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A na-aga n'ihu n'usoro ọmụmụ dị iche iche gbasara stent Eustachian tube (ET), mana ejibeghị ya na mmemme ụlọ ọgwụ.N'ime ọmụmụ ihe izizi, ET scaffolds ejedebere na mmụba anụ ahụ na-akpata scaffold.Ịdị irè nke cobalt-chromium sirolimus-eluting stent (SES) na-egbochi mgbasa nke anụ ahụ na-eme ka ọkpụkpụ na-eme ka ọkpụkpụ stent na-amụba n'ụdị porcine ET.E kewara ezì isii ahụ ụzọ abụọ (ya bụ otu njikwa na otu SES) nwere ezi atọ n'otu ọ bụla.Ndị na-ahụ maka njikwa natara stent cobalt-chromium na-enweghị mkpuchi (n = 6), na otu SES natara stent cobalt-chromium na mkpuchi sirolimus-eluting (n = 6).A chụrụ otu niile n'àjà 4 izu mgbe etinyere stent.Ntinye stent gara nke ọma na ET niile na-enweghị nsogbu metụtara ịwa ahụ.Ọ dịghị nke ọ bụla n'ime stent nwere ike idowe ọdịdị okirikiri mbụ ha, a na-ahụkwa mkpọkọ imi n'ime na gburugburu stent n'otu abụọ ahụ.Nyocha akụkọ ihe mere eme gosiri na mpaghara mgbasawanye anụ ahụ na ọkpụrụkpụ nke submucosal fibrosis na otu SES dị ntakịrị karịa na otu njikwa.SES na-egosi na ọ dị irè n'igbochi mmụba anụ ahụ na-akpata scaffold na pigs ET.Otú ọ dị, a chọrọ ọmụmụ ihe ọzọ iji kwado ihe ndị kachasị mma maka stent na ọgwụ mgbochi.
Eustachian tube (ET) nwere ọrụ dị mkpa na ntị etiti (dịka ọmụmaatụ, ikuku ventilashion, igbochi nnyefe nke nje na nzuzo na nasopharynx)1.Ọ gụnyekwara nchebe megide ụda nasopharyngeal na regurgitation2.A na-emechikarị ET, mana ọ na-eji ilo, ugha, ma ọ bụ ịta ahụhụ na-emepe.Agbanyeghị, arụrụ ọrụ ET nwere ike ime ma ọ bụrụ na tube anaghị emeghe ma ọ bụ mechie nke ọma3,4.Arụghị ọrụ nke ET na-ebelata ọrụ ET na, ọ bụrụ na echekwaghị ọrụ ndị a, nwere ike ịmalite n'ime nnukwu mgbasa ozi otitis ma ọ bụ nke na-adịghị ala ala, otu n'ime ọrịa ndị a na-ahụkarị na omume ENT.Ọgwụgwọ ugbu a maka arụrụ ọrụ ET (dịka ọmụmaatụ, ịwa ahụ imi, ebe ikuku ikuku, na ọgwụ) na-eji na ndị ọrịa.Agbanyeghị, ọgwụgwọ ndị a nwere oke nrụpụta ma nwee ike ibute mgbochi ET, ọrịa, yana perforation tympanic nke na-enweghị ike ịgbagha 3,6,7.Eustachian tube balloon angioplasty ka ewebatala dịka ọgwụgwọ ọzọ maka arụrụ arụ ọrụ ET 8.Ọ bụ ezie na ọtụtụ ọmụmụ kemgbe 2010 egosila na nrụzi balloon Eustachian dị elu karịa ọgwụgwọ a na-emekarị maka ọrịa ET, ụfọdụ ndị ọrịa anaghị anabata dilatation8,9,10,11.Ya mere, stenting nwere ike ịbụ nhọrọ ọgwụgwọ dị irè12,13.N'agbanyeghị ọtụtụ ọmụmụ preclinical na-aga n'ihu na-enyocha ike teknụzụ na nzaghachi anụ ahụ mgbe etinyere stent na ET, hyperplasia anụ ahụ na-akpata stent n'ihi mmebi n'ibu na-anọgide na-enwe mgbagwoju anya 14,15,16,17,18,19.mkpuchi ọgwụ, nke a na-ebunye ihe na-eme ka ọ dịkwuo mma na-eme ka ọnọdụ a dịkwuo mma.
