Ngā mihi nui ki a koe mō tō toro mai ki Nature.com. He iti noa te tautoko CSS mō te putanga pūtirotiro e whakamahia ana e koe. Mō te wheako pai rawa atu, ka tūtohu mātou kia whakamahia e koe he pūtirotiro kua whakahoutia (kia mono rānei i te Aratau Hototahi i roto i te Internet Explorer). I tēnei wā, hei whakarite i te tautoko tonu, ka whakaatuhia e mātou te pae me te kore he momo kāhua me te JavaScript.
Kei te haere tonu ngā rangahau haumanu maha o te stent ngongo Eustachian (ET) kua whakawhanakehia, engari kāore anō kia whakamahia i roto i te mahi haumanu. I roto i ngā rangahau haumanu, kua whakawhāitihia ngā tūāpapa ET ki te tipu kiko i puta mai i te tūāpapa. I rangahauhia te whai huatanga o te stent sirolimus-eluting cobalt-chromium (SES) ki te aukati i te tipu kiko i puta mai i te stent i muri i te whakatakotoranga stent i roto i te tauira ET poaka. I wehea ngā poaka e ono ki ngā rōpū e rua (arā, te rōpū whakahaere me te rōpū SES) me ngā poaka e toru i roto i ia rōpū. I whiwhi te rōpū whakahaere i tētahi stent cobalt-chromium kāore i pania (n = 6), ā, i whiwhi te rōpū SES i tētahi stent cobalt-chromium me te paninga sirolimus-eluting (n = 6). I patua ngā rōpū katoa i ngā wiki e 4 i muri i te whakatakotoranga stent. I angitu te whakatakotoranga stent i roto i ngā ET katoa me te kore he raruraru e pā ana ki te pokanga. Kāore i taea e tētahi o ngā stent te pupuri i tō rātou āhua porowhita taketake, ā, i kitea te kohikohinga huware i roto me te taha o ngā stent i roto i ngā rōpū e rua. I whakaatuhia e te tātaritanga histological he iti iho te horahanga o te tipu kiko me te matotoru o te fibrosis submucosal i roto i te rōpū SES i tērā i roto i te rōpū whakahaere. Te āhua nei he whai hua te SES ki te aukati i te tipu kiko i puta mai i te hanganga i roto i ngā poaka ET. Heoi, me whai atu rangahau hei whakaū i ngā rauemi tino pai mō ngā stent me ngā rongoā ārai tipu.
He mahi nui tā te ngongo Eustachian (ET) i roto i te taringa waenga (hei tauira, te whakapūhautanga, te aukati i te whakawhiti o ngā mate me ngā mea huna ki te ihu)1. Kei roto hoki te tiaki i ngā tangi ihu me te ruaki2. Ko te tikanga ka kati te ET, engari ka tuwhera i te horomitanga, te hamama, te ngaungau rānei. Heoi, ka puta te ngoikore o te ET mena kāore te ngongo e tuwhera, e kati tika rānei3,4. Ko te ngoikore whānui (ārai) o te ET ka pehia te mahi a te ET, ā, ki te kore ēnei mahi e tiakina, ka whanake pea hei otitis media whakapeka, mau tonu rānei, tētahi o ngā mate tino noa i roto i te mahi ENT. Ko ngā maimoatanga o nāianei mō te ngoikore o te ET (hei tauira, te pokanga ihu, te whakatakotoranga ngongo whakapūhautanga, me te rongoā) e whakamahia ana i roto i ngā tūroro. Heoi, he iti noa te whai huatanga o ēnei maimoatanga, ā, ka arahi pea ki te aukati ET, te mate, me te pakaru o te membrane tympanic kore e taea te whakatika3,6,7. Kua whakaurua te angioplasty poihau ngongo Eustachian hei maimoatanga rerekē mō te ngoikore whānui o te ET8. Ahakoa kua whakaatuhia e ētahi rangahau mai i te tau 2010 he pai ake te whakatikatika i te poihau ngongo Eustachian i te maimoatanga tikanga mō te ngoikore o te ET, kāore ētahi tūroro e aro ki te whakawhānui8,9,10,11. Nō reira, he kōwhiringa maimoatanga whai hua pea te stenting12,13. Ahakoa he maha ngā rangahau haumanu kei te haere tonu e aromatawai ana i te whaihua hangarau me te urupare kiko i muri i te whakatakotoranga stent ki te ET, ko te hyperplasia kiko i puta mai i te stent nā te kino miihini he raruraru nui tonu i muri i te 14,15,16,17,18,19. he rongoā kua pania ki ngā kaihoko ārai-whakatipu ka whakapai ake i tēnei āhuatanga.
Kua whakamahia ngā stent eluting-drug hei aukati i te restenosis in-stent i puta mai i te hyperplasia kiko me te neointimal i muri i te whakatakotoranga o te stent. I te nuinga o te wā, ka pania ngā papa, ngā arai rānei o te stent ki ngā rongoā (hei tauira, everolimus, paclitaxel, me te sirolimus)20,23,24. Ko te Sirolimus he rongoā antiproliferative noa e aukati ana i ētahi taahiraa o te raupapa restenosis (hei tauira, te mumura, te hyperplasia neointimal, me te hanganga collagen)25. Nō reira, i whakapaehia e tēnei rangahau ka taea e ngā stent pania ki te sirolimus te aukati i te hyperplasia kiko i puta mai i te stent i roto i ngā poaka ET (Pikitia 1). Ko te whāinga o tēnei rangahau he tirotiro i te whai huatanga o ngā stent eluting-sirolimus (SES) ki te aukati i te tipu kiko i puta mai i te stent i muri i te whakatakotoranga o te stent i roto i te tauira ET poaka.
