大鼠经耳道内镜耳手术鼓膜粘连模型的建立

文献信息

中文摘要

背景： 鼓膜粘连是耳科手术中具有临床意义且处理困难的并发症。然而，目前尚未建立一种简单且可重复的动物模型，适用于研究该疾病的发病机制并评估治疗策略。本研究旨在利用经耳道内镜耳手术（TEES）建立一种可重复的大鼠鼓膜粘连模型。
方法： 28只Sprague-Dawley大鼠接受TEES。每只大鼠的一侧耳接受完整的粘连诱导操作，包括鼓膜穿孔和切除中耳黏膜（模型组），而对侧耳仅接受鼓膜穿孔（假手术组）。术后至56天，采用微型计算机断层扫描、大体观察和组织学分析评估粘连形成和骨质增生。
结果： 术后14天，81.8%的耳发生鼓膜粘连。假手术组未观察到粘连。所有粘连阳性的耳在黏膜消融部位均显示中耳骨质增生，组织学分析证实鼓膜上皮与新形成的骨之间发生融合。在初次操作后未实现粘连的病例中，再次手术使所有耳均成功形成粘连。术后期间未观察到鼓膜内陷或中耳积液。
结论： 利用TEES建立了一种简单且高度可重复的大鼠鼓膜粘连模型。该模型能够稳定重现伴有中耳骨质增生的术后鼓膜粘连，为阐明粘连机制以及评估中耳再生或抗粘连治疗提供了有用的平台。

英文摘要

BACKGROUND: Tympanic membrane adhesion is a clinically significant and challenging complication of otologic surgery. However, a simple and reproducible animal model suitable for studying the pathogenesis of this disease and evaluating treatment strategies has not yet been established. This study aimed to develop a reproducible rat model of tympanic membrane adhesion using transcanal endoscopic ear surgery (TEES).
METHODS: Twenty-eight Sprague-Dawley rats underwent TEES. In each rat, 1 ear underwent a complete adhesion-inducing procedure involving tympanic membrane perforation and removal of the middle ear mucosa (model group), whereas the contralateral ear underwent tympanic membrane perforation only (sham group). Adhesion formation and bone hyperplasia were evaluated using micro-computed tomography, macroscopic observation, and histological analysis up to 56 days postoperatively.
RESULTS: Tympanic membrane adhesion occurred in 81.8% of ears 14 days after the procedure. No adhesions were observed in the sham group. All adhesion-positive ears showed middle ear bone hyperplasia at the mucosa-ablated sites, and histological analysis confirmed fusion between the tympanic membrane epithelium and the newly formed bone. In cases where adhesion was not achieved after the initial procedure, reoperation led to successful adhesion in all ears. No tympanic membrane retraction or middle ear effusion was observed during the postoperative period.
CONCLUSION: A simple and highly reproducible rat tympanic membrane adhesion model was established using TEES. This model consistently reproduces postoperative tympanic membrane adhesion accompanied by middle ear bone hyperplasia and provides a useful platform for elucidating the mechanisms of adhesion and evaluating regenerative or antiadhesion therapies in the middle ear.