A na-eji stent na-emepụta ọgwụ na-egbochi in-stent restenosis nke anụ ahụ na neointimal hyperplasia kpatara mgbe etinyere stent.Na-emekarị, a na-eji ọgwụ ekpuchi stent scaffolds ma ọ bụ mkpuchi (dịka, Everolimus, paclitaxel, na sirolimus)20,23,24.Sirolimus bụ ọgwụ na-ahụ maka mgbochi proliferative nke na-egbochi ọtụtụ nzọụkwụ nke restenosis cascade (dịka ọmụmaatụ, mbufụt, hyperplasia neointimal, na collagen synthesis)25.Ya mere, ọmụmụ ihe a na-eche na stent nke sirolimus nwere ike igbochi hyperplasia anụ ahụ na-akpata stent na ET pigs (Nyocha 1).Ebumnuche nke ọmụmụ a bụ iji nyochaa ịdị irè nke sirolimus-eluting stent (SES) na-egbochi mgbasa nke anụ ahụ na-akpata stent mgbe etinyere stent na ụdị porcine ET.
Ihe atụ nke atụmatụ nke cobalt-chromium sirolimus-eluting stent (SES) maka ọgwụgwọ nke Eustachian tube dysfunction, na-egosi na sirolimus-eluting stent na-egbochi mmụba anụ ahụ na-akpata stent.
Cobalt-chromium (Co-Cr) alloy stent bụ nke ejiri laser ịkpụ Co-Cr alloy tubes (Genoss Co., Ltd., Suwon, Korea).Igwe okwu stent na-eji njikọ abụọ mepere emepe nwere ụlọ ejikọtara ọnụ maka mgbanwe dị elu yana ike radial kacha mma, mkpụmkpụ na nnabata.Nkịta ahụ nwere dayameta nke 3 mm, ogologo nke 18 mm, na ọkpụrụkpụ strut nke 78 µm (Fig. 2a).Ekpebiri akụkụ nke etiti Co-Cr alloy dabere na ọmụmụ anyị gara aga.
Cobalt-chromium (Co-Cr) alloy stent na metal ndu n'ọbọ maka Eustachian tube stent ntinye.Foto ndị a na-egosi (a) Co-Cr alloy stent na (b) balloon catheter nwere stent.(c) A na-ebunye catheter balloon na stent nke ọma.(d) Emepụtara n'ọbọ nduzi igwe maka ihe atụ tube Eustachian porcine.
A na-etinye Sirolimus n'elu stent site na iji teknụzụ ịgbasa ultrasonic.Emebere SES iji wepụta ihe fọrọ nke nta ka ọ bụrụ 70% nke ibu ọgwụ izizi (1.15 μg/mm2) n'ime ụbọchị 30 mbụ ka etinyechara ya.A na-etinye ihe mkpuchi 3 µm dị oke mkpa naanị n'akụkụ dị nso nke stent iji nweta profaịlụ ntọhapụ ọgwụ a chọrọ ma belata ego polymer;Ihe mkpuchi nke biodegradable a nwere copolymer nke lactic na glycolic acid na ngwakọta nke poly (1) -lactic acid)26,27.Co-Cr alloy stent bụ crimped na balloon catheters 3 mm na dayameta na 28 mm ogologo (Genoss Co., Ltd.; fig. 2b).A na-enweta stent ndị a na South Korea maka ọgwụgwọ ọrịa obi.
