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Mechanisms of vestibular symptons in perilymph fistula

外淋巴瘘前庭症状的机制

基本信息

批准号：
04454436
负责人：
NOMURA Yasuya
金额：
$ 4.29万
依托单位：
Showa University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1992
资助国家：
日本
起止时间：
1992 至 1993
项目状态：
已结题

项目摘要

Lack of human temporal bone studies on perilymph fistula gives un little information on pathophysiology of dizziness.Two animal models of perilymph fistula are created in guinea pigs. Injection method is to inject artificial perilymph into the subarachnoid space until the round window ruptures. Suction method is to suction 4 mul of perilymph from the scala tympani of the basal turn through the round window. In celloidin specimens, these methods result in identical changes in the labyrinth. Those are collapse, hydrops and rupture. The utricle and semicircular ducts show only collapse.There is the trabecular mesh around the membranous labyrinth in the pars superior. However, this is completely missing in specimens showing moderate and severe collapse. Strange enough is that the membrane limitans is preserved. There is no rupture in the collapsed utricular and ampullary wall, instead it is found in Reissner's membrane.In these experiments, pressure of the perilymph rises suddenly and decreases immediately after the round window ruptures. This drastic change of perilymph pressure breaks Reissner's membrane and the endolymph is withdrawn. The endolymph in the pars superior movessimultaneously, resulting in collapse of the utricle and semicircular ducts.Even 2 months after the experiment, sensory cells of the utricle and semicircular ducts are intact. Collapsed ampullary wall is lying on the crista. In the macula utriculi, the collapse occurs in the pars interna of the macula.Collapsed utricular wall may sway when the perilymph moves. This produces shearing motion to the otolithic membrane and the senory cells. This may explain long-lasting dizziness inpatients with perilymph fistula.

由于人颞骨外淋巴瘘研究的缺乏，对眩晕的病理生理机制的了解也不多。注射方法是将人工外淋巴液注入蛛网膜下腔，直至圆窗破裂。抽吸方法为经圆窗从基回鼓阶抽吸外淋巴液4穆尔。在火棉胶标本中，这些方法导致迷路的相同变化。它们是塌陷，水肿和破裂。椭圆囊和半规管仅塌陷，在上级膜迷路周围可见小梁网。然而，这是完全缺失的标本显示中度和严重的崩溃。奇怪的是，膜界被保存了下来。在这些实验中，外淋巴压力突然升高，并在圆窗破裂后立即下降。这种外淋巴压力的剧烈变化破坏了Reissner膜，并撤回了内淋巴。上级内淋巴同时运动，导致椭圆囊和半规管塌陷，实验后2个月，椭圆囊和半规管的感觉细胞仍完整。塌陷的壶腹壁压在脊上。在椭圆囊斑，塌陷发生在黄斑的内部。当外淋巴液移动时，塌陷的椭圆囊壁可能会摆动。这对耳石膜和感觉细胞产生剪切运动。这可能解释了外淋巴瘘患者长期头晕的原因。