstract

If a destroyed ossicular chain is substituted by a drum-to-footplate prosthesis (TORP), not only sound pressures but also static pressures are conducted via this new connection. To measure these effects in the area of the oval window, in isolated temporal bones the stapes was removed and substituted by a piece of plastipore, attached to the incus. This piece was connected by a very fine needle to a foil strain gauge, in order to registrate the effects of experimentally changed pressures in the external ear canal towards the inner ear. The incus was then also removed too and a TORP was introduced. Under the same measuring condition we found the conducted pressures ten times higher than in the previous situation. This can only be explained by movements in the incudo-malleal joint, if this is intact. Consequently patients with TORPs should avoid all situations of rapid changes of surrounding pressure, such as diving etc., especially if the tube function is impaired. These situations may be dangerous for the footplate and the inner ear. In fortunately rare cases perforations of the footplate were reported by some ear surgeons.

摘要

如果用鼓膜-镫骨底板假体(TORP)替代已损坏的听骨链,不仅声压,静压力也会通过这种新连接传导。为了在椭圆窗区域测量这些影响,在离体颞骨中移除镫骨,并用一块附着于砧骨的普拉斯蒂波尔(plastipore)替代。这块普拉斯蒂波尔通过一根非常细的针连接到箔式应变片,以便记录外耳道内实验性改变的压力对内耳的影响。然后也移除砧骨并植入一个TORP。在相同的测量条件下,我们发现传导的压力比之前的情况高十倍。如果砧镫关节完好无损,这只能通过砧镫关节的运动来解释。因此,佩戴TORP的患者应避免所有周围压力快速变化的情况,如潜水等,尤其是当咽鼓管功能受损时。这些情况可能对镫骨底板和内耳有危险。在一些耳科医生报告的幸运的罕见病例中,出现了镫骨底板穿孔的情况。

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