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A na-eme nnyocha dị iche iche tupu a mụọ stent Eustachian tube (ET) nke e mepụtara ugbu a, mana ejibeghị ya eme ihe n'ọgwụgwọ. N'ọmụmụ ihe tupu a mụọ stent, ET scaffolds ejedebela na mmụba anụ ahụ nke scaffold kpatara. A mụrụ irè nke cobalt-chromium sirolimus-eluting stent (SES) n'igbochi mmụba anụ ahụ nke stent kpatara mgbe etinyechara stent na ụdị ET porcine. E kewara ezi isii ahụ n'ime otu abụọ (ya bụ, otu njikwa na otu SES) yana ezi atọ n'ime otu ọ bụla. Otu njikwa ahụ natara stent cobalt-chromium a na-ekpuchighị ekpuchi (n = 6), otu SES ahụ natara stent cobalt-chromium nwere mkpuchi sirolimus-eluting (n = 6). E gbukwara otu niile izu anọ ka etinyechara stent. Ntinye stent gara nke ọma na ET niile na-enweghị nsogbu metụtara ịwa ahụ. Ọ dịghị otu n'ime stents ahụ nwere ike ịnọgide na-enwe ọdịdị gburugburu mbụ ha, a hụkwara mkpokọta mucous n'ime na gburugburu stents n'ime otu abụọ ahụ. Nnyocha Histological gosiri na mpaghara mmụba nke anụ ahụ na ọkpụrụkpụ nke submucosal fibrosis na otu SES dị obere nke ukwuu karịa nke dị na otu njikwa. O yiri ka SES dị irè n'igbochi mmụba nke anụ ahụ nke scaffold kpatara na ET ezì. Agbanyeghị, achọrọ ọmụmụ ihe ndị ọzọ iji kwado ihe kacha mma maka stents na ọgwụ mgbochi mmụba.
Eustachian tube (ET) nwere ọrụ dị mkpa n'ime ntị etiti (dịka ọmụmaatụ, ikuku, igbochi mbufe nke nje na ihe ndị na-apụta na nasopharynx)1. Ọ gụnyekwara nchedo megide ụda nasopharyngeal na regurgitation2. A na-emechi ET, mana ọ na-emepe site na ilo, ịgbọ agbọ, ma ọ bụ ịta. Agbanyeghị, nsogbu ET nwere ike ime ma ọ bụrụ na tube ahụ emepeghị ma ọ bụ mechie nke ọma3,4. Nsogbu ET gbasaara agbasa (ihe mgbochi) na-ebelata ọrụ ET, ọ bụrụ na echekwaghị ọrụ ndị a, nwere ike ịghọ mgbasa ozi otitis dị nkọ ma ọ bụ nke na-adịghị ala ala, otu n'ime ọrịa ndị a na-ahụkarị na ENT. A na-eji ọgwụgwọ ugbu a maka nsogbu ET (dịka ọmụmaatụ, ịwa ahụ imi, itinye tube ikuku, na ọgwụ) na ndị ọrịa. Agbanyeghị, ọgwụgwọ ndị a nwere obere arụmọrụ ma nwee ike ibute mgbochi ET, ọrịa, na oghere akpụkpọ ahụ tympanic na-enweghị ike ịgbanwe agbanwe3,6,7. E webatara Eustachian tube balloon angioplasty dị ka ọgwụgwọ ọzọ maka nsogbu ET 8 gbasaara agbasa. Ọ bụ ezie na ọtụtụ nnyocha kemgbe 2010 egosila na ndozi balụn Eustachian tube dị mma karịa ọgwụgwọ ọdịnala maka nsogbu ET, ụfọdụ ndị ọrịa anaghị anabata mgbasa 8,9,10,11. Ya mere, stenting nwere ike ịbụ nhọrọ ọgwụgwọ dị irè12,13. N'agbanyeghị ọtụtụ ọmụmụ ihe tupu a mụọ ọgwụ na-aga n'ihu na-enyocha ohere teknụzụ na nzaghachi anụ ahụ mgbe etinyechara stent na ET, hyperplasia anụ ahụ nke stent kpatara n'ihi mmebi igwe ka bụ nnukwu nsogbu mgbe ịwa ahụ gasịrị 14,15,16,17,18,19. ejiri ọgwụ kpuchie ya, nke nwere ihe ndị na-egbochi mmụba na-eme ka ọnọdụ a ka mma.
