圆窗龛在内耳给药方面的临床意义及其解剖分析

Clinical Significance and Anatomy of Round Window Niches in Inner Ear Drug Administration

圆窗龛是中耳鼓岬上圆窗凹及周围骨壁组成的龛状结构;由前壁、后壁、上壁围成,龛底为圆窗膜,连通中耳及内耳,具有渗透性,在内耳给药治疗内耳疾病方面具有重要意义。经圆窗龛-圆窗膜途径的内耳给药方式能够明显提高内耳的药物浓度而降低全身利用度,但是目前尚缺乏临床指导标准,个体治疗间药物剂量及疗效存在差异,其中圆窗龛的解剖学差异被认为是主要因素。而圆窗龛在此方面缺乏系统全面的解剖资料。本文对圆窗龛在经圆窗龛-圆窗膜途径的内耳给药方面的临床意义及其相关解剖进行综述。

The round window is a niche-like structure composed of the round window concave and surrounding bony walls in the tympanic promontory.Its bottom is the round window membrane,a permeable membrane connecting the middle ear and the inner ear that is of great importance in the treatment of inner ear diseases.Round window niche-round window membrane approach can significantly increase the drug concentration in the inner ear and reduce systemic exposure.However,there lack guidelines on round window drug administration with drug dosage and treatment outcomes vary among individual studies,for which anatomical variability of the round window niche is considered to be a main factor.Meanwhile,the anatomical data of round window niches in this respect are limited.This article reviews the clinical significance and relevant anatomy of the round window niche for the purpose of drug administration into the inner ear through the round window niche-round window membrane approach.