鼓膜开放对咽鼓管异常开放中耳压力影响的体外模型研究

The effect of tympanic membrane opening on middle ear pressure: an in vitro model of patulous eustachian tube

张浩泽;王方园;李晓龙;郭蒙园;伏振豪;周兢程;丁雨麟;侯昭晖

1:华南理工大学医学院

2:中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科医学部听觉与平衡觉全国重点实验室国家耳鼻咽喉疾病临床医学研究中心聋病教育部重点实验室聋病防治北京市重点实验室

摘要
目的 利用简化的咽鼓管异常开放体外模型,分析鼓膜开放对咽鼓管异常开放(patulous eustachian tube, PET)患者呼吸源性中耳压力的影响。方法 选取一例PET患者的CT影像资料(Valsalva动作后屏气显示咽鼓管全程开放)为模板,采用硅胶3D打印技术构建咽鼓管体外简化模型(两版),将模型与压力控制器、压力传感器等仪器连接。启动压力控制器,在模型鼻咽部引入负压气流,模拟咽鼓管异常开放状态下的呼吸源性中耳压力波动。利用止血钳控制模型中耳处接口的开放与闭合,分别模拟鼓膜开放和鼓膜完整两种状态,用压力传感器实时监测模型中耳部分的压力变化。结果 在第一版模型中,鼻咽部引入-800 mbar压力后,鼓膜开放状态下中耳负压稳定在-3.9~-4.3 mbar之间;鼓膜完整状态下中耳负压约为-7.9~-8.2 mbar。在第二版模型中,压力设定相同,鼓膜开放状态下中耳负压稳定在-2.7~-3.1 mbar之间;鼓膜完整状态下中耳负压约为-5.0~-7.7 mbar。结论 基于简化的体外模型发现,鼓膜开放可有效降低呼吸源性中耳异常压力,这可能揭示了鼓膜切开置管术对部分PET患者有效的作用机制。
关键词
咽鼓管异常开放;鼓膜置管术;咽鼓管;3D打印
基金项目(Foundation):
国家耳鼻咽喉疾病临床医学研究中心资助、国家重点研发计划(2023YFC2508405)
作者
张浩泽;王方园;李晓龙;郭蒙园;伏振豪;周兢程;丁雨麟;侯昭晖
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