E jirila stents ndị na-ewepụta ọgwụ iji gbochie restenosis in-stent nke anụ ahụ na neointimal hyperplasia kpatara mgbe etinyechara stent. Dịka ọ na-adịkarị, a na-eji ọgwụ (dịka ọmụmaatụ, everolimus, paclitaxel, na sirolimus) ekpuchi scaffolds ma ọ bụ linings stent cascades (dịka ọmụmaatụ, everolimus, paclitaxel, na sirolimus)20,23,24. Sirolimus bụ ọgwụ na-egbochi mmụba nke na-egbochi ọtụtụ usoro nke restenosis cascade (dịka ọmụmaatụ, mbufụt, neointimal hyperplasia, na njikọ collagen)25. Ya mere, ọmụmụ ihe a chere na stents ndị e ji sirolimus kpuchie nwere ike igbochi hyperplasia anụ ahụ nke stent kpatara na ET pigs (Foto 1). Ebumnuche nke ọmụmụ ihe a bụ inyocha irè nke sirolimus-eluting stents (SES) n'igbochi mmụba anụ ahụ nke stent kpatara mgbe etinyechara stent na ụdị ET porcine.
Ihe atụ nke cobalt-chromium sirolimus-eluting stent (SES) maka ọgwụgwọ nsogbu nke ọkpọkọ Eustachian, na-egosi na stent sirolimus-eluting na-egbochi mmụba nke anụ ahụ nke stent kpatara.
E ji ígwè laser bee Co-Cr alloy (Genoss Co., Ltd., Suwon, Korea) kpụọ stents alloy Cobalt-chromium (Co-Cr). Ikpo okwu stent ahụ na-eji njikọ abụọ mepere emepe nwere usoro nhazi dị n'otu maka mgbanwe dị elu yana ike radial kacha mma, mkpụmkpụ na nrubeisi. Stent ahụ nwere dayameta nke 3 mm, ogologo nke 18 mm, na ọkpụrụkpụ strut nke 78 µm (Fig. 2a). E kpebiri nha nke etiti alloy Co-Cr dabere na ọmụmụ ihe anyị gara aga.
Stent alloy Cobalt-chromium (Co-Cr) na sheep nduzi ígwè maka itinye stent tube Eustachian. Foto ndị ahụ na-egosi (a) stent alloy Co-Cr na (b) catheter balloon nke stent jikọtara. (c) A na-etinye catheter balloon na stent ahụ nke ọma. (d) E mepụtara sheep nduzi ígwè maka ụdị tube Eustachian porcine.
E ji teknụzụ ultrasonic fesa ya tinye Sirolimus n'elu stent ahụ. Emebere SES ka ọ wepụta ihe fọrọ nke nta ka ọ bụrụ 70% nke ibu ọgwụ mbụ (1.15 µg/mm2) n'ime ụbọchị 30 mbụ mgbe etinyechara ya. A na-etinye mkpuchi dị gịrịgịrị nke 3 µm naanị n'akụkụ dị nso nke stent ahụ iji nweta profaịlụ mwepụta ọgwụ achọrọ ma belata ọnụọgụ nke polymer; mkpuchi a na-emebi emebi nwere copolymer nke lactic na glycolic acid na ngwakọta pụrụ iche nke poly(1)-lactic acid)26,27. E tinyere stents Co-Cr alloy n'elu catheters balloon nke dayameta ya bụ 3 mm na 28 mm (Genoss Co., Ltd.; Fig. 2b). E nwere stents ndị a na South Korea maka ọgwụgwọ ọrịa obi.
E ji ígwè anaghị agba nchara mee ihe mkpuchi nduzi ígwè ọhụrụ maka ụdị ET ezi (Foto 2c). Dayameta dị n'ime na mpụta nke shei ahụ bụ 2 mm na 2.5 mm, n'otu n'otu, ogologo ya niile bụ 250 mm. E tinyere shei 30 mm dị anya n'ụdị J na akụkụ 15° na axis iji mee ka ọ dị mfe ịnweta site na imi gaa na oghere nasopharyngeal nke ET na ụdị ezì ahụ.
