INNER-EAR INJURY CAUSED BY AIR INTRUSION TO THE SCALA-VESTIBULI OF THE COCHLEA
INNER-EAR INJURY CAUSED BY AIR INTRUSION TO THE SCALA-VESTIBULI OF THE COCHLEA
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DOI：
10.3109/00016489309135892
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发表时间：
1993-11-01
影响因子：
1.4
通讯作者：
TAKASAKA, T
中科院分区：
文献类型：
--
作者：
KOBAYASHI, T;SAKURADA, T;TAKASAKA, T
在以前的交流中，我们证明了将空气引入耳蜗的鼓阶会导致耳蜗电位降低;然而，耳蜗内直流电位（EP）的变化是轻微的，耳蜗微音电位（CM）和复合动作电位（CAP）的降低至少部分是可逆的。相反，我们现在发现前庭阶中的空气灌注（3-60穆尔/min）比鼓阶中的空气灌注更剧烈地降低耳蜗电位。在前庭阶中空气灌注后EP的变化的特征在于响应于缺氧的负EP的减少。CM急剧下降后，开始空气灌注，并没有恢复后，观察到再填充外淋巴液。组织学检查显示17个耳蜗中有12个出现Reissner膜塌陷。塌陷的程度和频率随着前庭阶中灌注的空气量的增加而增加。由于前庭阶的空气灌注引起内耳损伤所需的最小空气量为3穆尔，如果肺小叶参与了外淋巴瘘的病理生理学，则卵圆窗区瘘的预后可能比圆窗区更差。同时指出，在卵圆窗瘘管的病例中，中耳充气是危险的。
In a previous communication, we demonstrated that the introduction of air into the scala tympani of the cochlea causes a decrease of cochlear potentials; however, the change in endocochlear dc potential (EP) was mild and the decreased cochlear microphonics (CM) and compound action potentials (CAP) were, at least partially, reversible. In contrast, we have now found that air perfusion (3-60 mul/min) in the scala vestibuli decreased cochlear potentials more drastically than that in the scala tympani. The change in the EP after air perfusion in the scala vestibuli was characterized by a decrease of the negative EP in response to anoxia. The CM drastically decreased upon the initiation of air perfusion and no recovery was observed after refilling of the perilymph. Histological examination showed collapse of Reissner's membrane in 12 out of 17 cochleas examined. The extent and frequency of the collapse increased with an increase in the amount of air perfused in the scala vestibuli. As the minimal amount of air needed to cause inner ear damage by air perfusion in the scala vestibuli is as small as 3 mul, it is possible that the prognosis is worse in cases with fistula of the oval window compared to that of the round window area, if the pneumolabyrinth is involved in the pathophysiology of perilymphatic fistula. It is also indicated that air inflation of the middle ear is dangerous in cases with fistula in the oval window.