激光耳显微外科动物模型的建立

Establishment of an Animal Model of Laser Otomicrosurgery

目的重点探讨激光耳显微外科动物模型建立过程中如何选择最佳的麻醉方式、手术入路及激光种类。方法选用健康雄性听力正常的豚鼠70只,随机分为A组、B组及C组,其中A、B组各20只,C组30只,分别以速眠新、氯胺酮及复合麻醉,比较三组动物的存活率,并随机观察每组10只豚鼠麻醉后的苏醒时间,然后选用平对外耳道口的耳后入路打开听泡后壁暴露耳蜗底周和圆窗龛,采用CO2激光进行耳蜗底周造孔。结果 C组(复合麻醉组)动物存活率最高(p<a′(0.0125)),且该组动物麻醉苏醒时间最短(31.50±7.47min),平对外耳道口的耳后入路损伤小、出血少,易于暴露耳蜗底周及圆窗龛,从而满足CO2激光耳蜗底周造孔的需要。结论在激光耳显微外科动物模型建立的过程中,复合麻醉是最佳的麻醉方式,平对外耳道口的耳后入路是最佳的术式,CO2激光是近年来研究的热点。

Objective The aim is to determine appropriate anesthetic and surgical approaches and optimal type of laser in an animal model of laser otomicrosurgery. Methods Seventy male guinea pigs with normal hearing were divided into groups A, B and C （n=20 in groups A and B,and n=30 in group C）. Animals received anesthesia with either SU MIAN XIN （Group A）, ketamine （Group B） or compound anesthesia （Group C）. The survival rate was compared between groups, as well as the anesthesia recovery time of ten guinea pigs in each group. The bulla was opened to expose the basal turn of the cochlea and round window niche via a postauricular approach parallel to the external auditory canal. Fenestration on the basal turn was performed with CO2 laser. Results Group C showed the highest survival rate（p〈a′ 0.0125）and shortest anesthesia recov？ery time（31.50±7.47min）. The postauricular approach resulted in minimal tissue damage and bleeding, and led to easy expo？sure of the basal turn and round window niche,adequate for fenestration in the basal turn CO2 laser. Conclusions In establish？ing this animal model of laser otomicrosurgery, compound anesthesia appears to be the safest anesthesia approch, with a post？auricular approach parallel to the external auditory canal providing a perfect approach for operation, CO2 laser has become the focus of laser otomicrosurgery in recent years.