Guinea pig'de gürültüye bağlı işitme kaybında intratimpanik PRP uygulamasının etkisinin değerlendirilmesi
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Dosyalar
Tarih
2022
Yazarlar
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Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Guinea piglerde gürültüye bağlı işitme kaybında intratimpanik PRP uygulamasının etkinliğini değerlendirdiğimiz çalışmamızda, ABR ile normal işitme eşiği ve DPOEA ile emisyon varlığı saptanan 32 adet erişkin pigmente Hartley suşu kobayın 8 adedi kan donörü olarak ayrılmış, geri kalan 24 adet kobay 6-10 kHz frekansında, geniş band formunda, 110+/5 dB SPL şiddetinde gürültü uygulamasına günde 90 dakika olmak üzere ardışık 3 gün süreyle maruz bırakılarak gürültüye bağlı işitme kaybı modellemesi yapılmıştır. Gürültüye maruziyet sonrası tüm kobaylarda son gürültü dozu sonrası elektrofizyolojik ölçümler tekrarlanmıştır. Ardından randomize olarak 3 gruba ayrılarak her gruptaki kobayların rastlantısal olarak seçilen birer kulaklarına Grup 1’de yer alan kobaylar için serum fizyolojik, Grup 2’de yer alan kobaylar için 4 mg/ml deksametazon, Grup 3’te yer alan kobaylar için ise kan donörü grubundaki kobaylardan intrakardiyak yolla alınan kandan hazırlanan allojenik PRP; son gün gürültü maruziyeti sonrası ilk 8 saat içerisinde olacak şekilde intratimpanik yolla tek doz enjeksiyon yapılmıştır. İkinci ölçümler ve enjeksiyonlar sonrası 7. günde tüm gruplarda elektrofizyolojik ölçümler tekrarlanmış ve sakrifikasyon sonrası ultrastrüktürel incelemeler için tüm kobayların temporal kemikleri hazırlanmış, kokleadaki tüy hücre hasarı ve koklea dejenerasyonu istatistiksel olarak karşılaştırılmıştır. Tüm gruplarda, çalışılan tüm DPOAE frekansları SNR ortalamalarınıngrup içi karşılaştırmasında bazal ölçüm-gürültü sonrası ölçüm ile bazal ölçüm-son ölçüm arasında istatistiksel anlamlı değişim izlendi (p<0,05). Ancak gürültü sonrası ölçüm ile son ölçüm arasında tüm gruplarda ve tüm frekanslarda SNR değer ortalamalarında son ölçümde yükselme gözlenmiş olsa da istatistiksel anlamlı fark elde edilemedi. Son ölçüm açısından gruplar arası ortalama SNR değerlerinde 3130 Hz haricindeki frekanslarda anlamlı fark saptanmadı. 3130 Hz’de Grup 3’ün SNR ortalaması (12,3 ± 5), Grup 1’den (8,6 ± 5,7) anlamlı ölçüde yüksekti. Tone burst ABR eşikleri açısından grup içi değerlendirmede bazal ölçüm- gürültü sonrası ölçüm arasında, gürültü sonrası ölçüm-son ölçüm arasında ve bazal ölçüm-son ölçüm arasında Grup 1 ve 2’de istatistiksel olarak anlamlı değişim mevcuttu. Ancak Grup 3’te 1000 Hz’de bazal ölçüm ile son ölçüm arasında (p=0,07), 12000 Hz’de gürültü sonrası ölçümson ölçüm arasında (p=0,054) ve 16000 Hz’de gürültü sonrası ölçüm-son ölçüm arasında (p=0,07) istatistiksel anlamlı fark saptandı. Bazal ölçüm-son ölçüm arası eşik değer değişim ortalaması 1000 Hz ve 4000 Hz’de Grup 3’te diğer gruplara göre daha düşüktü ve istatistiksel açıdan anlamlı fark mevcuttu. Klik ABR verileri açısından gruplar arasında son ölçümlerde 1. dalga amplitüdü Grup 3’te Grup 1 ve 2’ye göre anlamlı ölçüde yüksekti (p=0,027), bunun dışında anlamlı farklılık yoktu. Scanning elektron mikroskopi ile yapılan değerlendirmede kan donörü olarak kullanılan, manipülasyon yapılmayan kobay kulaklarına ait örneklerde morfoloji normal iken,deney gruplarında yer alan, gürültüye maruz kalan ancak intratimpanik manipülasyon yapılmayan kulaklara ait örneklerde ağır dereceli dejenerasyon saptandı. Serum fizyolojik uygulaması yapılan grupta (Grup 1) ağır, deksametazon uygulanan grupta (Grup 2) orta, PRP uygulanan grupta (Grup 3) hafif dereceli dejenerasyon saptanmış olup Grup 3’te görülen bulgular Grup 1 ve 2’den istatistiki olarak anlamlı izlendi. Bu çalışmada gürültüye bağlı işitme kaybında intratimpanik PRP uygulamasının; morfolojik açıdan rejenerasyon üzerine olumlu etkisinin bulunduğunu, kısa izlem sürelerinde elektrofizyolojide sınırlı düzeyde değişimler saptanabildiğini, rejenerasyonun işitme eşiği ve elektrofizyolojik bulgulara yansıması için daha uzun izlem sürelerine ihtiyaç bulunduğunu ifade edebilmekteyiz.