Kọmitii Nlekọta na Ojiji nke Asan Institute of Life Sciences (Seoul, South Korea) kwadoro ọmụmụ ihe a ma na-agbaso ntuziaka National Institutes of Health Guidelines maka Ọgwụgwọ Mmadụ nke Anụmanụ Ụlọ Nyocha (IACUC-2020-12-189). . Emere ọmụmụ ihe a dịka ntuziaka ARRIVE si dị. Ọmụmụ ihe a jiri ET iri na abụọ n'ime ezi isii dị kilogram 33.8-36.4 mgbe ha dị ọnwa atọ. E kewara ezi isii ahụ n'ime otu abụọ (dịka otu njikwa na otu SES) yana ezi atọ n'ime otu ọ bụla. Otu njikwa ahụ natara stent Co-Cr alloy na-enweghị mkpuchi, ebe otu SES natara stent Co-Cr alloy na-ekpuchi sirolimus. Ezi niile nwere ohere ịnweta mmiri na nri n'efu ma debe ha na okpomọkụ 24°C ± 2°C maka usoro ehihie-abalị nke awa iri na abụọ. Mgbe nke ahụ gasịrị, a chụrụ ezi niile n'àjà izu anọ mgbe e tinyere stent.
E nyere ezi niile ngwakọta nke 50mg/kg zolazepam, 50mg/kg teletamide (Zoletil 50; Virbac, Carros, France) na 10mg/kg xylazine (Rompun; Bayer HealthCare, Les Varkouzins, Germany). E wee tinye ọkpọkọ tracheal site na iku ume nke 0.5-2% isoflurane (Ifran®; Hana Pharm. Co., Seoul, Korea) na oxygen 1:1 (510 ml/kg/min) maka anesthesia. E tinyere ezi n'ọnọdụ dị n'elu ma mee nyocha endoscopy nke ntọala (VISERA 4K UHD rhinolaryngoscope; Olympus, Tokyo, Japan) iji lelee oghere nasopharyngeal nke ET. E tinyere shea nduzi ígwè site na oghere imi ruo nasopharyngeal nke ET n'okpuru njikwa endoscopic (Fig. 3a, b). A na-etinye katita balloon, nke bụ stent corrugated, site na ihe na-ewebata ya n'ime ET ruo mgbe nsọtụ ya zutere iguzogide na osteochondral isthmus nke ET (Foto 3c). E tinyere saline na katita balloon ahụ kpamkpam ruo ikuku 9, dịka ihe nlele manometer siri chọpụta (Foto 3d). E wepụrụ katita balloon ahụ mgbe etinyechara stent (Foto 3f), a nyochakwara oghere nasopharyngeal nke ọma maka nsogbu ịwa ahụ (Foto 3f). E mere endoscopy ezì niile tupu na ozugbo emechara stent, yana izu anọ mgbe emechara stent, iji chọpụta ikike nke ebe stent ahụ na ihe ndị gbara ya gburugburu.
Usoro teknụzụ maka itinye stent n'ime ọkpọkọ eustachian (ET) nke ezi n'okpuru njikwa endoscopic. (a) Foto endoscopic na-egosi oghere nasopharyngeal (akụ) na mkpuchi nduzi ígwè etinyere (akụ). (b) Ntinye mkpuchi ígwè (akụ) n'ime oghere nasopharyngeal. (c) A na-etinye catheter balloon a kpara akpa (akụ) n'ime ET site na mkpuchi (akụ). (d) A na-afụ ikuku nke ọma na catheter balloon (akụ). (e) Ọgwụgwụ nso nke stent na-apụta site na oghere ET nke nasopharynx. (f) Foto endoscopic na-egosi ikike stent lumen.
