Yüksek basınca maruz kalan kobaylarda Bulla hacmi değişikliğinin orta kulak barotravma oluşumuna etkisinin araştırılması
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Dosyalar
Tarih
2020
Yazarlar
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Yayıncı
Trakya Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bulla hacmi değişikliğinin barotravma gelişimi üzerine etkisini araştırdığımız çalışmamızda normal otoskopik muayenesi ve işitme eşiği olan 18 adet erişkin kobay çalışmaya dahil edilmiştir. Kobaylar ilk olarak deney basınç odasına teker teker alınmış ve kabin basıncı 3 atm olarak ayarlandıktan sonra toplam 9 dakikalık dalış protokolü uygulanmıştır. Dalış öncesi ve sonrası otoskopik muayene, timpanometrik test ve ABR ölçümü yapılmıştır. Sonrasında barotravma gelişen kulaklar 3 haftalık iyileşme süresinden sonra iki ayrı gruba bölünmüşlerdir. İlk gruptaki 12 kobayın sağ kulağına cerrahi işlem yapılmış, sol kulağına ise kısmi bullaobliterasyonu yapılmıştır. İlk gruptaki kobaylar 2 haftalık iyileşme süresi sonrasında tekrar deney basınç odasına alınarak aynı dalış protokolü uygulanmıştır. İkinci gruptaki 6 kobayın ise çift kör olarak bir taraf östaki borusunu açan tubal kaslarına serum fizyolojik,diğer taraf tubal kaslarına ise botulunium toksin enjeksiyonu yapılmıştır. Enjeksiyondan 3 gün sonra tekrar deney basınç odasına alınarak aynı dalış protokolü uygulanmıştır.Bu işlemden sonra kobaylara otoskopik muayene, timpanometrik test ve ABR ölçümü tekrarlandıktan sonra kobaylar dekapite edilmiştir. Her iki grupta da 1 adet kobayın işlemler tamamlanmadan ex olması sonucu çalışma 16 hayvanla tamamlanmıştır. Barotravma gelişimi açısından sonuçlar karşılaştırıldığında,cerrahi işlem yapılan kobaylar (p:1,00), obliterasyon yapılan kobaylar (p:1,00) ve serumfizyolojik uygulanan kobaylar (p:1,00), birinci dalış simülasyonu uygulanan kobaylar ile karşılaştırıldığında istatistiksel olaraK anlamlı fark izlenmedi. Botulinium toksin uygulanan kulakların hepsinde barotravma geliştiğinden istatistiksel analiz yapılamadı fakat botulinium toksin ile östaki borusu fonksiyonunun bloke edilmesinin barotravma üzerine belirgin etkisi olduğu görüldü. Bu çalışmanın sonucunda bulla hacminin küçültülmesinin barotravma oranını arttırmadığı fakat östaki borusu fonksiyonu bloke edildiğinde mutlak barotravma geliştiğ isaptandı.
In our study where we investigated the effect of bulla volume change on thedevelopment of barotrauma, 18 adult guinea pigs with normal otoscopic examination andhearing threshold were included in the study.Guinea pigs were first taken to the experimentalpressure chamber one by one and after the cabin pressure was adjusted as 3 atm, a total of 9minutes diving protocol was applied. Before and after diving, otoscopic examination,tympanometric test and ABR measurement were performed. Ears that developed barotraumalater were divided into two separate groups after a 3-week recovery period. Surgical procedures were performedon the right ears of 12 guinea pigs in the firstgroup, andpartial bullaobliteration was performed on the left ears. The guinea pigs in thefirst group were taken back to the experimental pressure chamber after 2 weeks recoveryperiod and the same diving protocol was applied. In the secondgroup of 6 guinea pigs,botulunium toxin was applied to the tubal muscles on one side andsaline was applied to thetubal muscles on the other. 3 days after the injection, the same diving protocol was applied bytaking it back to the experimental pressurechamber.After this procedure, after repeatingotoscopic examination, tympanometric test and ABR measurement, guinea pigs weredecapitated. The study was completed with 16 animals as a result of 1 guinea pig in both groupsdiedbefore the procedures werecompleted. When the results were compared in terms of thedevelopment of brotrauma, no statistically significant difference was observed between theguinea pigs who were subjected to the first dive simulation and the guinea pigs whounderwentsurgery (p:1.00), the guinea pigs with obliteration (p:1.00),guinea pigs that wereapplied saline(p: 1.00).Since barotrauma developed in all ears treated with botulinium toxin,statistical analysis could not be performed, but blocking of eustachian tube function withbotulinium toxin had a significant effect on barotrauma. As a result of this study, it was found that the reduction of bulla volume does notincrease the barotrauma rate, but absolute barotrauma develops when the eustachian tubefunction is blocked.
In our study where we investigated the effect of bulla volume change on thedevelopment of barotrauma, 18 adult guinea pigs with normal otoscopic examination andhearing threshold were included in the study.Guinea pigs were first taken to the experimentalpressure chamber one by one and after the cabin pressure was adjusted as 3 atm, a total of 9minutes diving protocol was applied. Before and after diving, otoscopic examination,tympanometric test and ABR measurement were performed. Ears that developed barotraumalater were divided into two separate groups after a 3-week recovery period. Surgical procedures were performedon the right ears of 12 guinea pigs in the firstgroup, andpartial bullaobliteration was performed on the left ears. The guinea pigs in thefirst group were taken back to the experimental pressure chamber after 2 weeks recoveryperiod and the same diving protocol was applied. In the secondgroup of 6 guinea pigs,botulunium toxin was applied to the tubal muscles on one side andsaline was applied to thetubal muscles on the other. 3 days after the injection, the same diving protocol was applied bytaking it back to the experimental pressurechamber.After this procedure, after repeatingotoscopic examination, tympanometric test and ABR measurement, guinea pigs weredecapitated. The study was completed with 16 animals as a result of 1 guinea pig in both groupsdiedbefore the procedures werecompleted. When the results were compared in terms of thedevelopment of brotrauma, no statistically significant difference was observed between theguinea pigs who were subjected to the first dive simulation and the guinea pigs whounderwentsurgery (p:1.00), the guinea pigs with obliteration (p:1.00),guinea pigs that wereapplied saline(p: 1.00).Since barotrauma developed in all ears treated with botulinium toxin,statistical analysis could not be performed, but blocking of eustachian tube function withbotulinium toxin had a significant effect on barotrauma. As a result of this study, it was found that the reduction of bulla volume does notincrease the barotrauma rate, but absolute barotrauma develops when the eustachian tubefunction is blocked.
Açıklama
Anahtar Kelimeler
Dalgıçlık, Mastoid, Pnömatizasyon, Östaki Borusu, Barotravma, Orta Kulak, Botulinium Toksini, Guinea Pig, Diving, Mastoid, Pneumatization, Eustachian Tube, Barotrauma, Middle Ear, Botulinium Toxin, Guinea Pig
