二氧化碳激光鼓膜切开术的实验研究

Experimental study of CO_2 laser myringotomy

目的:研究CO2激光鼓膜切开术的治疗能力及鼓膜的组织学变化。方法:25只豚鼠随机分为3组行鼓膜紧张部穿孔,前2组各10只分别为圆形或肾形穿孔,左耳用CO2激光,右耳用鼓膜切开刀,比较穿孔愈合时间,并观察鼓膜穿孔愈合过程的组织学变化,第3组5只用不同功率的CO2激光,左耳直接照射,右耳鼓室内注射生理盐水后再照射。结果:CO2激光组穿孔愈合时间较鼓膜切开刀组明显延长(P<0.01);肾形穿孔愈合时间更长(P<0.01)。CO2激光组穿孔边缘出现炎症反应。小剂量激光对内耳无影响,鼓室内注水可以避免或减轻对耳蜗的损伤。结论:CO2激光鼓膜切开术可用于治疗分泌性中耳炎。

Objective： To study the therapeutic efficacy of carbon dioxide （ CO2 ） laser myringotomy and the following histopathological changes of tympanic membranes. Methods： Twenty-five guinea pigs were randomly divided into 3 groups： group 1 （ n = 10） , group 2 （ n = 10）, and group 3 （ n =5）. In groups 1 and 2, CO2 laser round and kidney-shaped myringotomy were performed on the left ears, respectively, and incisional round and kidney-shaped myringotomy were performed on the right ears, respectively. The healing time was compared, and the histopathological changes were observed. In group 3, CO2 laser of different powers were performed on the left ears directly and on the right ears after saline was injected into the middle ear cavity. Results： The healing time in CO2 laser myringotomy group was significandy longer than that in incisional myringotomy group （ P 〈0.01 ）. The healing time in CO2 laser kidney-shaped myringotomy group was longer than that in CO2 laser round myringotomy group （ P 〈 0.01 ）. Inflammation was found in the CO2 laser myringotomy group. The low power of CO2 laser had no effect on the inner ear. Injecting saline into the middle ear cavity could avoid or alleviate the cochlear impairment. Conclusion： CO2 laser myringotomy can be used in the treatment of secretory otitis media.