E gburu ezi niile site n'inye potassium chloride 75 mg/kg site na ịgba ọgwụ n'akwara ntị. E jiri chainsaw mee akụkụ dị n'etiti sagittal nke isi porcine ahụ, wee jiri nlezianya wepụ ihe nlele anụ ahụ ET scaffold maka nyocha histological (Foto mgbakwunye 1a,b). E tinyere ihe nlele anụ ahụ ET na formalin nke nwere 10% nke na-anọpụ iche ruo awa 24.
E jiri mmanya dị iche iche tee ihe nlele anụ ahụ ET n'usoro. E tinyere ihe nlele n'ime blọk resin site na ịbanye na ethylene glycol methacrylate (Technovit 7200® VLC; Heraus Kulzer GMBH, Wertheim, Germany). E mere akụkụ axial na ihe nlele anụ ahụ ET agbakwunyere na ngalaba proximal na distal (Foto mgbakwunye 1c). E tinyezie blọk polymer na ihe ngosi iko acrylic. E jiri obere ala mee ihe ngosi resin ma jiri akwụkwọ silicon carbide dị iche iche mee ka ọ dị mma site na iji sistemụ grid (Apparatebau GMBH, Hamburg, Germany). E tinyere ihe ngosi niile na nyocha histological site na iji hematoxylin na eosin staining.
E mere nnyocha histological iji chọpụta pasentị nke mmụba anụ ahụ, ọkpụrụkpụ nke submucosal fibrosis, na ogo nke ntinye mkpụrụ ndụ mkpali. A gbakọrọ pasentị nke hyperplasia anụ ahụ nwere mpaghara ET dị warara site na idozi nha nhata ahụ:
A tụrụ ọkpụrụkpụ nke submucosal fibrosis kwụ ọtọ site na stent struts ruo submucosa. A na-ekpebi ogo nke mbepụ mkpụrụ ndụ mkpali site na nkesa na njupụta nke mkpụrụ ndụ mkpali, ya bụ: ogo nke mbụ (dị nro) - otu ntinye leukocyte otu; ogo nke abụọ (dị nro ruo n'ọkwa) - ntinye leukocyte focal; ogo nke atọ (dị oke) - jikọtara. ya na leukocytes enweghị ike ịmata ọdịiche dị n'etiti loci nke ọ bụla; ọkwa nke anọ (dị oke ruo n'ọkwa dị njọ) leukocytes na-agbasa na submucosa dum, na ọkwa nke ise (dị oke njọ) ntinye diffustration nwere ọtụtụ foci nke necrosis. E nwetara ọkpụrụkpụ nke submucosal fibrosis na ogo ntinye mkpụrụ ndụ mkpali site na nkezi isi asatọ gburugburu gburugburu. E mere nyocha histological nke ET site na iji microscope (BX51; Olympus, Tokyo, Japan). E ji ngwanrọ CaseViewer (CaseViewer; 3D HISTEC Ltd., Budapest, Hungary) nweta nha ndị a. Nnyocha nke data histological dabere na nkwenye nke ndị na-ekiri ihe atọ na-esonyeghị na nnyocha ahụ.
E jiri ule Mann-Whitney U mee ihe iji nyochaa ọdịiche dị n'etiti otu dị iche iche dịka ọ dị mkpa. A na-ewere p <0.05 dị ka ihe dị mkpa n'ọnụọgụgụ. A na-ewere p <0.05 dị ka ihe dị mkpa n'ọnụọgụgụ. Значение p <0,05 считалось статистически значимым. A na-ewere uru p < 0.05 dị ka ihe dị mkpa n'ọgụgụ. p <0.05 被认为具有统计学意义。 p < 0.05 p <0,05 считали статистически значимым. A na-ewere p < 0.05 dị ka ihe dị mkpa n'ọnụọgụgụ. E mere ule Mann–Whitney U nke Bonferroni gbaziri maka uru p < 0.05 iji chọpụta ọdịiche otu (p < 0.008 dị ka nke dị mkpa na ọnụọgụgụ). E mere ule Mann–Whitney U nke Bonferroni gbaziri maka ụkpụrụ p < 0.05 iji chọpụta ọdịiche otu (p < 0.008 dị ka ihe dị mkpa na ọnụọgụgụ). U-критерий Манна-Уитни с поправкой на Бонферрони был выполнен для значений p <0,05 как статистически значимое). E mere ule Mann-Whitney U nke Bonferroni gbanwere maka uru p <0.05 iji chọpụta ọdịiche otu (p <0.008 dị ka nke dị mkpa na ọnụọgụgụ).对p 值< 0.05 进行Bonferroni 校正的 Mann-Whitney U 检验以检测组差异（p <0.008对p 值< 0.05 进行Bonferroni 校正的 Mann-Whitney U U-критерий Манна-Уитни с поправкой на Бонферрони был выполнен для значений p <0,05 0,008 bыl статистически значимым). E mere ule Mann-Whitney U nke Bonferroni gbanwere maka p < 0.05 iji chọpụta ọdịiche otu (p < 0.008 dị mkpa na ọnụọgụgụ).E jiri ngwanrọ SPSS (mbipụta 27.0; SPSS, IBM, Chicago, IL, USA) mee nyocha ọnụọgụgụ.