He whakaahua kauwhata o tētahi stent sirolimus-eluting cobalt-chromium (SES) hei rongoā mō te ngoikore o te ngongo Eustachian, e whakaatu ana ka aukati te stent sirolimus-eluting i te tipu o ngā kiko i puta mai i te stent.
I hangaia ngā stent koranu Cobalt-chromium (Co-Cr) mā te tapahi laser i ngā ngongo koranu Co-Cr (Genoss Co., Ltd., Suwon, Korea). Ka whakamahia e te papa stent he hononga takirua tuwhera me te hoahoa kotahi mō te ngāwari teitei me te kaha radial tino pai, te whakapoto me te piripono. Ko te diameter o te stent he 3 mm, he roa he 18 mm, ā, he 78 µm te matotoru o te pou (Pikitia 2a). I whakatauhia ngā ine o te anga koranu Co-Cr i runga i tā mātou rangahau o mua.
He stent koranu Cobalt-chromium (Co-Cr) me te pūranga arataki whakarewa mō te whakatakotoranga stent ngongo Eustachian. E whakaatu ana ngā whakaahua i (a) he stent koranu Co-Cr me (b) he catheter poihau kua herea ki te stent. (c) Kua tino horahia te catheter poihau me te stent. (d) I hangaia he pūranga arataki whakarewa mō te tauira ngongo poaka Eustachian.
I pania te Sirolimus ki te mata o te stent mā te whakamahi i te hangarau rehu ultrasonic. Kua hangaia te SES hei tuku tata ki te 70% o te kawenga rongoā taketake (1.15 µg/mm2) i roto i ngā rā 30 tuatahi i muri i te whakatakotoranga. Ka pania he paninga tino angiangi 3 µm ki te taha tata o te stent hei whakatutuki i te kōtaha tukunga rongoā e hiahiatia ana, me te whakaiti i te nui o te polymer; kei roto i tēnei paninga pirau he copolymer o ngā waikawa lactic me te glycolic me te ranunga motuhake o te poly(1)-lactic acid)26,27. I whakapikohia ngā stent koranu Co-Cr ki runga i ngā catheter poihau he 3 mm te whānui me te 28 mm te roa (Genoss Co., Ltd.; Pikitia 2b). Kei te wātea ēnei stent i Korea ki te Tonga hei rongoā i te mate ngakau coronary.
Ko te anga arataki whakarewa hou mō te tauira poaka ET i hangaia ki te kowiri tira (Pikitia 2c). Ko te diameter o roto me waho o te anga he 2 mm me te 2.5 mm, ia, ko te roa katoa he 250 mm. I pikohia te anga 30 mm ki te āhua-J i te koki 15° ki te tuaka kia ngāwari ai te uru atu mai i te ihu ki te kōhao ihu o te ET i roto i te tauira poaka.
I whakaaetia tēnei rangahau e te Komiti Tiaki me te Whakamahi Kararehe Whare o te Asan Institute of Life Sciences (Seoul, South Korea) ā, e tutuki ana i ngā Aratohu Hauora ā-Motu mō te Maimoatanga Tangata o ngā Kararehe Taiwhanga (IACUC-2020-12-189). . I whakahaerehia te rangahau i runga anō i ngā aratohu ARRIVE. I whakamahia e tēnei rangahau te 12 ET i roto i ngā poaka e 6, e 33.8-36.4 kg te taumaha i te 3 marama te pakeke. I wehea ngā poaka e ono ki ngā rōpū e rua (arā, te rōpū whakahaere me te rōpū SES) me ngā poaka e toru i ia rōpū. I whiwhi te rōpū whakahaere i tētahi stent koranu Co-Cr kāore i pania, ko te rōpū SES i whiwhi i tētahi stent koranu Co-Cr e whakakī ana i te sirolimus. I wātea ngā poaka katoa ki te wai me te kai, ā, i puritia ki te 24°C ± 2°C mō te huringa 12-hāora o te ao-pō. Nō muri mai, i patua ngā poaka katoa i muri i te 4 wiki i muri i te whakatakotoranga o te stent.
I whiwhi ngā poaka katoa i te ranunga o te 50mg/kg zolazepam, 50mg/kg teletamide (Zoletil 50; Virbac, Carros, France) me te 10mg/kg xylazine (Rompun; Bayer HealthCare, Les Varkouzins, Germany). Kātahi ka whakanohoia te ngongo tracheal mā te manawa i te 0.5-2% isoflurane (Ifran®; Hana Pharm. Co., Seoul, Korea) me te hāora 1:1 (510 ml/kg/min) hei rongoā whakamoe. I whakatakotoria ngā poaka ki te tūranga takoto, ā, i mahia te endoscopy taketake (VISERA 4K UHD rhinolaryngoscope; Olympus, Tokyo, Japan) hei tirotiro i te kōhao ihu o te ET. I tukuna he uhi arataki whakarewa mā roto i te ihu ki te kōhao ihu o te ET i raro i te mana endoscopic (Pikitia 3a, b). Ka whakaurua he catheter poihau, he stent kōpikopiko, mā roto i te whakauru ki roto i te ET kia tae rā anō tōna pito ki te ātete i roto i te osteochondral isthmus o te ET (Pikitia 3c). I pupuhi katoatia te catheter poihau ki te tote ki te 9 hauhautanga, e ai ki te aroturuki manometer (Pikitia 3d). I tangohia te catheter poihau i muri i te whakatakotoranga o te stent (Pikitia 3f), ā, i arotakehia marietia te whakatuwheratanga o te ihu i te endoscope mō ngā raruraru pokanga (Pikitia 3f). I tirotirohia ngā poaka katoa i mua me muri tonu i te stenting, tae atu ki ngā wiki e 4 i muri i te stenting, hei aromatawai i te āheinga o te wāhi stent me ngā hinu huna e karapoti ana.
