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水肿的实验性发病机制

Experimental pathogenesis of hydrops.

作者信息

Kimura R S

出版信息

Arch Otorhinolaryngol. 1976 Sep 16;212(4):263-75. doi: 10.1007/BF00453674.

Abstract
  1. The best method for inducing hydrops in guinea pigs is obliteration of the endolymphatic duct. 2. The location of hydrops produced in the guinea pig is comparable to that of Menière's disease. 3. The major histopathological finding in the guinea pig is atrophy of sensorineural elements in the apical turns of the cochlea. 4. The vestibular sensory cell population is rarely decreased, though ultrastructural changes are noted. 5. Attempts to prevent or minimize development of hydrops by surgical fistulization of the vestibular endolymphatic walls or by administration of a diuretic drug, ethacrynic acid, failed in the guinea pig. Treatment of Menière's disease by these means is questionable. 6. Electron microscopy of the organ of Corti in cochleas taken from a patient with bilateral Menière's disease revealed that only a small percentage of te sensorineural elements was abnormal at the apical turns. Thus, it is questionable whether these small ultrastructural changes in the organ of Corti are a major cause of severe hearing loss. 7. In Menière's disease biochemical changes in cochlear fluid and/or changes in motion mechanics of the cochlear duct are probably important factors producing the hearing loss. 8. The present ultrastructural study did not resolve the question of the etiology of Menière's disease.
摘要
  1. 在豚鼠中诱发积水的最佳方法是闭塞内淋巴管。2. 豚鼠中产生的积水位置与梅尼埃病的积水位置相当。3. 豚鼠的主要组织病理学发现是耳蜗顶转中感觉神经元件的萎缩。4. 前庭感觉细胞数量很少减少,尽管有超微结构变化。5. 通过在前庭内淋巴壁上进行手术造瘘或给予利尿药依他尼酸来预防或最小化积水发展的尝试在豚鼠中失败了。用这些方法治疗梅尼埃病存在疑问。6. 对一名双侧梅尼埃病患者的耳蜗进行的柯蒂器电子显微镜检查显示,仅一小部分感觉神经元件在顶转处异常。因此,柯蒂器中的这些微小超微结构变化是否是严重听力损失的主要原因存在疑问。7. 在梅尼埃病中,耳蜗液中的生化变化和/或耳蜗管运动力学的变化可能是导致听力损失的重要因素。8. 目前的超微结构研究未解决梅尼埃病的病因问题。

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