N'ụzọ teknụzụ, ntinye stent porcine niile gara nke ọma. E tinyere sheath nduzi ígwè nke ọma n'ime oghere nasopharyngeal nke ET n'okpuru njikwa endoscopic, ọ bụ ezie na a hụrụ mmerụ ahụ mucous na ọbara ọgbụgba na 4 n'ime 12 ihe atụ (33.3%) n'oge ntinye sheath metal. Mgbe izu anọ gachara, ọbara ọgbụgba a na-ahụ anya kwụsịrị ozugbo. Ezi niile dị ndụ ruo na njedebe nke ọmụmụ ihe ahụ na-enweghị nsogbu ndị metụtara stent.
E gosiri nsonaazụ Endoscopy na Foto nke 4. N'ime izu anọ nke nyocha ahụ, stents ndị ahụ nọgidere n'ọnọdụ ha n'ime ezi niile. A hụrụ mkpokọta imi n'ime na gburugburu stent ET niile (100%) n'ime otu njikwa ahụ na atọ (50%) n'ime ET isii dị na otu SES, ọ dịghịkwa ihe dị iche n'ihe merenụ n'etiti otu abụọ ahụ (p = 0.182). Ọ dịghị stents ndị etinyere nwere ike ịnọgide na-enwe ọdịdị gburugburu.
Foto endoscopic nke tube Eustachian (ET) nke ezi nọ n'òtù njikwa na otu ahụ nwere cobalt-chromium stent (CXS) na-ewepụta sirolimus. (a) Foto endoscopic nke ala e sere tupu etinye stent na-egosi oghere nasopharyngeal (akụ) nke ET. (b) Foto endoscopic e sere ozugbo e tinyere stent na-egosi ET nke itinye stent. A hụla ọbara ọgbụgba n'ihi ihe mkpuchi ígwè (akụ). (c) Foto endoscopic e sere izu anọ mgbe e tinyere stent na-egosi mkpokọta mucous gburugburu stent (akụ). (d) Foto endoscopic na-egosi na stent enweghị ike ịnọgide gburugburu (akụ).