Ngā mahi hangarau mō te whakatakoto i tētahi stent ki roto i te ngongo eustachian (ET) o tētahi poaka i raro i te mana endoscopic. (a) Whakaahua endoscopic e whakaatu ana i te whakatuwheratanga o te ihu (pere) me te uhi arataki whakarewa kua whakauruhia (pere). (b) Te whakaurunga o tētahi uhi whakarewa (pere) ki roto i te whakatuwheratanga o te ihu. (c) Ka whakaurua he catheter poihau kua herea ki te stent (pere) ki roto i te ET mā roto i tētahi uhi (pere). (d) Kua pupuhi katoa te catheter poihau (pere). (e) Ka puta te pito tata o te stent mai i te kōhao ET o te ihu. (f) Whakaahua endoscopic e whakaatu ana i te āheinga o te lumen stent.
I whakamatea ngā poaka katoa mā te werohanga i te 75 mg/kg pāhare pākawa waro mā te werohanga i te uaua taringa. I mahia ngā wāhanga sagittal waenga o te pane poaka mā te whakamahi i te kani mekameka, ā, i muri mai ka tangohia marietia ngā tauira kiko o te tūāpapa ET mō te whakamātautau histological (Pikitia Tāpiri 1a,b). I whakapirihia ngā tauira kiko ET ki roto i te 10% formalin kua whakapūmauhia mō ngā haora 24.
I whakamaroketia ngā tauira kiko ET i ia wā ki te waipiro o ngā kukū rerekē. I whakanohoia ngā tauira ki roto i ngā poraka kapia mā te whakauru ki te ethylene glycol methacrylate (Technovit 7200® VLC; Heraus Kulzer GMBH, Wertheim, Tiamana). I mahia ngā tapahi axial ki runga i ngā tauira kiko ET kua whakauruhia ki ngā wāhanga proximal me te distal (Pikitia Tāpiri 1c). Kātahi ka whakairihia ngā poraka polymer ki runga i ngā kiriata karāhe kiriaku. I hurihia ngā kiriata poraka kapia ki roto i te moroiti, ā, i whakakanapahia ki te pepa silicon carbide o ngā matotoru rerekē tae atu ki te matotoru o te 20 µm mā te whakamahi i te pūnaha whatunga (Apparatebau GMBH, Hamburg, Tiamana). I arotakehia ngā kiriata katoa ki te hematoxylin me te eosin.
I whakahaerehia he aromatawai histological hei aromatawai i te ōrau o te tipu kiko, te matotoru o te fibrosis submucosal, me te nui o te urunga o ngā pūtau mumura. I tatauhia te ōrau o te hyperplasia kiko me te horahanga whakawhiti ET whaiti mā te whakaoti i te whārite:
I inehia te matotoru o te fibrosis submucosal poutū mai i ngā pou stent ki te submucosa. I aromatawaihia te nui o te urunga o ngā pūtau mumura mā te tohatoha me te mātotoru o ngā pūtau mumura, arā: te nui 1 (ngāwari) – he urunga kotahi te leukocyte; te nui 2 (ngāwari ki te whakaōrite) – te urunga arotahi o ngā leukocyte; te nui 3 (ngāwari) – kua whakakotahitia. me ngā leukocyte kāore e taea te wehewehe i waenga i ngā loci takitahi; te nui 4 (ngāwari ki te kino) ngā leukocyte e uru whānui ana ki te submucosa katoa, me te nui 5 (kino) te urunga whānui me ngā arotahi maha o te necrosis. I whiwhihia te matotoru o te fibrosis submucosal me te nui o te urunga o ngā pūtau mumura mā te toharite i ngā tohu e waru huri noa i te porowhita. I mahia te tātaritanga histological o te ET mā te whakamahi i te karuārai (BX51; Olympus, Tokyo, Hapani). I whiwhihia ngā inenga mā te whakamahi i te pūmanawa CaseViewer (CaseViewer; 3D HISTECH Ltd., Budapest, Hungary). I ahu mai te tātaritanga o ngā raraunga histological i te whakaae a te tokotoru o ngā kaimātakitaki kāore i whai wāhi ki te rangahau.
I whakamahia te whakamātautau-U a Mann-Whitney hei tātari i ngā rerekētanga i waenga i ngā rōpū inā hiahiatia. I kiia he hiranga ā-tatauranga te p < 0.05. I kiia he hiranga ā-tatauranga te p < 0.05. Значение p < 0,05 считалось статистически значимым. I kiia he hiranga ā-tatauranga te uara p < 0.05. p < 0.05 被认为具有统计学意义。 p < 0.05 p < 0,05 считали статистически значимым. i kiia he hiranga ā-tatauranga te p < 0.05. I whakahaerehia he whakamātautau U Mann–Whitney i whakatikatikaina e Bonferroni mō ngā uara p < 0.05 hei kite i ngā rerekētanga rōpū (p < 0.008 hei mea nui i te tatauranga). I whakahaerehia he whakamātautau U Mann–Whitney i whakatikatikaina e Bonferroni mō ngā uara p < 0.05 hei kite i ngā rerekētanga rōpū (p < 0.008 hei mea nui i te tatauranga). U-критерий Манна-Уитни с поправкой на Бонферрони был выполнен для значений p <0,05 для выявления групвый групвый групвый групвый 8 статистически значимое). I whakahaerehia te whakamātautau U Mann-Whitney i whakatikatikaina e Bonferroni mō ngā uara p <0.05 hei kite i ngā rerekētanga rōpū (p <0.008 hei mea nui i te tatauranga).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 具有统计幦意。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 для выявления групвления групвих,0л групвых (0. статистически значимым). I whakahaerehia te whakamātautau-U Mann-Whitney i whakatikatikaina e Bonferroni mō te p < 0.05 hei kite i ngā rerekētanga rōpū (he hiranga tatauranga te p < 0.008).I whakahaerehia te tātaritanga tatauranga mā te whakamahi i te pūmanawa SPSS (putanga 27.0; SPSS, IBM, Chicago, IL, USA).