Shei ndu igwe emepụtara ọhụrụ maka ụdị ezi ET bụ nke igwe anaghị agba nchara (Fig 2c).Ihe dị n'ime na mpụta nke shei ahụ bụ 2 mm na 2.5 mm, n'otu n'otu, ngụkọta ogologo bụ 250 mm.A na-ehulata n'ọbọ 30 mm dị anya ka ọ bụrụ ọdịdị J na akụkụ 15 ° na axis iji mee ka ọ dị mfe site na imi gaa na nasopharyngeal orifice nke ET na ụdị ezi.
A kwadoro ọmụmụ ihe a site na Kọmitii Nlekọta Animal Animal Care and Use of Asan Institute of Life Sciences (Seoul, South Korea) ma na-akwado National Institutes of Health Guidelines for Humane Treatment of Laboratory Animals (IACUC-2020-12-189)..Emere ọmụmụ ihe a dịka ntuziaka ARRIVE siri dị.Ọmụmụ ihe a jiri 12 ET na 6 pigs na-atụ 33.8-36.4 n'arọ na ọnwa 3.E kewara ezì isii ahụ ụzọ abụọ (ya bụ otu njikwa na otu SES) nwere ezi atọ n'otu ọ bụla.Otu njikwa ahụ nwetara stent Co-Cr alloy na-enweghị mkpuchi, ebe ndị otu SES nwetara Co-Cr alloy stent eluting sirolimus.Ezi ezi niile nwere ohere ịnweta mmiri na nri n'efu ma debe ya na 24 ° C ± 2 ° C maka oge elekere 12 nke abalị.E mesịa, a na-achụ ezì nile n'àjà 4 izu mgbe etinyere stent.
Ezi ezi natara ngwakọta nke 50mg/kg zolazepam, 50mg/kg teletamide (Zoletil 50; Virbac, Carros, France) na 10mg/kg xylazine (Rompun; Bayer HealthCare, Les Varkouzins, Germany).Mgbe ahụ, a na-etinye tube 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 nkwụsịtụ.A na-etinye ezì n'ọnọdụ dị elu na endoscopy baseline (VISERA 4K UHD rhinolaryngoscope; Olympus, Tokyo, Japan) ka a na-eme iji nyochaa isi nasopharyngeal nke ET.A na-ebuli n'ọbọ nduzi ígwè site n'oghere imi ruo na nasopharyngeal orifice nke ET n'okpuru nchịkwa endoscopic (Fig. 3a, b).A na-etinye catheter balloon, stent corrugated, site na onye na-ebubata ya na ET ruo mgbe ọnụ ya zutere nguzogide na osteochondral isthmus nke ET (Fig 3c).Ejiri saline jupụta na catheter balloon nke ọma na ikuku 9, dịka onye nyocha manometer siri kpebisie ike (Fig 3d).E wepụrụ catheter balloon mgbe etinyere stent (Fig 3f), ma jiri nlezianya nyochaa oghere nasopharyngeal endoscopy maka nsogbu ịwa ahụ (Fig 3f).All pigs mere endoscopy tupu na ozugbo stenting, yana 4 izu mgbe stenting, iji chọpụta patency nke stent saịtị na gburugburu secretions.
Usoro nka maka itinye stent na eustachian tube (ET) nke ezi n'okpuru njikwa endoscopic.(a) Ihe onyonyo endoscopic na-egosi oghere nasopharyngeal (akụ) yana n'ọbọ ntụ ntụ ígwè etinyere (akụ).(b) Ịtinye n'ọbọ ígwè (akụ) n'ime oghere imi.(c) A na-ewebata catheter balloon stent (akụ) n'ime ET site n'ọbọ (akụ).(d) Kateta balloon (akụ) agbachaala nke ọma.(e) Ọgwụgwụ dị nso nke stent na-apụta site na ET orifice nke nasopharynx.(f) Onyonyo Endoscopic na-egosi patency stent lumen.
