将汉普郡绵羊作为人工耳蜗植入的大型动物模型

Nicholas A. Waring, Alexander Chern, Brandon J. Vilarello, Yew Song Cheng, Chaoqun Zhou, Jeffrey H. Lang, Elizabeth S. Olson, Hideko Heidi Nakajima
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摘要

背景绵羊被提议作为研究人工耳蜗植入的大型动物模型。然而,之前的绵羊研究报告称,面神经(FN)会遮挡圆窗膜(RWM),因此需要牺牲面神经或在面后开孔以进入面神经后方的中耳腔进行人工耳蜗植入。我们研究了汉普郡绵羊与萨福克-多塞特绵羊的 RWM 手术入路,以及汉普郡绵羊通过面部凹陷入路进行人工耳蜗植入的可行性。方法对尸体绵羊头部的 16 块颞骨(10 块汉普郡绵羊和 6 块萨福克-多塞特绵羊)进行解剖,通过扩展面部凹陷入路获得 RWM 的手术入路。采用圣托马斯医院(STH)分类法对RWM能见度进行分级。在两个汉普郡样本中进行了人工耳蜗(CI)电极阵列插入。对每块颞骨进行显微 CT 扫描,确认电极阵列的适当位置和内耳结构的分割。结果汉普郡标本的 RWM 可见度平均为 83%,萨福克-多塞特标本为 59%(p = 0.0262)。汉普郡 3 个标本的 RWM 可见度为 I 类(100% 可见度),7 个标本的可见度为 IIa 类(50% 可见度)。萨福克-多塞特的 RWM 可见度在四个标本中为 IIa 型,在两个标本中为 IIb 型(可见度为 50%)。在萨福克-多塞特标本中,FN似乎更多地向前侧延伸。结论汉普郡绵羊似乎是一种合适的大型动物模型,可在不牺牲 FN 的情况下通过扩展面凹方法插入 CI 电极。在这个小样本中,与萨福克-多塞特羊相比,汉普郡羊标本的 RWM 可见度更高。因此,汉普郡绵羊可能比其他品种的绵羊更易于耳蜗植入,其FN和面部凹陷的解剖结构与人类更为相似。
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Hampshire Sheep as a Large-Animal Model for Cochlear Implantation

Background

Sheep have been proposed as a large-animal model for studying cochlear implantation. However, prior sheep studies report that the facial nerve (FN) obscures the round window membrane (RWM), requiring FN sacrifice or a retrofacial opening to access the middle-ear cavity posterior to the FN for cochlear implantation. We investigated surgical access to the RWM in Hampshire sheep compared to Suffolk-Dorset sheep and the feasibility of Hampshire sheep for cochlear implantation via a facial recess approach.

Methods

Sixteen temporal bones from cadaveric sheep heads (ten Hampshire and six Suffolk-Dorset) were dissected to gain surgical access to the RWM via an extended facial recess approach. RWM visibility was graded using St. Thomas’ Hospital (STH) classification. Cochlear implant (CI) electrode array insertion was performed in two Hampshire specimens. Micro-CT scans were obtained for each temporal bone, with confirmation of appropriate electrode array placement and segmentation of the inner ear structures.

Results

Visibility of the RWM on average was 83% in Hampshire specimens and 59% in Suffolk-Dorset specimens (p = 0.0262). Hampshire RWM visibility was Type I (100% visibility) for three specimens and Type IIa (> 50% visibility) for seven specimens. Suffolk-Dorset RWM visibility was Type IIa for four specimens and Type IIb (< 50% visibility) for two specimens. FN appeared to course more anterolaterally in Suffolk-Dorset specimens. Micro-CT confirmed appropriate CI electrode array placement in the scala tympani without apparent basilar membrane rupture.

Conclusions

Hampshire sheep appear to be a suitable large-animal model for CI electrode insertion via an extended facial recess approach without sacrificing the FN. In this small sample, Hampshire specimens had improved RWM visibility compared to Suffolk-Dorset. Thus, Hampshire sheep may be superior to other breeds for ease of cochlear implantation, with FN and facial recess anatomy more similar to humans.

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