I angitu te whakatakotoranga o ngā stent poaka katoa. I angitu te whakatakotoranga o tētahi uhi arataki whakarewa ki roto i te kōhao ihu o te ET i raro i te mana tirotiro endoscopic, ahakoa i kitea te whara o te mucosal me te toto pa ki roto i te 4 o te 12 tauira (33.3%) i te wā i whakauruhia ai te uhi whakarewa. I muri i ngā wiki e 4, ka mutu te toto i kitea. I ora katoa ngā poaka tae noa ki te mutunga o te rangahau, kāore he raruraru e pā ana ki te stent.
Kei te Pikitia 4 ngā hua o te tirotiro endoskopika. I roto i te wiki e 4 o te arotakenga, i noho tonu ngā stent ki te wāhi tika i roto i ngā poaka katoa. I kitea te kohikohinga o te huware i roto me te taha o te stent ET i roto i ngā ET katoa (100%) i roto i te rōpū whakahaere me te toru (50%) o ngā ET e ono i roto i te rōpū SES, ā, kāore he rerekētanga o te auau i waenga i ngā rōpū e rua (p = 0.182). Kāore i taea e tētahi o ngā stent i tāutahia te pupuri i te āhua porowhita.
Ngā whakaahua endoscopic o te ngongo Eustachian (ET) o tētahi poaka i roto i te rōpū whakahaere me te rōpū me te stent cobalt-chromium (CXS) e whakapūtā ana i te sirolimus. (a) Whakaahua endoscopic turanga i tangohia i mua i te whakatakotoranga stent e whakaatu ana i te whakatuwheratanga o te ihu (pere) o te ET. (b) Whakaahua endoscopic i tangohia i muri tonu i te whakatakotoranga stent e whakaatu ana i te ET o te whakatakotoranga stent. Kua kitea te toto whakapā nā te hipoki arataki whakarewa (pere). (c) Ko te whakaahua endoscopic i tangohia i te 4 wiki i muri i te whakatakotoranga stent e whakaatu ana i te kohikohinga huware huri noa i te stent (pere). (d) Whakaahua endoscopic e whakaatu ana kāore e taea e te stent te noho porowhita (pere).
Kei te whakaatuhia ngā kitenga histological i te Pikitia 5 me te Pikitia Tāpiri 2. Te tipu o ngā kiko me te tipu o ngā muka i raro i te kiriuhi i waenga i ngā pou stent i roto i te lumen ET o ngā rōpū e rua. He nui ake te ōrau toharite o te horahanga hyperplasia kiko i roto i te rōpū whakahaere i tērā i roto i te rōpū SES (79.48% ± 6.82% vs. 48.36% ± 10.06%, p < 0.001). He nui ake te ōrau toharite o te horahanga hyperplasia kiko i roto i te rōpū whakahaere i tērā i roto i te rōpū SES (79.48% ± 6.82% vs. 48.36% ± 10.06%, p < 0.001). Средний процент площади гиперплазии тканей был значительно больше в контрольной группе, чем в группе (2 ± 6,8%) против 48,36% ± 10,06%, p <0,001). He nui ake te ōrau horahanga toharite o te hyperplasia kiko i roto i te rōpū whakahaere i tērā i roto i te rōpū SES (79.48% ± 6.82% vs. 48.36% ± 10.06%, p < 0.001).SES 组（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 группе был значительно выше, чем в группе СЭС (7 ± 8,8%) 48,36% ± 10,06%, p <0,001). Ko te ōrau horahanga toharite o te hyperplasia kiko i roto i te rōpū whakahaere he nui ake i te rōpū SES (79.48% ± 6.82% vs. 48.36% ± 10.06%, p < 0.001). Heoi anō, he nui ake te matotoru toharite o te fibrosis submucosal i roto i te rōpū whakahaere i tērā i roto i te rōpū SES (1.41 ± 0.25 vs. 0.56 ± 0.20 mm, p < 0.001). Heoi anō, he nui ake te matotoru toharite o te fibrosis submucosal i roto i te rōpū whakahaere i tērā i roto i te rōpū SES (1.41 ± 0.25 vs. 0.56 ± 0.20 mm, p < 0.001). Более того, средняя толщина подслизистого фиброза также была значительно выше в контрольной группе, чепсв1 ,4±5 против 0,56 ± 0,20 мм, p <0,001). Heoi anō, he nui ake te matotoru toharite o te fibrosis submucosal i roto i te rōpū whakahaere i tērā i roto i te rōpū 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 в контрольной группе также была значительно выше, чем в ,4 ± Спе (1 група против 0,56 ± 0,20 мм, p <0,001). Hei tāpiritanga, ko te matotoru toharite o te fibrosis submucosal i roto i te rōpū whakahaere he nui ake i te rōpū SES (1.41 ± 0.25 vs. 0.56 ± 0.20 mm, p < 0.001).Heoi, kāore he rerekētanga nui i roto i te nui o te urunga o ngā pūtau mumura i waenga i ngā rōpū e rua (rōpū mana [3.50 ± 0.55] vs. rōpū SES [3.00 ± 0.89], p = 0.270).
