Pathology of labyrinthine ossification

1991 ◽  
Vol 105 (8) ◽  
pp. 621-624 ◽  
Author(s):  
Christopher deSouza ◽  
Michael M. Paparella ◽  
Pat Schachern ◽  
Tae H. Yoon
Keyword(s):  
Inner Ear ◽  
Otitis Media ◽  
Osseous Tissue ◽  
Scala Tympani ◽  
Fabry’S Disease ◽  
Fabry's Disease ◽  
Basal Turn ◽  
Vascular Compromise ◽  
Temporal Bones

AbstractOssification of the inner ear is the result of multifactorial pathogeneses, such as infection or malignant infiltration, and otosclerosis. Ossification of the innerear spaces is a well documented sequela of suppurative labyrinthitis. In this study of human temporal bones, sections from 14 patients (28 temporal bones)were studied. In additionto the osseous tissue within the inner ear, findings included neoplasms, otosclerosis, otitis media, trauma, and Fabry's disease. We have attempted to correlate these conditions and their influence on the formation of osseous tissue within the spaces of the inner ear. Tympanogenic infection and vascular compromise were found to play an important role in ossification. The scala tympani ofthe basal turn of the cochlea was frequently the site involved.

Otologic Histopathology of Fabry's Disease

1989 ◽  
Vol 98 (5) ◽  
pp. 359-363 ◽  
Author(s):  
Patricia A. Schachern ◽  
Michael M. Paparella ◽  
Donald A. Shea ◽  
Tae H. Yoon
Keyword(s):  
Temporal Bone ◽  
Ganglion Cells ◽  
Spiral Ganglion ◽  
Cell Loss ◽  
The Body ◽  
Spiral Ligament ◽  
Fabry’S Disease ◽  
Fabry's Disease ◽  
Temporal Bones ◽  
Spiral Ganglia

Fabry's disease is a rare progressive X-linked recessive disorder of glycosphingolipid metabolism. The accumulation of glycosphingolipids occurs in virtually all areas of the body, including the endothelial, perithelial, and smooth-muscle cells of blood vessels, the ganglion cells of the autonomic nervous system, and the glomeruli and tubules of the kidney. Although otologic symptoms have been described in these patients, to our knowledge there have been no temporal bone histopathologic reports. We describe the clinical histories, audiometric results, and temporal bone findings of two patients with this rare disorder. Both patients demonstrated a bilateral sloping sensorineural hearing loss audiometrically. Middle ear findings of seropurulent effusions and hyperplastic mucosa were seen in all four temporal bones. Strial and spiral ligament atrophy in all turns, and hair cell loss mainly in the basal turns, were also common findings. The number of spiral ganglion cells was reduced in all temporal bones; however, evidence of glycosphingolipid accumulation was not observed in the spiral ganglia.

scholarly journals Microimaging of a novel intracochlear drug delivery device in combination with cochlear implants in the human inner ear

2021 ◽  
Author(s):  
Eric Lehner ◽  
Matthias Menzel ◽  
Daniel Gündel ◽  
Stefan K. Plontke ◽  
Karsten Mäder ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Inner Ear ◽  
Cochlear Implants ◽  
Drug Carrier ◽  
Drug Application ◽  
Scala Tympani ◽  
Carrier System ◽  
Temporal Bones ◽  
Drug Carrier System ◽  
Human Inner Ear

AbstractThe effective delivery of drugs to the inner ear is still an unmet medical need. Local controlled drug delivery to this sensory organ is challenging due to its location in the petrous bone, small volume, tight barriers, and high vulnerability. Local intracochlear delivery of drugs would overcome the limitations of intratympanic (extracochlear) and systemic drug application. The requirements for such a delivery system include small size, appropriate flexibility, and biodegradability. We have developed biodegradable PLGA-based implants for controlled intracochlear drug release that can also be used in combination with cochlear implants (CIs), which are implantable neurosensory prosthesis for hearing rehabilitation. The drug carrier system was tested for implantation in the human inner ear in 11 human temporal bones. In five of the temporal bones, CI arrays from different manufacturers were implanted before insertion of the biodegradable PLGA implants. The drug carrier system and CI arrays were implanted into the scala tympani through the round window. Implanted temporal bones were evaluated by ultra-high-resolution computed tomography (µ-CT) to illustrate the position of implanted electrode carriers and the drug carrier system. The µ-CT measurements revealed the feasibility of implanting the PLGA implants into the scala tympani of the human inner ear and co-administration of the biodegradable PLGA implant with a CI array. Graphical abstract

scholarly journals Atraumatic Insertion of a Cochlear Implant Pre-Curved Electrode Array by a Robot-Automated Alignment with the Coiling Direction of the Scala Tympani