In our study, in which we evaluated the effectiveness of intratympanic PRP application in noise-induced hearing loss in guinea pigs, 8 of 32 adult pigmented Hartley strains guinea pigs with normal hearing threshold with ABR and presence of emission with DPOAE were allocated as blood donors, and the remaining 24 guinea pigs were in 6-10 kHz frequency, in wide band form, 110 +/-5 dB SPL intensity NİHL modeling was performed by exposure to noise for 90 minutes a day for 3 consecutive days. Electrophysiological measurements were repeated after the last dose of noise in all guinea pigs after exposure to noise.Then, they were randomly divided into 3 groups and each of the guinea pigs in each group was given a randomly selected ear, with saline for the guinea pigs in Group 1, 4 mg/ml dexamethasone for the guinea pigs in Group 2, for the guinea pigs in group 3, allogeneic PRP prepared from the blood taken by the intracardiac puncture from the guinea pigs in the blood donor group;a single intratympanic injection was administered within the first 8 hours after noise exposure on the last day.Electrophysiological measurements were repeated in all groups on the 7th day after the second measurements and injections, and temporal bones of all guinea pigs were prepared for ultrastructural examinations after sacrification, hair cell damage in the cochlea and cochleal degeneration were compared statistically. In all groups, a statistically significant difference was observed between baseline measurement - post-noise measurement and baseline measurement - final measurement in the in-group comparison of all studied DPOAE frequencies (p<0.05). However, although an increase was observed in the mean SNR values between the post-noise measurement and the last measurement in all groups and all frequencies in the last measurement, no statistically significant difference could be obtained. In terms of the last measurement, no significant difference was found in the mean SNR values between the groups at frequencies other than 3130 Hz. At 3130 Hz, the mean SNR of Group 3 (12.3 ± 5) was significantly higher than Group 1 (8.6 ± 5.7). In terms of tone burst ABR thresholds, there was a statistically significant difference between baseline measurement- post-noise measurement, post-noise measurement- post-measurement, and baseline measurement-post measurement in Group 1 and 2 in terms of tone burst ABR thresholds. However, in Group 3, 1000 Hz between baseline measurement and last measurement (p=0.07), post-noise measurement-last measurement at 12000 Hz (p=0.054), and post-noise measurement-last measurement at 16000 Hz (p=0.07) statistically significant difference wasn’t found. The mean of threshold change between baseline measurement and last measurement was lower in Group 3 at 1000 Hz and 4000 Hz, and there was a statistically significant difference. In terms of click ABR data, there is a statistically significant difference between the groups. 3 was significantly higher than Groups 1 and 2 (p=0.027), other than that there was no significant difference. In the evaluation made by scanning electron microscopy, the morphology was normal in the samples of the guinea pigs that were not manipulated and used as blood donors, while severe degeneration was detected in the samples of the ears in the experimental groups, that were exposed to noise but not subjected to intratympanic manipulation. Severe degeneration was detected in the group in which saline was administered (Group 1), moderate degeneration in the group administered dexamethasone (Group 2), and mild degeneration in the group in which PRP was applied (Group 3), and the findings in Group 3 were statistically significant in Groups 1 and 2. In this study, intratympanic PRP application in noise-induced hearing loss; we can state that it has a positive effect on regeneration in terms of morphology, limited changes in electrophysiology can be detected in short follow-up periods, longer follow-up periods are needed for the reflection of regeneration on hearing threshold and electrophysiological findings.