Te tātari i te whakamātautau histological o ngā rōpū e rua o ngā stent i whakanohoia ki roto i te lumen Eustachian. (a, b) Ko te horahanga o te hyperplasia kiko (1 o a me b) me te matotoru o te fibrosis submucosal (2 o a me b; pere takirua) he nui ake i roto i te rōpū whakahaere i te rōpū SES me te strut stenting (ngā ira pango), te horahanga o te lumen whaiti (kōwhai) me te horahanga stent taketake (whero). Kāore i tino rerekē te nui o te urunga pūtau mumura (3 o a me b; pere) i waenga i ngā rōpū e rua. (c) Ngā hua histological o te ōrau horahanga o te hyperplasia kiko, (d) te matotoru o te fibrosis submucosal, me te (e) te nui o te urunga pūtau mumura 4 wiki i muri i te whakatakotoranga stent i roto i ngā rōpū e rua. SES, cobalt-chromium sirolimus eluting stent.
Ka āwhina ngā stent e tango ana i te rongoā ki te whakapai ake i te āheinga o te stent me te ārai i te restenosis o te stent20,21,22,23,24. Ko ngā stricture i puta mai i te stent ka puta mai i te hanganga kiko granulation me ngā huringa kiko fibrous i roto i ngā momo okana kore-toto, tae atu ki te esophagus, trachea, gastroduodenum, me ngā awa waikura. Ka pania ngā rongoā pēnei i te dexamethasone, paclitaxel, gemcitabine, EW-7197, me te sirolimus ki te mata o te mata waea, te paninga stent rānei hei ārai, hei rongoā rānei i te hyperplasia kiko i muri i te whakatakotoranga stent29,30,34,35,36. Kei te rangahauhia ngā auahatanga hou i roto i te mara o ngā stent maha-mahi e whakamahi ana i te hangarau whakakotahitanga hei rongoā i ngā mate occlusive kore-toto37,38,39. I roto i tētahi rangahau o mua i roto i tētahi tauira ET poaka, i kitea te tipu kiko i puta mai i te tūāpapa. Ahakoa kāore i te tino mārama te whanaketanga o te stent i roto i te ET, kua kitea he rite te urupare a te kiko i muri i te whakatakotoranga o te stent ki ērā o ētahi atu okana lumen kore-toto19. I roto i tēnei rangahau, i whakamahia te SES hei aukati i te tipu o te kiko i puta mai i te tūāpapa i roto i te tauira ET poaka. He paitini te Sirolimus ki ngā moutere pancreatic me ngā raina pūtau beta, ka whakaiti i te oranga o te pūtau, ā, ka whakarei ake i te apoptosis40,41. Tērā pea ka āwhina tēnei pānga ki te aukati i te hanganga o te tipu o te kiko mā te whakaoho i te mate o te pūtau. I whakaatuhia e tā mātou rangahau ko te whakamahinga tuatahi o ngā stent eluting drug i roto i te ET i aukati pai i te tipu o te kiko i puta mai i te stent i roto i te ET.
Kei te wātea te stent Co-Cr ka taea te whakawhanui i roto i tēnei rangahau, nā te mea he mea noa te whakamahi hei rongoā i ngā mate uaua o te ngakau 42. Hei tāpiri, he āhuatanga ā-pūkaha ō ngā koranu Co-Cr (hei tauira, he kaha teitei te radial me ngā kaha kore-whakapūmau) 43. E ai ki te endoscopy o te rangahau o nāianei, kāore e taea e te stent koranu Co-Cr e whakamahia ana mō te ET o ngā poaka te pupuri i te āhua porowhita i roto i ngā poaka katoa nā te kore e ranea te whakapūmau, ā, kāore e taea te whakawhanui i a ia anō. Ka taea hoki te whakarerekē i te āhua o te stent kua whakaurua mā te nekehanga huri noa i te ET o tētahi kararehe ora (hei tauira, te ngaungau me te horomi). Kua waiho ngā āhuatanga ā-pūkaha o ngā stent koranu Co-Cr hei ngoikoretanga i te whakatakotoranga o ngā stent ET poaka. Hei tāpiri, ko te whakatakotoranga o tētahi stent ki te isthmus ka hua ake he ET tuwhera tonu. Mā te ET tuwhera tonu, te roa rānei ka taea e ngā oro kōrero me te ihu o te ihu, te reflux gastrointestinal, me ngā pathogens1 te haere ki runga ki te taringa waenga, ka puta te riri o te mucosal me te mate. Nō reira, me karohia ngā whakatuwheratanga ihu pumau. Nō reira, i runga i te hanganga o te kiriuhi ET, he pai ake te hanga i ngā tūāpapa mai i ngā koranu mahara āhua me ngā āhuatanga superelastic, pērā i te nitinol. I te nuinga o te wā, i kitea he rerenga nui i roto me te taha o te kōhao ihu o te stent. Nā te mea kua āraia te nekehanga mucociliary noa o te huware, e whakaarohia ana ka kohia te mea ngaro ki roto i ngā tūāpapa e puta mai ana i te whakatuwheratanga ihu. Ko te aukati i te mate taringa waenga e piki ake ana tētahi o ngā whāinga matua o te ET, ā, me karohia te whakatakotoranga o ngā stent e puta ake ana i tua atu i te ET, nā te mea ko te pa atu o ngā stent ki ngā tipu huakita ihu ka arahi pea ki te pikinga o ngā mate e piki ake ana.