Emechara ezì niile site n'inye 75 mg/kg potassium chloride site na ịgba ọgwụ mgbochi ntị.A na-eme akụkụ sagittal nke etiti nke isi porcine site na iji chainsaw sochiri ya wee jiri nlezianya wepụta ihe nlele anụ ahụ ET maka nyocha akụkọ ihe mere eme (Foto mgbakwunye. 1a,b).Edobere ihe nlele anụ ahụ ET na 10% formalin na-anọpụ iche maka awa 24.
mmanya na-aba n'anya dị iche iche wepụrụ n'omume ET anụ ahụ n'usoro.A na-etinye ihe nlele na resin blocks site na ntinye na ethylene glycol methacrylate (Technovit 7200® VLC; Heraus Kulzer GMBH, Wertheim, Germany).A na-eme akụkụ axial na ụdị anụ ahụ ET agbakwunyere na akụkụ dị nso na nke dị anya (Mgbakwunye Fig. 1c).Mgbe ahụ, a na-etinye ihe mgbochi polymer na ihe nkiri slide acrylic.Ihe mmịfe nke resin bụ microground ma jiri akwụkwọ silicon carbide nke ọkpụrụkpụ dị iche iche gbuchapụ ruo ọkpụrụkpụ nke 20µm site na iji sistemụ grid (Apparatebau GMBH, Hamburg, Germany).Ejiri hematoxylin na eosin na-acha odo odo wee nyochaa ihe mmịfe niile.
A na-eme nyocha akụkọ ihe mere eme iji chọpụta pasent nke mmụba anụ ahụ, ọkpụkpụ nke submucosal fibrosis, na ogo nke ntinye sel na-egbuke egbuke.A gbakọọ pasentị hyperplasia anụ ahụ nwere mpaghara obe dị warara ET site na idozi nha anya:
A tụrụ ọkpụrụkpụ fibrosis submucosal kwụ ọtọ site na stent struts ruo submucosa.A na-ekpebi ogo nke infiltration cell infiltration nke onwe ya site na nkesa na njupụta nke mkpụrụ ndụ na-egbuke egbuke, ya bụ: 1st degrees (dị nwayọọ) - otu leukocyte infiltration;2nd ogo (dị nwayọọ na agafeghị oke) - leukocyte infiltration leukocyte focal;3rd ogo (agafeghị oke) - jikọtara.na leukocytes enweghị ike ịmata ọdịiche dị n'etiti ebe onye ọ bụla;ọkwa 4 (nke dị oke oke ma dị njọ) leukocytes na-agbasa nke ọma na-abanye n'ime submucosa dum, yana ọkwa 5 (siri ike) na-agbasa infiltration na otutu foci nke necrosis.A na-enweta ọkpụrụkpụ nke fibrosis submucosal na ogo nke infiltration cell mkpali site na nkezi isi asatọ gburugburu gburugburu.Emere nyocha akụkọ ihe mere eme nke ET site na iji microscope (BX51; Olympus, Tokyo, Japan).Enwetara nha ndị ahụ site na iji sọftụwia CaseViewer (CaseViewer; 3D HISTECH Ltd., Budapest, Hungary).Nyocha nke data histological dabeere na nkwenye nke ndị na-ekiri ihe atọ na-etinyeghị aka na ọmụmụ ihe ahụ.