A na-egosi ihe ndị a chọpụtara na Histological na Foto nke 5 na Foto nke 2. Mgbasa nke anụ ahụ na mmụba nke eriri submucosal n'etiti ogidi stent na lumen ET nke otu abụọ ahụ. Pasentị nkezi nke mpaghara hyperplasia anụ ahụ buru ibu nke ukwuu n'òtù njikwa karịa na otu SES (79.48% ± 6.82% vs. 48.36% ± 10.06%, p < 0.001). Pasentị nkezi nke mpaghara hyperplasia anụ ahụ buru ibu nke ukwuu n'òtù njikwa karịa na otu SES (79.48% ± 6.82% vs. 48.36% ± 10.06%, p < 0.001). Средний процент площади гиперплазии тканей былзначительно быльше в контрольной группе, 8 6,82% nkeji 48,36% ± 10,06%, p <0,001). Pasentị nkezi nke hyperplasia anụ ahụ dị ukwuu n'ime otu njikwa karịa na otu SES (79.48% ± 6.82% vs. 48.36% ± 10.06%, p < 0.001).SES (79.48% ± 6.82% vs.48.36% ± 10.06%,p < 0.001). 48.36% ± 10.06%,p < 0.001). Средний процент площади гиперплазии тканей в контрольной групе был значительно выше, чем в групер 7 (9%) 6,82% nkeji 48,36% ± 10,06%, p <0,001). Pasentị nkezi nke hyperplasia anụ ahụ n'ime otu njikwa dị elu nke ukwuu karịa nke dị na otu SES (79.48% ± 6.82% vs. 48.36% ± 10.06%, p < 0.001). Ọzọkwa, nkezi ọkpụrụkpụ nke submucosal fibrosis dịkwa elu nke ukwuu n'òtù njikwa karịa na otu SES (1.41 ± 0.25 vs. 0.56 ± 0.20 mm, p < 0.001). Ọzọkwa, nkezi ọkpụrụkpụ nke submucosal fibrosis dịkwa elu nke ukwuu n'òtù njikwa karịa na otu SES (1.41 ± 0.25 vs. 0.56 ± 0.20 mm, p < 0.001). Более того, средняя толщина подслизистого фиброза также быlia СЭС (1,41 ± 0,25 prọt 0,56 ± 0,20 mm, p <0,001). Ọzọkwa, nkezi ọkpụrụkpụ nke submucosal fibrosis dịkwa elu nke ukwuu n'òtù njikwa karịa na otu SES (1.41 ± 0.25 vs. 0.56 ± 0.20 mm, p < 0.001).SES 组 (1.41 ± 0.25 vs.0.56 ± 0.20 mm, p < 0.001). 0.56±0.20mm,p<0.001). Кроме того, средняя толщина подслизистого фиброза. СЭС (1,41 ± 0,25 prọt 0,56 ± 0,20 mm, p <0,001). Tinyere nke ahụ, nkezi ọkpụrụkpụ nke submucosal fibrosis n'ime otu njikwa dịkwa elu nke ukwuu karịa nke dị na otu SES (1.41 ± 0.25 vs. 0.56 ± 0.20 mm, p < 0.001).Agbanyeghị, enweghị nnukwu ọdịiche dị na oke nke ntinye mkpụrụ ndụ mkpali n'etiti otu abụọ ahụ (otu njikwa [3.50 ± 0.55] vs. otu SES [3.00 ± 0.89], p = 0.270).
Nyocha nke nyocha histological nke otu stents abụọ e tinyere na lumen Eustachian. (a, b) Mpaghara nke hyperplasia anụ ahụ (1 nke a na b) na ọkpụrụkpụ nke submucosal fibrosis (2 nke a na b; akụ abụọ) dị ukwuu karịa na otu njikwa karịa na otu SES nwere strut stenting (ntụpọ ojii), mpaghara nke lumen dị warara (odo) na mpaghara stent mbụ (uhie). Ogo nke ntinye mkpụrụ ndụ mkpali (3 nke a na b; akụ) adịghị iche nke ukwuu n'etiti otu abụọ ahụ. (c) Nsonaazụ histological nke pasent mpaghara nke hyperplasia anụ ahụ, (d) ọkpụrụkpụ nke submucosal fibrosis, na (e) ogo ntinye mkpụrụ ndụ mkpali izu anọ mgbe etinyechara stent n'ime otu abụọ ahụ. SES, cobalt-chromium sirolimus eluting stent.