Ko te kirihou poihau ngongo Eustachian mā roto i te whakatuwheratanga o te ihu he maimoatanga hou iti te whakaekenga mō te ngoikore o te ET e aro ana ki te whakatuwhera me te whakawhānui i te wāhanga cartilaginous o te ET8,9,10,46. Heoi, kāore anō kia tautuhia te tikanga rongoā matua47, ā, ko ōna putanga mo te wā roa kāore pea i te tino pai8,9,11,46. I raro i ēnei āhuatanga, ko te stenting whakarewa rangitahi he kōwhiringa maimoatanga whai hua pea mō ngā tūroro kāore e aro ki te whakatikatika poihau ngongo Eustachian, ā, kua whakaaturia te whaihua o te stenting ET i roto i ngā rangahau maha o mua i te haumanu. I whakatōngia ngā tūāpapa poly-l-lactide mā roto i te membrane tympanic i roto i ngā chinchilla me ngā rāpeti hei aromatawai i te manawanui me te whakahekenga i roto i te tinana ora17,18. Hei tāpiri, i hangaia he tauira hipi hei aromatawai i te kōtaha o ngā stents poihau whakarewa ka taea te whakawhānui i roto i te tinana ora. I roto i tā mātou rangahau o mua, i whakawhanakehia he tauira ET poaka hei tirotiro i te whaihua hangarau me te aromatawai i ngā raruraru i puta mai i te stent,19 e whakarato ana i te pūtake pakari mō tēnei rangahau ki te tirotiro i te whai huatanga o te SES mā te whakamahi i ngā tikanga kua whakatūria i mua. I roto i tēnei rangahau, i angitu te whakanoho o te SES ki te kiriuhi, ā, i aukati pai i te tipu o te kiko. Kāore he raruraru e pā ana ki te stent, engari i whara te mucosal i puta mai i te hipoki arataki whakarewa me te toto pa i memeha noa i roto i ngā wiki e 4. I runga i ngā raruraru pea o ngā hipoki whakarewa, he mea nui, he mea nui hoki te whakapai ake i te pūnaha tuku SES.
He iti noa ngā herenga o tēnei rangahau. Ahakoa he rerekē ngā kitenga histological i waenga i ngā rōpū, he iti rawa te maha o ngā kararehe i roto i tēnei rangahau mō tētahi tātaritanga tatauranga pono. Ahakoa i matapohia ngā kaimātakitaki e toru ki te aromatawai i te rerekētanga i waenga i ngā kaimātakitaki, i whakatauhia te nui o te urunga o ngā pūtau mumura i raro i te mucosa i runga i te tohatoha me te kiato o ngā pūtau mumura nā te uaua o te tatau i ngā pūtau mumura. Nā te mea i whakahaerehia tā mātou rangahau mā te whakamahi i tētahi maha iti o ngā kararehe nunui, kotahi te horopeta o te rongoā i whakamahia, kāore i whakahaerehia ngā rangahau pharmacokinetic in vivo. Me whai atu ngā rangahau hei whakaū i te horopeta pai o te rongoā me te haumaru o te sirolimus i roto i te ET. Hei whakamutunga, ko te wā aroturuki 4-wiki he herenga anō hoki o te rangahau, nō reira me whai rangahau mō te whai huatanga roa o te SES.
E whakaatu ana ngā hua o tēnei rangahau ka taea e te SES te aukati i te tipu o ngā kiko i puta mai i te whara miihini i muri i te whakatakotoranga o ngā tūāpapa Co-Cr ka taea te whakawhānui i roto i te tauira ET poaka. E whā wiki i muri i te whakatakotoranga o te stent, ko ngā taurangi e pā ana ki te tipu o ngā kiko i puta mai i te stent (tae atu ki te horahanga o te tipu o ngā kiko me te matotoru o te fibrosis submucosal) he iti ake i roto i te rōpū SES i tērā i roto i te rōpū whakahaere. Te āhua nei he whai hua te SES ki te aukati i te tipu o ngā kiko i puta mai i te tūāpapa i roto i ngā poaka ET. Ahakoa me whai rangahau anō hei whakamātautau i ngā rauemi stent me ngā horopeta pai rawa atu o ngā rongoā, he kaha rongoā ā-rohe tō te SES ki te aukati i te hyperplasia kiko ET i muri i te whakatakotoranga o te stent.
Di Martino, EF Whakamātautau mahi o te ngongo Eustachian: he whakahoutanga. Waikawa hauota 61, 467–476. https://doi.org/10.1007/s00106-013-2692-5 (2013).
Adil, E. & Poe, D. He aha te whānuitanga katoa o ngā maimoatanga hauora me ngā maimoatanga pokanga e wātea ana mō ngā tūroro e pāngia ana e te ngoikore o te ngongo Eustachian?. Adil, E. & Poe, D. He aha te whānuitanga katoa o ngā maimoatanga hauora me ngā maimoatanga pokanga e wātea ana mō ngā tūroro e pāngia ana e te ngoikore o te ngongo Eustachian?.Adil, E. me Poe, D. He aha te whānuitanga katoa o ngā maimoatanga hauora me ngā maimoatanga pokanga e wātea ana mō ngā tūroro e pāngia ana e te ngoikore o te ngongo Eustachian? Adil, E. & Poe, D. 咽鼓管功能障碍患者可使用的全方位内科和外科治疗方法是什么？ Adil, E. & Poe, D.Adil, E. me Poe, D. He aha te whānuitanga katoa o ngā maimoatanga hauora me ngā maimoatanga pokanga e wātea ana ki ngā tūroro e pāngia ana e te ngoikore o te ngongo Eustachian?Ngā Whakaaro o Nāianei. Te Rongoā Rongoā. Te Pokanga o te Upoko me te Kaki. 22:8-15. https://doi.org/10.1097/moo.0000000000000020 (2014).