Eji Mann-Whitney U-ule iji nyochaa ọdịiche dị n'etiti otu dị ka achọrọ. A p <0.05 ka a tụlere dị ka ihe dị mkpa. A p <0.05 ka a tụlere dị ka ihe dị mkpa. Значение p <0,05 считалось статистически значимым. A tụlere p uru <0.05 dị ka ọnụ ọgụgụ dị mkpa. p <0.05 被认为具有统计学意义。 p <0.05 p <0,05 считали статистически значимым. p <0.05 ka a tụlere dị ka ihe dị mkpa. Emere Bonferroni-Mgbanwe Mann–Whitney U-ule maka p ụkpụrụ <0.05 iji chọpụta ndịiche otu (p <0.008 dị ka ọnụ ọgụgụ dị ịrịba ama). Emere Bonferroni-Mgbanwe Mann-Whitney U-ule maka p ụkpụrụ <0.05 iji chọpụta ndịiche otu (p <0.008 dị ka ọnụ ọgụgụ dị ịrịba ama). U-критерий Манна-Уитни с поправкой на Бонферрони был выполнен для значений p <0,05 атистически значимое). Emere ule Mann-Whitney U nke Bonferroni maka p ụkpụrụ <0.05 iji chọpụta ndịiche otu (p <0.008 dị ka ọnụ ọgụgụ dị ịrịba ama).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 для выявления гируй статистически значимым). Emere Bonferroni-gbanwee Mann-Whitney U-ule maka p <0.05 iji chọpụta ndịiche otu (p <0.008 dị ịrịba ama ọnụ ọgụgụ).Emere nyocha ndekọ aha site na iji ngwa SPSS (ụdị 27.0; SPSS, IBM, Chicago, IL, USA).
Ndokwa stent niile nwere ihe ịga nke ọma na teknụzụ.A na-etinye n'ọbọ nduzi ígwè nke ọma na orifice nasopharyngeal nke ET n'okpuru nchịkwa endoscopic, ọ bụ ezie na a na-ahụ mmerụ ahụ mucosal na ọbara ọgbụgba na 4 nke 12 ụdị (33.3%) n'oge ntinye n'ọbọ ígwè.Mgbe izu anọ gachara, ọbara ọgbụgba na-apụ apụ kwụsịrị ozugbo.Ezi pigs niile dị ndụ ruo na njedebe nke ọmụmụ ihe na-enweghị nsogbu ndị metụtara stent.
E gosipụtara nsonaazụ endoscopy na eserese 4. N'ime nyocha nke izu 4, stent nọgidere na-adị na ezì niile.A na-ahụ mkpokọta mucus na gburugburu ET stent niile (100%) ET na otu njikwa na atọ (50%) nke isii ET na otu SES, ọ nweghịkwa ọdịiche dị n'etiti otu abụọ ahụ (p = 0.182).Ọ nweghị stent arụnyere nwere ike idowe udi okirikiri.
Ihe onyonyo Endoscopic nke Eustachian tube (ET) nke ezi na otu njikwa yana otu nwere cobalt-chromium stent (CXS) eluting sirolimus.(a) Foto endoscopic Baseline ewepụtara tupu etinye stent na-egosi oghere nasopharyngeal (akụ) nke ET.(b) Endoscopic onyonyo ewepụtara ozugbo etinyere stent na-egosi ET nke ntinye stent.A hụla ọbara ọgbụgba kọntaktị n'ihi n'ọbọ ndu igwe (akụ).(c) Ihe onyonyo Endoscopic emere izu 4 ka etinyere stent na-egosi mkpokọta imi gburugburu stent (akụ).(d) Foto endoscopic na-egosi na stent enweghị ike ịdịgide gburugburu (akụ).
