Otic Probe for Neurocochlear Intraoperative Monitoring

描述（由申请人提供）：许多感觉神经性听力损失（SNHL）病例可能是由耳蜗血流中断（CBF）引起的。在切除听神经瘤（ANs）的手术过程中，内听动脉的破坏可能是许多术后耳聋病例的原因。此外，许多临床SNHL病例，如突发性SNHL，被认为与CBF减少有关。先前的实验已经证明了使用激光多普勒血流测量技术测量耳蜗血流的实用性。本提案涉及改进和临床人体测试的新型耳探头和仪器能够测量脑血流和耳蜗电位。该探头还具有冲洗和吸引的治疗功能，可以将药物输送到圆窗和内耳。第一阶段的结果证明了这些功能在动物实验中使用原型探针的可行性。在第二阶段，一种改良的探针将用于测试人体手术期间的安全性和有效性。最终，预计该仪器将用于(1)术中协助外科医生在AN移除过程中保留听力；(2)研究CBF在SNHL中的作用；(3)在临床上对血管功能不全引起的SNHL进行诊治。

DESCRIPTION (provided by applicant): Many cases of sensorineural hearing loss (SNHL) likely are caused by interruption of cochlear blood flow (CBF). Disruption of the internal auditory artery during surgical procedures to remove acoustic neuromas (ANs) probab'y account for many cases of postoperative deafness. Also, many cases of clinical SNHL, such as sudden SNHL, are thought to involve reduction of CBF. Previous experiments have demonstrated the utility of measuring cochlear blood flow using laser-Doppler flowmetry techniques. This proposal involves the refinement and clinical human testing of a novel otic probe and instrumentation capable of measuring CBF and electrocochleographic potentials. The probe will also have treatment capability in the form of irrigation and suction to present medications to the round window and inner ear. Phase I results demonstrated the feasibility of these functions in animal experiments using a prototype probe. In Phase II, a refined probe will be used to test safety and efficacy during human surgery. Ultimately, it is anticipated that this instrumentation will be used (1) intraoperatively to assist surgeons in preserving hearing during AN removal; (2) in research applications to elucidate the role of CBF in SNHL; (3) in the clinic for diagnosis and treatment of SNHL caused by vascular insufficiency.