Stent ndị na-ewepụta ọgwụ na-enyere aka imeziwanye ikike stent ma gbochie stent restenosis20,21,22,23,24. Mgbochi nke stent na-akpata sitere na nhazi anụ ahụ granulation na mgbanwe anụ ahụ fibrous na akụkụ ahụ dị iche iche na-abụghị vascular, gụnyere esophagus, trachea, gastroduodenum, na bile ducts. A na-etinye ọgwụ dịka dexamethasone, paclitaxel, gemcitabine, EW-7197, na sirolimus n'elu waya mesh ma ọ bụ stent mkpuchi iji gbochie ma ọ bụ gwọọ hyperplasia anụ ahụ mgbe etinyechara stent29,30,34,35,36. A na-enyocha ihe ọhụrụ ndị ọhụrụ n'ọhịa nke stent multifunctional na-eji teknụzụ fusion maka ọgwụgwọ nke ọrịa ndị na-abụghị vascular occlusive37,38,39. Na nnyocha gara aga na ụdị ET porcine, a hụrụ mmụba anụ ahụ nke scaffold kpatara. Ọ bụ ezie na a ghọtaghị nke ọma mmepe stent na ET, achọpụtala na mmeghachi omume anụ ahụ mgbe etinyechara stent yiri nke akụkụ ahụ ndị ọzọ na-abụghị nke akwara19. N'ọmụmụ ihe a, ejiri SES gbochie mmụba anụ ahụ nke scaffold kpatara na ụdị ET porcine. Sirolimus na-egbu egbu nye agwaetiti pancreatic na ahịrị mkpụrụ ndụ beta, na-ebelata ndụ mkpụrụ ndụ ma na-eme ka apoptosis dịkwuo mma40,41. Mmetụta a nwere ike inye aka igbochi mmepe nke mmụba anụ ahụ site na ịkpalite ọnwụ mkpụrụ ndụ. Ọmụmụ ihe anyị gosiri na ojiji mbụ nke stents na-ewepụta ọgwụ na ET gbochiri mmụba anụ ahụ nke stent kpatara na ET nke ọma.
A na-enweta stent Co-Cr alloy nke a na-agbasa site na balloon n'ihi na a na-ejikarị ya agwọ ọrịa akwara obi 42. Na mgbakwunye, stent Co-Cr nwere ihe ndị dị na ya (dịka ọmụmaatụ, ike radial dị elu na ike inelastic) 43. Dịka endoscopy nke ọmụmụ ihe a si dị, stent Co-Cr alloy nke e ji mee ET nke ezì enweghị ike ịnọgide na-enwe ọdịdị gburugburu n'ime ezì niile n'ihi enweghị ike ịgbatị ahụ zuru oke ma ọ nweghị ike ịgbasa onwe ya. Enwere ike ịgbanwe ọdịdị stent etinyere site na mmegharị gburugburu ET nke anụmanụ dị ndụ (dịka ọmụmaatụ, ịta na ilo). Njirimara mechanical nke stent Co-Cr alloy aghọwo ihe na-adịghị mma na itinye stent porcine ET. Na mgbakwunye, itinye stent na isthmus nwere ike ibute ET mepere emepe kpamkpam. ET na-adịgide adịgide ma ọ bụ gbasaa na-enye ohere ka okwu na ụda nasopharyngeal, reflux eriri afọ, na nje bacteria1 banye n'etiti ntị, na-akpata iwe na ọrịa mucosal. Ya mere, a ga-ezere oghere nasopharyngeal na-adịgide adịgide. Ya mere, ebe ọ bụ na e nwere nhazi nke cartilage ET, a na-eji ihe ndị dị ka memory alloys nwere ihe ndị dị oke mma, dịka nitinol, eme scaffolds. N'ozuzu, a hụrụ nnukwu mmiri na-agbapụta n'ime na gburugburu oghere nasopharyngeal nke stent ahụ. Ebe ọ bụ na a na-egbochi mmegharị mucociliary nkịtị nke mucociliary, a na-atụ anya na ihe nzuzo ahụ ga-agbakọta na scaffolds ndị si na oghere nasopharyngeal pụta. Mgbochi nke ọrịa ntị etiti na-arị elu bụ otu n'ime ebumnuche bụ isi nke ET, a kwesịkwara izere itinye stents ndị na-apụta karịa ET, ebe ọ bụ na kọntaktị kpọmkwem nke stents na nasopharyngeal bacterial flora nwere ike ibute mmụba nke ọrịa.