E gosipụtara nchoputa nke akụkọ ihe mere eme na eserese 5 na ihe mgbakwunye 2. Mmụba nke anụ ahụ na submucosal fibrous proliferation n'etiti posts stent na ET lumen nke otu abụọ ahụ. Pasent pasent nke hyperplasia anụ ahụ dị ukwuu na njikwa njikwa karịa na otu SES (79.48% ± 6.82% vs. 48.36% ± 10.06%, p <0.001). Pasent pasent nke hyperplasia anụ ahụ dị ukwuu na njikwa 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% ротив 48,36% ± 10,06%, p <0,001). Onu ogugu onu ogugu nke hyperplasia nke anụ ahụ dị ukwuu 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 грипот 6, 8% 48,36% ± 10,06%, p <0,001). Onu ogugu nke hyperplasia anụ ahụ dị na njikwa ahụ dị elu karịa na otu SES (79.48% ± 6.82% vs. 48.36% ± 10.06%, p <0.001). Ọzọkwa, ọkpụrụkpụ nke submucosal fibrosis dịkwa elu nke ukwuu na njikwa njikwa karịa na otu SES (1.41 ± 0.25 vs. 0.56 ± 0.20 mm, p <0.001). Ọzọkwa, ọkpụrụkpụ nke submucosal fibrosis dịkwa elu nke ukwuu na njikwa njikwa karịa na otu SES (1.41 ± 0.25 vs. 0.56 ± 0.20 mm, p <0.001). Боле того, средня толщина подслизистого фиброза также была значительно выше в контрольной, 4. 1 ± 0,25 против 0,56 ± 0,20 мм, p <0,001). Ọzọkwa, ọkpụrụkpụ nke submucosal fibrosis dịkwa elu nke ukwuu na njikwa 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) Крометого, средня толщина подслизистого фиброза в контрольной 1 ± 0,25 против 0,56 ± 0,20 мм, p <0,001). Tụkwasị na nke ahụ, ọkpụrụkpụ nke submucosal fibrosis dị na njikwa ahụ dịkwa elu karịa na otu SES (1.41 ± 0.25 vs. 0.56 ± 0.20 mm, p <0.001).Otú ọ dị, ọ dịghị ihe dị iche iche dị ịrịba ama na ogo nke ntinye sel na-egbuke egbuke n'etiti otu abụọ ahụ (otu njikwa [3.50 ± 0.55] vs. SES otu [3.00 ± 0.89], p = 0.270).
Nyocha nke nyocha akụkọ ihe mere eme nke ìgwè abụọ nke stent etinye na Eustachian lumen.(a, b) Mpaghara hyperplasia anụ ahụ (1 nke a na b) na ọkpụrụkpụ nke fibrosis submucosal (2 nke a na b; akụ abụọ) dị ukwuu na njikwa njikwa karịa na otu SES nwere strut stenting (ntụpọ ojii), mpaghara nke lumen narrowed (odo odo) na mpaghara stent mbụ (acha ọbara ọbara).Ogo nke infiltration cell mkpali (3 nke a na b; akụ) adịghị iche nke ukwuu n'etiti otu abụọ ahụ.(c) Nsonaazụ akụkọ ihe mere eme nke pasent pasent nke hyperplasia anụ ahụ, (d) ọkpụrụkpụ nke fibrosis submucosal, na (e) ogo nke infiltration cell inflammatory 4 izu mgbe etinyere stent na otu abụọ ahụ.SES, cobalt-chromium sirolimus eluting stent.
Stent na-ekpochapụ ọgwụ na-enyere aka melite stent patency ma gbochie stent restenosis20,21,22,23,24.Ihe mgbochi stent na-ebute site na nhazi anụ ahụ granulation na mgbanwe anụ ahụ fibrous na akụkụ dị iche iche na-adịghị vaskụla, gụnyere esophagus, trachea, gastroduodenum, na bile ducts.A na-etinye ọgwụ ndị dị ka dexamethasone, paclitaxel, gemcitabine, EW-7197, na sirolimus n'elu eriri waya ma ọ bụ mkpuchi stent iji gbochie ma ọ bụ na-emeso hyperplasia anụ ahụ mgbe stent placement29,30,34,35,36.A na-enyocha ihe ọhụrụ ọhụrụ n'oge na-adịbeghị anya n'ọhịa nke stent multifunctional na-eji nkà na ụzụ fusion na-arụsi ọrụ ike maka ọgwụgwọ ọrịa ndị na-adịghị vaskụla vaskụla37,38,39.N'ime ọmụmụ ihe gara aga na ụdị porcine ET, a hụrụ mmụba anụ ahụ na-akpata scaffold.Ọ bụ ezie na aghọtachaghị mmepe stent na ET, nzaghachi anụ ahụ mgbe etinyere stent dị ka nke akụkụ ahụ ndị ọzọ na-adịghị vaskụla luminal 19.N'ime ọmụmụ ihe ugbu a, a na-eji SES mee ihe iji gbochie mgbasawanye anụ ahụ na-akpata scaffold na ụdị porcine ET.Sirolimus na-egbu egbu na agwaetiti pancreatic na ahịrị mkpụrụ ndụ beta, na-ebelata ike cell ma na-akwalite apoptosis40,41.Mmetụta a nwere ike inye aka igbochi nguzobe nke mmụba anụ ahụ site na-akpali akpali ọnwụ cell.Ọmụmụ ihe anyị gosiri na ojiji mbụ e ji stent ọgwụ eme ihe na ET gbochiri anụ ahụ na-eme ka stent na-abawanye na ET nke ọma.
