Otic Probe for Neurocochlear Intraoperative Monitoring

描述（由申请人提供）：许多感音神经性听力损失（SNHL）病例可能是由耳蜗血流（CBF）中断引起的。在手术切除听神经瘤（AN）的过程中，内听动脉的中断可能是许多术后耳聋的原因。此外，许多临床SNHL病例，如突发SNHL，被认为涉及CBF减少。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。该提案涉及一种新型耳探头和仪器能够测量CBF和耳蜗电图电位的改进和临床人体测试。探针还将具有冲洗和抽吸形式的治疗能力，以将药物提供给圆窗和内耳。第一阶段的结果表明，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，一种改进的探针将用于测试人体手术过程中的安全性和有效性。最终，预计该仪器将用于（1）术中辅助外科医生在AN切除过程中保留听力;（2）研究应用，以阐明CBF在SNHL中的作用;（3）临床诊断和治疗血管功能不全引起的SNHL。

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.