Antonelli P J, Bouchard K R, Kartush J M, Kubilis P S
Department of Otolaryngology, University of Florida, Gainesville 32610, USA.
Otolaryngol Head Neck Surg. 1997 Nov;117(5):509-15. doi: 10.1016/S0194-59989770023-8.
Hearing preservation is possible with translabyrinthine procedures, but the optimal means of sealing the remaining labyrinth has not been determined. The purpose of this study was to compare the effects of mechanical and nonmechanical (CO2 laser-assisted) triple semicircular canal occlusion on hearing in the guinea pig. All three semicircular canals of 19 guinea pigs were treated with one of four techniques: fenestration without packing (control), fenestration with packing, CO2 laser coagulation of the membranous canal without packing, or laser coagulation with packing. Six weeks postoperatively, electrocochleographic thresholds were significantly elevated in one of five ears treated with packing alone, in one of five ears treated with laser and packing, in two of five ears treated with the laser alone, and in all four control ears. Thresholds were significantly elevated in control versus occluded ears (p < 0.05). There were no significant differences between the ears treated with laser or packing. These findings suggest that hearing can be preserved in triple canal occlusion by means of sealing the membranous labyrinth with either CO2 laser coagulation or mechanical packing. Further study on the feasibility of hearing preservation with complete labyrinthectomy is warranted.
经迷路入路手术有可能保留听力，但封闭剩余迷路的最佳方法尚未确定。本研究的目的是比较机械性和非机械性（二氧化碳激光辅助）三半规管阻塞对豚鼠听力的影响。对19只豚鼠的所有三个半规管采用以下四种技术之一进行处理：开窗不填充（对照）、开窗填充、二氧化碳激光凝固膜性半规管不填充、激光凝固并填充。术后六周，单独填充治疗的五只耳朵中有一只、激光加填充治疗的五只耳朵中有一只、单独激光治疗的五只耳朵中有两只以及所有四只对照耳朵的电耳蜗图阈值均显著升高。对照耳与阻塞耳之间的阈值有显著升高（p<0.05）。激光治疗或填充治疗的耳朵之间无显著差异。这些发现表明，通过二氧化碳激光凝固或机械填充封闭膜迷路，在三半规管阻塞中可保留听力。有必要对全迷路切除术保留听力的可行性进行进一步研究。