Plastị balụn Eustachian site na oghere nasopharyngeal bụ ọgwụgwọ ọhụrụ nke na-adịghị emerụ ahụ maka nsogbu ET ezubere imeghe ma gbasaa akụkụ cartilaginous nke ET8,9,10,46. Agbanyeghị, achọpụtabeghị usoro ọgwụgwọ dị n'okpuru ya47 na nsonaazụ ogologo oge ya nwere ike ịbụ ihe na-adịghị mma8,9,11,46. N'okpuru ọnọdụ ndị a, stenting ígwè nwa oge nwere ike ịbụ nhọrọ ọgwụgwọ dị irè maka ndị ọrịa na-anaghị anabata ndozi balụn Eustachian tube, a gosipụtakwala ohere nke stenting ET n'ọtụtụ ọmụmụ tupu ọgwụgwọ. E tinyere ihe mkpuchi Poly-l-lactide site na akpụkpọ ahụ tympanic na chinchillas na oke bekee iji nyochaa nnabata na mmebi na vivo17,18. Na mgbakwunye, e mepụtara ihe nlereanya atụrụ iji nyochaa profaịlụ nke stents balụn ígwè a na-agbasa na vivo. N'ọmụmụ ihe anyị gara aga, e mepụtara ụdị ET porcine iji nyochaa ohere teknụzụ na nyocha nke nsogbu ndị stent kpatara,19 na-enye ntọala siri ike maka ọmụmụ ihe a iji nyochaa irè nke SES site na iji usoro ndị e guzobere na mbụ. N'ọmụmụ ihe a, e tinyere SES n'ime cartilage nke ọma ma gbochie mmụba nke anụ ahụ nke ọma. Enweghị nsogbu ọ bụla metụtara stent, mana enwere mmerụ ahụ mucosal nke sheath ntuziaka ígwè kpatara na ọbara ọgbụgba kọntaktị nke kwụsịrị n'onwe ya n'ime izu anọ. N'ihi nsogbu ndị nwere ike ime na sheath metal, imeziwanye sistemụ nnyefe SES dị ngwa ma dị oke mkpa.
Nnyocha a nwere oke ụfọdụ. Ọ bụ ezie na nchọpụta histological dị iche iche n'etiti otu dị iche iche, ọnụọgụ anụmanụ dị na nnyocha a pere mpe maka nyocha ọnụọgụgụ a pụrụ ịtụkwasị obi. Ọ bụ ezie na ndị na-ekiri ihe atọ kpuru ìsì iji chọpụta mgbanwe dị n'etiti ndị na-ekiri ihe, a chọpụtara oke nke ntinye mkpụrụ ndụ mkpali submucosal dabere na nkesa na njupụta nke mkpụrụ ndụ mkpali n'ihi nsogbu nke ịgụta mkpụrụ ndụ mkpali. Ebe ọ bụ na ejiri obere ọnụọgụ anụmanụ buru ibu mee ọmụmụ ihe anyị, ejiri otu dose nke ọgwụ ahụ, emebeghị ọmụmụ ihe pharmacokinetic in vivo. A chọrọ ọmụmụ ihe ndị ọzọ iji kwado oke dose nke ọgwụ ahụ na nchekwa nke sirolimus na ET. N'ikpeazụ, oge nleba anya nke izu anọ bụkwa oke nke ọmụmụ ihe ahụ, yabụ ọ dị mkpa ka a mụọ ọmụmụ ihe gbasara irè ogologo oge nke SES.
Nsonaazụ nke ọmụmụ a na-egosi na SES nwere ike igbochi mmụba nke anụ ahụ nke mmerụ ahụ mekanyere mgbe etinyechara ihe mkpuchi Co-Cr alloy nke a na-agbasa na balloon n'ụdị porcine ET. Izu anọ ka etinyechara stent, mgbanwe ndị metụtara mmụba nke anụ ahụ nke stent kpatara (gụnyere mpaghara mmụba nke anụ ahụ na ọkpụrụkpụ nke submucosal fibrosis) dị obere nke ukwuu na otu SES karịa na otu njikwa. SES yiri ka ọ dị irè n'igbochi mmụba nke anụ ahụ nke scaffold kpatara na ET ezì. Ọ bụ ezie na achọrọ nyocha ọzọ iji nwalee ihe stent kacha mma na dose nke ndị na-achọ ọgwụ, SES nwere ikike ọgwụgwọ mpaghara n'igbochi hyperplasia anụ ahụ ET mgbe etinyechara stent.
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