In our study, in which we evaluated the effectiveness of intratympanic PRP application in noise-induced hearing loss in guinea pigs, 8 of 32 adult pigmented Hartley strains guinea pigs with normal hearing threshold with ABR and presence of emission with DPOAE were allocated as blood donors, and the remaining 24 guinea pigs were in 6-10 kHz frequency, in wide band form, 110 +/-5 dB SPL intensity NİHL modeling was performed by exposure to noise for 90 minutes a day for 3 consecutive days. Electrophysiological measurements were repeated after the last dose of noise in all guinea pigs after exposure to noise.Then, they were randomly divided into 3 groups and each of the guinea pigs in each group was given a randomly selected ear, with saline for the guinea pigs in Group 1, 4 mg/ml dexamethasone for the guinea pigs in Group 2, for the guinea pigs in group 3, allogeneic PRP prepared from the blood taken by the intracardiac puncture from the guinea pigs in the blood donor group;a single intratympanic injection was administered within the first 8 hours after noise exposure on the last day.Electrophysiological measurements were repeated in all groups on the 7th day after the second measurements and injections, and temporal bones of all guinea pigs were prepared for ultrastructural examinations after sacrification, hair cell damage in the cochlea and cochleal degeneration were compared statistically. In all groups, a statistically significant difference was observed between baseline measurement - post-noise measurement and baseline measurement - final measurement in the in-group comparison of all studied DPOAE frequencies (p<0.05). However, although an increase was observed in the mean SNR values between the post-noise measurement and the last measurement in all groups and all frequencies in the last measurement, no statistically significant difference could be obtained. In terms of the last measurement, no significant difference was found in the mean SNR values between the groups at frequencies other than 3130 Hz. At 3130 Hz, the mean SNR of Group 3 (12.3 ± 5) was significantly higher than Group 1 (8.6 ± 5.7). In terms of tone burst ABR thresholds, there was a statistically significant difference between baseline measurement- post-noise measurement, post-noise measurement- post-measurement, and baseline measurement-post measurement in Group 1 and 2 in terms of tone burst ABR thresholds. However, in Group 3, 1000 Hz between baseline measurement and last measurement (p=0.07), post-noise measurement-last measurement at 12000 Hz (p=0.054), and post-noise measurement-last measurement at 16000 Hz (p=0.07) statistically significant difference wasn’t found. The mean of threshold change between baseline measurement and last measurement was lower in Group 3 at 1000 Hz and 4000 Hz, and there was a statistically significant difference. In terms of click ABR data, there is a statistically significant difference between the groups. 3 was significantly higher than Groups 1 and 2 (p=0.027), other than that there was no significant difference. In the evaluation made by scanning electron microscopy, the morphology was normal in the samples of the guinea pigs that were not manipulated and used as blood donors, while severe degeneration was detected in the samples of the ears in the experimental groups, that were exposed to noise but not subjected to intratympanic manipulation. Severe degeneration was detected in the group in which saline was administered (Group 1), moderate degeneration in the group administered dexamethasone (Group 2), and mild degeneration in the group in which PRP was applied (Group 3), and the findings in Group 3 were statistically significant in Groups 1 and 2. In this study, intratympanic PRP application in noise-induced hearing loss; we can state that it has a positive effect on regeneration in terms of morphology, limited changes in electrophysiology can be detected in short follow-up periods, longer follow-up periods are needed for the reflection of regeneration on hearing threshold and electrophysiological findings.
Açıklama
Anahtar Kelimeler
Gürültüye bağlı işitme kaybı, Plateletten zengin plazma, Otoakustik emisyon, Spontan, Uyarılmış potansiyeller, İşitsel beyinsapı, Mikroskopi, Elektron, Tarama, Hearing loss, Noise-induced, Platelet rich plasma, Otoacoustic emission, Spontaneous, Evoced potentials, Auditory brainstem, Microscopy, Electron, Scanning
