Study on establishment of cochlear preserving type minimally invasive underwater endoscopic labyrinthine approach for neurofibromatosis type II

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K11171
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Otorhinolaryngology
• Research Institution: Tohoku University
• Principal Investigator: Yamauchi Daisuke 東北大学, 大学病院, 講師 (70361102)
• Co-Investigator(Kenkyū-buntansha): 香取 幸夫 東北大学, 医学系研究科, 教授 (20261620)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 水中内視鏡 / 内耳機能温存 / 聴神経腫瘍

Outline of Final Research Achievements

In underwater endoscopic partial labyrinthectomy with sheep and guinea pigs, cochlear function preservation before and after the operation was verified using the auditory brainstem response, and differences due to types of perfusion fluid were investigated. The previous experiments and clinical data were analyzed, and it was suggested that the perfusion fluid should be artificial spinal fluid with the composition closest to the perilymph fluid. In addition, it is thought that the approach to the pyramidal part by partial labyrinthectomy using underwater endoscope technique is feasible in surgery simulation using a human temporal bone model. As future tasks, it was considered desirable to study the influence of mechanical manipulation on labyrinth and to improve the closing material that can be reliably sealed in water.

Free Research Field

耳鼻咽喉科学

Academic Significance and Societal Importance of the Research Achievements

神経線維腫症Ⅱ型は両側聴神経腫瘍によって両側高度感音難聴を来す指定難病であるが、手術治療や放射線治療を施行した際の聴力温存率は満足できるもので はないため、有効な聴力の残存している間は経過観察することが多い。一方で、最近我々が施行している水中内視鏡下耳科手術は内耳より明瞭に観察できる手術法であり、聴力温存に有効である。本研究課題は経迷路法による聴神経腫瘍摘出術の際に水中内視鏡下に迷路削開を行い、蝸牛を保護し聴力を温存するための低侵襲な手術方法を開発する基盤となった。