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Laser labyrinthectomy

激光迷路切除术

基本信息

批准号：
02404068
负责人：
NOMURA Yasuya
金额：
$ 14.66万
依托单位：
University of Tokyo
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (A)
财政年份：
1990
资助国家：
日本
起止时间：
1990 至 1991
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-02404068/
关键词：
Argon laser labyrinthectomy inner ear diseases human 内耳手術耳石器眼振

项目摘要

Using guinea pigs, effects of argon laser irradiation to the utricle was confirmed. After stapedectomy, the macula utricli was irradiated by Argon laser beam (1.5w x 0.5s) from behind. A small depression was observed on the surface of the macula utricli immediately after surgery. Transmission electron microscopic findings revealed that the sensory cells and supporting cells were detached from the basement membrane. Size of the depression was twice of that of the spot size. Changes of the hair cells and supporting cells spread towards periphery. These cells disappeared in 10 weeks and a layer of flat cells replaced them. Immediately after irradiation, migrated macrophages trapped and digested otoconia particles. Macrophages were found scattered in the endolymphatic space. They were also observed in the endolymphatic sac and number of them was maximum on the 4th day postoperatively. However, otoconia particles were not included in the macrophages. Small vacuoles were observed within epitheliijm of the intermediate portion of thd endolymphatic sac. The otoconia completely disappeared from the inner ear in 2 weeks.In humans, the otolithic membrane can be seen in the vestibule after stapedectomy. Therefore, irradiation of maculae utricli and sacculi was quite possible.Destruction of the crista ampullaris of the anterior and lateral semicircular canals are almost impossible from the middle ear side without making fistula in the labyrinthin wall. However, we can destroy the utriculo-ampullary nerve through the stapedectomized oval window using argon laser.Singular neurectomy using Argon laser is possible in humans.

用豚鼠证实了氩激光照射椭圆囊的效果。镫骨切除术后，用氩激光束（1.5w × 0.5s）从后面照射椭圆囊斑。术后立即在椭圆囊斑表面观察到小凹陷。透射电镜下可见感觉细胞和支持细胞脱离基底膜。凹陷的大小是斑点大小的两倍。毛细胞和支持细胞的变化向周围扩散。这些细胞在10周内消失，取而代之的是一层扁平细胞。照射后，迁移的巨噬细胞立即捕获并消化耳石颗粒。内淋巴间隙内散在分布着大量淋巴细胞。内淋巴囊内也有阳性细胞，术后第4天数量最多。然而，耳石颗粒不包括在巨噬细胞中。内淋巴囊中部上皮内可见小空泡。2周内耳石从内耳完全消失，人类镫骨切除后前庭可见耳石膜。因此，椭圆囊斑和球囊的照射是完全可能的，从中耳侧破坏前半规管和外半规管壶腹嵴而不使极薄的管壁形成瘘管几乎是不可能的。然而，我们可以用氩激光通过镫骨切除卵圆窗破坏椭圆囊壶腹神经，在人类中使用氩激光进行单一神经切除是可能的。