Llewellyn, A. et al. Ngā wawaotanga mō te ngoikore o te ngongo eustachian i roto i ngā pakeke: he arotake pūnaha. hangarau hauora. Arotake. 18 (1-180), v-vi. https://doi.org/10.3310/hta18460 (2014).
Schilder, AG me ētahi atu. Te ngoikore o te ngongo Eustachian: te whakaae whānui mō ngā whakamāramatanga, ngā momo, ngā whakaaturanga haumanu, me te tautuhi mate. haumanu. Otolaryngology. 40, 407–411. https://doi.org/10.1111/coa.12475 (2015).
Bluestone, CD Te whanaketanga o te otitis media: te mahi a te ngongo Eustachian. Pediatrics. Infect. Dis. J. 15, 281–291. https://doi.org/10.1097/00006454-199604000-00002 (1996).
McCoul, ED, Singh, A., Anand, VK & Tabaee, A. Te whakawhānuitanga o te poihau o te ngongo Eustachian i roto i te tauira tūpāpaku: Ngā whakaaro hangarau, te pihi ako, me ngā arai pea. McCoul, ED, Singh, A., Anand, VK & Tabaee, A. Te whakawhānuitanga o te poihau o te ngongo Eustachian i roto i te tauira tūpāpaku: Ngā whakaaro hangarau, te pihi ako, me ngā arai pea.McCole, ED, Singh, A., Anand, VK me Tabai, A. Te whakawhānuitanga o te poihau o te ngongo eustachian i roto i te tauira trophoblastic: ngā whakaaro hangarau, te pihi ako, me ngā arai pea. McCoul, ED, Singh, A., Anand, VK & Tabaee, A. McCoul, ED, Singh, A., Anand, VK & Tabaee, A. 尸体model中少鼓管的气球 whakawhānui: whakaaro hangarau, ānau ako me nga raruraru pea.McCole, ED, Singh, A., Anand, VK me Tabai, A. Te whakawhānuitanga o te poihau o te ngongo eustachian i roto i te tauira trophoblastic: ngā whakaaro hangarau, te pihi ako, me ngā arai pea.Laryngoscope 122, 718–723. https://doi.org/10.1002/lary.23181 (2012).
Norman, G. et al. He arotake pūnaha o te iti o ngā taunakitanga mō te maimoatanga o te ngoikore o te ngongo eustachian: he aromatawai hangarau hauora. haumanu. Otolaryngology. Whārangi 39, 6-21. https://doi.org/10.1111/coa.12220 (2014).
Ockermann, T., Reineke, U., Upile, T., Ebmeyer, J. & Sudhoff, HH Te whakanui i te poihau Te pokanga Eustachian: He rangahau whaihua. Ockermann, T., Reineke, U., Upile, T., Ebmeyer, J. & Sudhoff, HH Te whakanui i te poihau Te pokanga Eustachian: He rangahau whaihua.Okkermann, T., Reineke, U., Upile, T., Ebmeyer, J. me Sudhoff, HH Te whakanui i te poihau o te Eustachian tuboplasty: he rangahau whaihua. Ockermann, T., Reineke, U., Upile, T., Ebmeyer, J. & Sudhoff, HH 球囊扩张咽鼓管成形术：可行性研究。 Ockermann, T., Reineke, U., Upile, T., Ebmeyer, J. & Sudhoff, HH.Okkermann T., Reineke U., Upile T., Ebmeyer J. me Sudhoff HH Te whakanui i te poihau o te angioplasty ngongo Eustachian: he rangahau whaihua.Ko te kaituhi. neuron. 31, 11:00–11:03. https://doi.org/10.1097/MAO.0b013e3181e8cc6d (2010).
Randrup, TS & Ovesen, T. Te pokatahi Eustachian Balloon: He arotake pūnaha. Randrup, TS & Ovesen, T. Te pokatahi Eustachian Balloon: He arotake pūnaha.Randrup, TS me Ovesen, T. Ballon, Te pokatahi Eustachian: he arotake pūnaha. Randrup, TS & Ovesen, T. Poihau Eustachian tuboplasty：系统评价。 Randrup, TS & Ovesen, T. Poihau Eustachian tuboplasty：系统评价。Randrup, TS me Ovesen, T. Ballon, Te pokatahi Eustachian: he arotake pūnaha.Te Rongoā Rongoā. Te Pokanga o te Upoko me te Kaki. 152, 383–392. https://doi.org/10.1177/0194599814567105 (2015).
Song, HY me ētahi atu. Te whakanui i te poihau fluoroscopic mā te whakamahi i tētahi waea arataki ngāwari mō te koretake o te mahi a te ngongo Eustachian. J. Vaske. uiuinga. irahiko. 30, 1562-1566. https://doi.org/10.1016/j.jvir.2019.04.041 (2019).
