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目的 探讨激光鼓膜造孔对听力的影响。方法 用不同功率密度的CO2激光或Nd∶YAG激光照射豚鼠鼓膜不同时间后,观察中耳和耳蜗结构的变化。结果 以功率密度153Wmm2的CO2激光照射豚鼠鼓膜2s,或以相同功率密度的Nd∶YAG激光照射豚鼠鼓膜10s,可引起鼓膜穿孔,听骨链和耳蜗凝固或点状炭化,凝固和炭化处柯蒂氏器官均明显破坏或变化。激光输出功率密度愈大,损伤听骨和耳蜗所需的照射时间愈短。中耳腔内注水可避免或明显减轻CO2激光对听骨和耳蜗的损伤,但对Nd∶YAG激光无效。结论 激光鼓膜造孔应严格控制激光功率密度和照射时间,以免损伤听力。用CO2激光造孔时,中耳腔内注水可避免或减轻激光对听骨和耳蜗的损伤。
Objective To investigate the effect of laser tympanostomy on hearing. Methods The changes of the structure of the middle ear and cochlea were observed after guinea pig’s tympanic membrane was irradiated with CO2 laser or Nd:YAG laser with different power density for different time. Results The guinea pig’s tympanic membrane was irradiated with CO2 laser with power density of 153Wmm2 for 2 seconds or irradiated with Nd:YAG laser of the same power density for 10 seconds to induce tympanic membrane perforation, Organs were significantly damaged or changed. The greater the laser output power density, the shorter the exposure time required to damage the ossicles and cochlea. Infusion of the middle ear cavity can avoid or significantly reduce CO2 laser damage to the auditory bones and cochlea, but not Nd:YAG laser. Conclusion Laser tympanostomy should be strictly controlled laser power density and irradiation time, so as not to damage the hearing. With CO2 laser hole, the middle ear cavity water injection to avoid or reduce the laser on the bone and cochlear injury.