Co-Cr alloy stent nke balloon-expandable ejiri mee ihe n'ọmụmụ ihe a dị ngwa ngwa dịka a na-ejikarị agwọ ọrịa akwara obi 42 .Na mgbakwunye, Co-Cr alloys nwere ihe eji arụ ọrụ (dịka ọmụmaatụ, ike radial dị elu na ndị na-adịghị ahụkebe) 43 .Dị ka endoscopy nke ọmụmụ ihe ugbu a, Co-Cr alloy stent eji maka ET nke ezì enweghị ike ịnọgide na-enwe ọdịdị gburugburu na ezì niile n'ihi enweghị ike zuru ezu na enweghị ike ịgbasa onwe ya.Enwere ike gbanwee ọdịdị nke stent etinyere site na mmegharị gburugburu ET nke anụmanụ dị ndụ (dịka ọmụmaatụ, ịta na ilo).Njirimara akụrụngwa nke Co-Cr alloy stent abụrụla ihe ọjọọ na ntinye nke porcine ET stent.Na mgbakwunye, itinye stent na isthmus nwere ike ime ka ET meghee kpamkpam.ET na-emeghe ma ọ bụ gbatịa na-adịgide adịgide na-enye ohere ikwu okwu na ụda nasopharyngeal, reflux eriri afọ, na pathogens1 ịbanye n'ime ntị etiti, na-eme ka mgbakasị ahụ na ọrịa mucosal.Ya mere, a ga-ezere oghere nasopharyngeal na-adịgide adịgide.Ya mere, n'inye nhazi nke cartilage ET, a na-akacha mma ka a na-emepụta ihe ndị na-emepụta ihe site na alloys ebe nchekwa ọdịdị nke nwere ihe ndị dị elu, dị ka nitinol.N'ozuzu, a na-ahụ ihe mgbapụta dị arọ na na gburugburu oghere nasopharyngeal nke stent.Ebe ọ bụ na a na-egbochi mmegharị nke mucociliary nkịtị nke imi, a na-atụ anya na ihe nzuzo ahụ ga-agbakọta na scaffolds na-apụta site na oghere imi.Mgbochi ịrịgo ọrịa ntị etiti bụ otu n'ime ebumnuche ET bụ isi, ebe ekwesịrị izere itinye stent nke na-apụta n'ofe ET, ebe ọ bụ na kọntaktị stent na ahịhịa nje nasopharyngeal nwere ike ibute ọrịa na-arị elu.