Silvola, J., Kivekäs, I. & Poe, DS Te whānui o te poihau o te wāhanga wheua o te ngongo Eustachian. Silvola, J., Kivekäs, I. & Poe, DS Te whānui o te poihau o te wāhanga wheua o te ngongo Eustachian. Silvola, J., Kivekäs, I. & Poe, DS Баллонная дилатация хрящевой части евстахиевой трубы. Silvola, J., Kivekäs, I. & Poe, DS Poihau whakawhanaungatanga o te wahi cartilaginous o te ngongo Eustachian. Silvola, J., Kivekäs, I. & Poe, DS 咽鼓管软骨部分的气球扩张。 Silvola, J., Kivekäs, I. & Poe, DS Silvola, J., Kivekäs, I. & Poe, DS Баллонная дилатация хрящевой части евстахиевой трубы. Silvola, J., Kivekäs, I. & Poe, DS Poihau whakawhanaungatanga o te wahi cartilaginous o te ngongo Eustachian.Te Rongoā Rongoā. Te Hautaka Pokanga o Shea. 151, 125–130. https://doi.org/10.1177/0194599814529538 (2014).
Song, HY me ētahi atu. Stent pania-nitinol ka taea te tiki: he wheako ki te rongoā i te 108 tūroro me ngā uauatanga esophageal kino. Uiui a J. Wask. irahiko. 13, 285-293. https://doi.org/10.1016/s1051-0443(07)61722-9 (2002).
Song, HY me ētahi atu. Ngā stent whakarewa e whakawhanui ana i a ia anō i roto i ngā tūroro hyperplasia prostatic benign mōrearea nui: he tirotiro roa. Radiology 195, 655–660. https://doi.org/10.1148/radiology.195.3.7538681 (1995).
Schnabl, J. et al. He hipi hei tauira kararehe nui mō ngā taputapu whakarongo kua whakatōkia ki te taringa waenga me te taringa o roto: he rangahau whaihua mō ngā tūpāpaku. Kaituhi. neurons. 33, 481–489. https://doi.org/10.1097/MAO.0b013e318248ee3a (2012).
Pohl, F. et al. Te tānga o te ngongo Eustachian hei rongoā mō te otitis media mau tonu – he rangahau whaihua mō ngā hipi. Te rongoā mō te upoko me te mata. 14, 8. https://doi.org/10.1186/s13005-018-0165-5 (2018).
Park, JH et al. Te whakatakotoranga ihu o ngā stent whakarewa ka taea te whakawhanui i te poihau: he rangahau mō te ngongo Eustachian i roto i te tūpāpaku tangata. J. Vaske. uiuinga. irahiko. 29, 1187-1193. https://doi.org/10.1016/j.jvir.2018.03.029 (2018).
Litner, JA me ētahi atu. Te manawanui me te haumaru o ngā stent ngongo eustachian poly-l-lactide mā te whakamahi i te tauira kararehe chinchilla. J. Intern. Advanced. Author. 5, 290–293 (2009).
Presti, P., Linstrom, CJ, Silverman, CA & Litner, J. Te stent ngongo Eustachian poly-l-lactide: Te manawanui, te haumaru me te mimiti i roto i te tauira rāpeti. Presti, P., Linstrom, CJ, Silverman, CA & Litner, J. Te stent ngongo Eustachian poly-l-lactide: Te manawanui, te haumaru me te mimiti i roto i te tauira rāpeti. Presti, P., Linstrom, CJ, Silverman, CA & Litner, J. Стент для евстахиевой трубы из поли-l-лактида: переносимость, безопасность безопасность и резоклина Presti, P., Linstrom, CJ, Silverman, CA & Litner, J. Te stent ngongo eustachian Poly-l-lactide: te manawanui, te haumaru, me te mimiti i roto i te tauira rāpeti. Presti, P., Linstrom, CJ, Silverman, CA & Litner, J. 聚-l-丙交酯咽鼓管支架：兔模型的耐受性、安全性和吸收。 Presti, P., Linstrom, CJ, Silverman, CA & Litner, J. 聚-l-丙交阿师鼓管板入：兔注册的耐受性、security and absorption。Presti, P., Linstrom, SJ, Silverman, KA me Littner, J. Te stent ngongo eustachian Poly-1-lactide: te manawanui, te haumaru, me te mimiti i roto i te tauira rāpeti.J. I waenganui i a rātou. Whakamua. Te kaituhi. 7, 1-3 (2011).
Kim, Y. et al. Te whaihua hangarau me te tātaritanga histological o ngā stent whakarewa ka taea te whakawhanui i te poihau kua whakanohoia ki roto i te ngongo Eustachian poaka. tauākī. te pūtaiao. 11, 1359 (2021).
Shen, JH me ētahi atu. Te whakanui ake i te kiko: he rangahau whakamātautau mō ngā stent kua pania ki te paclitaxel i roto i te tauira urethra kuri. Radiology 234, 438–444. https://doi.org/10.1148/radiol.2342040006 (2005).
Shen, JH et al. Te pānga o ngā tākai stent pania ki te dexamethasone ki te urupare kiko: he rangahau whakamātautau i roto i te tauira pūkahukahu kuri. EURO. irahiko. 15, 1241–1249. https://doi.org/10.1007/s00330-004-2564-1 (2005).
Kim, E.Yu. IN-1233 Ka Ārai te Stent Whakarewa Panipani i te Hyperplasia: He Rangahau Whakamātautau i roto i te Tauira Esophagus Rāpeti. Radiology 267, 396–404. https://doi.org/10.1148/radiol.12120361 (2013).
Bunger, KM me ētahi atu. Ngā stent poly-1-lactide e whakamahi ana i te Sirolimus e pirau ana hei whakamahi i roto i ngā oko toto ā-taha: he rangahau tuatahi mō ngā uaua carotid poaka. J. Surgical journal. tank rokiroki. 139, 77-82. https://doi.org/10.1016/j.jss.2006.07.035 (2007).