Analysis of blood flow in the tympanic membrane: the use of intravital fluorescence microscopy.
The successful healing of the tympanic membrane (TM) following myringotomy or tympanoplasty is dependent upon the maintenance of the blood supply to the injured area of the TM. The blood supply of the TM is derived from the manubrial plexus and the peripheral plexus of vessels. This study concentrated on measuring blood flow derived from the manubrial vessels. The TM of the guinea pig was used as an in vivo model. Ten Outbred Hartley guinea pigs were anesthetized with Inactin 100 mg/kg, the common carotid artery cannulated, and FITC-dextran 150 injected intra-arterially. Blood pressures (mean 66.0 mmHg +/- 5.0 mmHg) and heart rates (330 bpm +/- 12.0 bpm) remained relatively constant throughout the experiment. Following injection of FITC-dextran 150, the TM was visualized under fluorescence microscopy and images recorded by video recorder; measurements of vessel diameter, blood velocity, and blood flow were made. Analysis of the in vivo studies revealed blood flow in the tympanic membrane to travel in two directions: down the manubrial artery towards the periphery and up the manubrial veins from vessels in the periphery. The manubrial artery divides and branches into a series of arcading vessels that extend towards the periphery of the TM. Manubrial artery diameter was measured (mean 0.0521 mm +/- 0.0004 mm) and blood flow calculated (mean 0.0439 mm3/min +/- 0.0007 mm3/min). Blood flow from the manubrial artery supplying the superior quadrants (0.18 mm3/min +/- 0.01) was statistically greater when compared to the blood flow in the inferior quadrants (0.08 mm3/min +/- 0.007) (p less than .001).
Division of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7070.
R J
RJ
Triana
J
J
Prazma
V N
VN
Carrasco
H C
HC
Pillsbury
D000818:Animals; D001783:Blood Flow Velocity; D001808:Blood Vessels / Q000033:anatomy & histology; D006168:Guinea Pigs; D008856:Microscopy, Fluorescence; D012039:Regional Blood Flow; D014432:Tympanic Membrane / Q000098:blood supply*