Eustachian tube balloon plasty site na oghere nasopharyngeal bụ ọgwụgwọ ọhụrụ dị ntakịrị na-emerụ ahụ maka arụrụ ọrụ ET nke ezubere imeghe na ịgbasa akụkụ cartilaginous nke ET8,9,10,46.Agbanyeghị, achọpụtabeghị usoro ọgwụgwọ ahụ dị n'okpuru47 yana nsonaazụ ogologo oge ya nwere ike ịbụ suboptimal8,9,11,46.N'okpuru ọnọdụ ndị a, stenting metal nwa oge nwere ike ịbụ nhọrọ ọgwụgwọ dị irè maka ndị ọrịa na-adịghị anabata nrụzi balloon tube Eustachian, na egosiputala ike nke ET stenting n'ọtụtụ ọmụmụ ihe.Akụnyere ihe mkpuchi poly-l-lactide site na akpụkpọ anụ tympanic na chinchillas na oke bekee iji chọpụta nnabata na mmebi na vivo17,18.Na mgbakwunye, e mepụtara ihe atụ atụrụ iji nyochaa profaịlụ nke balloon igwe na-agbasa stent na vivo.N'ime ọmụmụ ihe anyị gara aga, e mepụtara ihe ngosi ET porcine iji nyochaa ohere ọrụ aka na nyocha nke nsogbu ndị na-akpata stent,19 na-enye ihe ndabere siri ike maka ọmụmụ ihe a iji nyochaa irè SES site na iji ụzọ ndị e guzobere na mbụ.N'ime ọmụmụ ihe a, e debere SES nke ọma na cartilage ma gbochie mgbasawanye anụ ahụ nke ọma.Enweghị nsogbu ọ bụla metụtara stent, mana enwere mmerụ ahụ mucosal kpatara n'ọbọ ntuziaka ígwè nwere ọbara ọgbụgba kọntaktị nke kpebiri ozugbo n'ime izu anọ.N'inye nsogbu ndị nwere ike ịnweta n'ọbọ ígwè, imeziwanye usoro nnyefe SES dị ngwa ngwa ma dị oke egwu.
Ọmụmụ ihe a nwere oke ụfọdụ.Ọ bụ ezie na nchọpụta akụkọ ihe mere eme dịgasị iche iche n'etiti otu dị iche iche, ọnụ ọgụgụ ụmụ anụmanụ dị na ọmụmụ ihe a dị ntakịrị maka nyocha ndekọ ọnụ ọgụgụ a pụrụ ịdabere na ya.Ọ bụ ezie na ndị na-ekiri ihe atọ kpuru ìsì iji chọpụta mgbanwe ndị na-ahụ maka ndị na-ahụ maka ndị na-ahụ anya, a na-ekpebi ogo nke submucosal inflammatory cell infiltration dabere na nkesa na njupụta nke mkpụrụ ndụ na-egbuke egbuke n'ihi ihe isi ike nke ịgụta mkpụrụ ndụ mkpali.Ebe ọ bụ na a na-eduzi ọmụmụ ihe anyị site na iji ọnụ ọgụgụ buru ibu buru ibu, a na-eji otu dose nke ọgwụ ahụ eme ihe, na vivo pharmacokinetic ọmụmụ emeghị.A chọrọ ọmụmụ ihe ndị ọzọ iji kwado usoro ọgwụgwọ kachasị mma na nchekwa nke sirolimus na ET.N'ikpeazụ, oge nleba anya nke 4-izu bụkwa njedebe nke ọmụmụ ihe, ya mere ọmụmụ banyere ịdị irè ogologo oge nke SES dị mkpa.
Nsonaazụ nke ọmụmụ a na-egosi na SES nwere ike igbochi mgbasa nke anụ ahụ na-emerụ ahụ nke ọma mgbe etinyechara balloon-expandable Co-Cr alloy scaffolds na ụdị porcine ET.Izu anọ mgbe etinyere stent, mgbanwe dị iche iche jikọtara ya na mmụba anụ ahụ na-akpata stent (gụnyere mpaghara mgbasa nke anụ ahụ na ọkpụrụkpụ nke fibrosis submucosal) dị ntakịrị na SES otu karịa na njikwa.SES na-egosi na ọ dị irè n'igbochi mmụba anụ ahụ na-akpata scaffold na pigs ET.Ọ bụ ezie na achọrọ nyocha ọzọ iji nwalee ihe stent kacha mma na usoro nke ndị na-achọ ọgwụ, SES nwere ikike ọgwụgwọ mpaghara iji gbochie hyperplasia anụ ahụ ET mgbe etinyere stent.
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