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• W2939851946 abstract "Acute and chronic otitis media are among the most common diseases in children and adults. Approximately 20% of acute otitis media persist longer than three months and turn into chronic otitis media. Eardrum perforation, ossicular chain disruption and other severe damages of the middle ear can be the result and hearing impairment as well as hearing loss the long term consequences. Thus, an early successful treatment, preventing chronic otitis media and severe hearing impairment, has to be one of the major goals in otorhinolaryngology. Despite profound improvements in the development of therapeutic options, few approaches deal with the Eustachian tube itself, which is one of the key factors in the development of these diseases. Valid therapeutic interventions to restore Eustachian tube function are not available hitherto. The minimal invasive implantation of stents into the auditory tube to improve middle ear ventilation and facilitate tubal opening could be an innovative option. One of the obstacles is a missing in vivo model where stents in their original dimension for human use can be tested pre-clinically. Thus, the aim of this thesis was the implementation of a minimal invasive surgical approach for the in vivo stenting of the Eustachian tube in a large animal model and in addition, to identify a method for the functional evaluation of the implanted medical device.  For the evaluation of the middle ear function tympanometry in conscious sheep was performed. Sheep were used as animal model based on previously performed cadaver studies identifying this species as the ideal candidate. The presented methods for the evaluation of a stent implanted in the Eustachian tube are the following: the minimal-invasive method of stent application, induced aseptic middle ear inflammation with effusion, evaluation of the in vivo reaction on the implant in the region of the pharyngeal orifice by means of an endoscopic score, tympanometry for the assessment of middle ear function and structures, computed tomography for the assessment of location of the stent and the ventilation of middle ear and stent, and histologic analysis of tissue formation, stent diameter and regeneration or reparation of prismatic and ciliated epithelium. Commercial coronary stents were bilaterally implanted into the Eustachian tubes of three blackface sheep and remained implanted for 12 weeks. Implantation of the stent was possible in each case. The used combination of in vivo and ex vivo tests displayed ventilated middle ears and incorporation of the struts into tissue topped with ciliated epithelium. The stent was expanded in all 4 parts of the analysed section of the Eustachian tube. Additionally, the stent appeared to be sufficiently fixed in the cartilaginous part of the Eustachian tube. In endoscopic examination of the external auditory canal no symptoms of otitis externa, eardrum perforation or otitis media with effusion were apparent. Tympanometry provided reliable results for the evaluation of middle ear function in conscious sheep. Thus, it can be inferred that this combination of tests already provided a diverse spectrum of data, facilitating the evaluation of the studied stent. In general, the methods were very well suitable to provide the necessary data according to the used stent. It can be concluded that the here presented assessment of stents in the large animal model of the sheep provide a profound basis for the testing of these kinds of medical devices in pre-clinical studies. The transfer of the animal model from in vitro to in vivo could be demonstrated, as well as the suitability of the proceeded tests for the valuation of the used implant." @default.
• W2939851946 created "2019-04-25" @default.
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• W2939851946 date "2016-01-01" @default.
• W2939851946 modified "2023-09-27" @default.
• W2939851946 title "Stenting of the Tuba auditiva Eustachii as a valid treatment concept in chronic otitis media, chroinic auditory tube dysfunction and ists sequelae" @default.
• W2939851946 hasPublicationYear "2016" @default.
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