Smouha E E, Namdar I, Michaelides E M
Division of Otolaryngology, State University of New York at Stony Brook, USA.
Otolaryngol Head Neck Surg. 1996 Jun;114(6):777-84. doi: 10.1016/s0194-5998(96)70101-8.
Recent advances in neurotologic surgery have challenged the traditional belief that violating the labyrinth is incompatible with hearing. Our aim in this study was to define the conditions that result in hearing preservation and hearing loss after surgery on the labyrinth. A guinea pig model was developed. Click-evoked auditory brain stem responses were used to determine hearing thresholds. Animals underwent surgical destruction of part or all of the vestibular labyrinth. Transection and plugging of the lateral semicircular canal resulted in normal hearing. Transection of multiple semicircular canals also resulted in hearing preservation. Intentional suctioning of perilymph from a transected canal led to transient hearing loss with complete recovery. Sequential destruction of the entire lateral semicircular canal resulted in preserved hearing as long as the vestibule was not opened. Wide vestibulotomy resulted in hearing loss. Preliminary histologic studies showed that cochlear hair cells were preserved in most cases. The results of our experiments demonstrate the feasibility of preservation of hearing after partial labyrinthectomy and provide physiologic criteria for developing new operations on the inner ear in human subjects.
耳神经外科的最新进展对传统观念提出了挑战,即破坏内耳迷路就无法保留听力。本研究的目的是确定在内耳迷路手术后导致听力保留和听力丧失的条件。建立了豚鼠模型。使用短声诱发的听觉脑干反应来确定听力阈值。动物接受部分或全部前庭迷路的手术破坏。横断并堵塞外侧半规管可导致听力正常。横断多个半规管也可导致听力保留。故意从横断的半规管中吸出外淋巴会导致短暂性听力丧失,但可完全恢复。只要不打开前庭,依次破坏整个外侧半规管可保留听力。广泛的前庭切开术会导致听力丧失。初步组织学研究表明,大多数情况下耳蜗毛细胞得以保留。我们的实验结果证明了部分迷路切除术后保留听力的可行性,并为在人类受试者中开展内耳新手术提供了生理学标准。