2021 ◽  
pp. 1-8
Author(s):  
Renato Torres ◽  
Baptiste Hochet ◽  
Hannah Daoudi ◽  
Fabienne Carré ◽  
Isabelle Mosnier ◽  
...  
Keyword(s):  
Navigation System ◽  
Electrode Array ◽  
Automated System ◽  
Cone Beam ◽  
Scala Tympani ◽  
Basal Turn ◽  
Coiling Direction ◽  
Grinding Technique ◽  
Temporal Bones ◽  
Automated Alignment

<b><i>Introduction:</i></b> Electrode array translocation is an unpredictable event with all types of arrays, even using a teleoperated robot in a clinical scenario. We aimed to compare the intracochlear trauma produced by the HiFocus™ Mid-Scala (MS) electrode array (Advanced Bionics, Valencia, CA, USA) using a teleoperated robot, with an automated robot connected to a navigation system to align the pre-curved tip of the electrode array with the coiling direction of the scala tympani (ST). <b><i>Methods:</i></b> Fifteen freshly frozen temporal bones were implanted with the MS array using the RobOtol® (Collin, Bagneux, France). In the first group (<i>n</i> = 10), the robot was teleoperated to insert the electrode array into the basal turn of the ST under stereomicroscopic vision, and then the array was driven by a slow-speed hydraulic insertion technique with an estimated placement of the pre-curved electrode tip. In the second group (<i>n</i> = 5), 3 points were obtained from the preoperative cone-beam computed tomography: the 2 first defining the ST insertion axis of the basal turn and a third one at the center of the ST at 270°. They provided the information to the automated system (RobOtol® connected with a navigation system) to automatically align the electrode array with the ST insertion axis and to aim the pre-curved tip toward the subsequent coiling of the ST. After this, the electrode array was manually advanced. Finally, the cochleae were obtained and fixed in a crystal resin, and the position of each electrode was determined by a micro-grinding technique. <b><i>Results:</i></b> In all cases, the electrode array was fully inserted into the cochlea and the depth of insertion was similar using both techniques. With the teleoperated robotic technique, translocations of the array were observed in 7/10 insertions (70%), but neither trauma nor array translocation occurred with automated robotic insertion. <b><i>Conclusion:</i></b> We have successfully tested an automated insertion system (robot + navigation) that could accurately align a pre-curved electrode array to the axis of the basal turn of the ST and its subsequent coiling, which reduced intracochlear insertion trauma and translocation.

scholarly journals Modern approaches to the diagnosis of vestibulopathy in patients with chronic suppurative otitis media

2020 ◽  
pp. 53-59
Author(s):  
Azamat Razakov ◽  
Abdumannap Abdukayumov ◽  
Shavkat Amanov ◽  
Nargiza Karimova ◽  
Jakhongir Olіmov
Keyword(s):  
Hearing Loss ◽  
Inner Ear ◽  
Otitis Media ◽  
Video Recording ◽  
Diagnostic Methods ◽  
Chronic Suppurative Otitis Media ◽  
Spontaneous Nystagmus ◽  
Suppurative Otitis Media ◽  
The Republic ◽  
Temporal Bones

Chronic suppurative otitis media (CSOM), according to statistics, is one of the most common diseases in otorhinolaryngological practice, accounting for, on average, from 5.8 to 20.7% of all ENT pathology. The incidence of CSOM in the Republic of Uzbekistan is up to 6.5%. The pathological process in CSOM leads to the destruction of the bone structures of the middle ear and progressive hearing loss, and in some cases - to an increase in vestibular symptoms. Purpose of the study: vestibular disorders in chronic purulent otitis media using modern diagnostic methods. Materials and methods: In order to study the features of cochleovestibular disorders in CSOM, in the Department of Congenital and Acquired ENT Diseases at the Republican Specialized Scientific and Practical Medical Center of Pediatrics of the Ministry of Health of the Republic of Uzbekistan were examined 13 patients with CSOM with labial complications . All patients underwent a set of standard examinations: ENT examination, otoscopy with video recording, stato coordination tests, complex vestibulometry using modern computer video nystagmography, a set of audiometric tests, computed tomography of the temporal bones. Results: 38.4% of patients complained of dizziness, but when using the method of active survey complaints of dizziness were detected in 61.5% of cases. The analysis of the results of stato-coordination tests in 30.7% of patients revealed a deviation towards the affected ear, in 61.5% of cases - spontaneous nystagmus. Conclusions: the results allow us to conclude that the main complaint of patients with CSOM are of hearing loss (100%), discharge from the ear cavity (100%), complaints of vestibular manifestations were present in 30 to 55% of subjects. Detection of mixed deafness in 53.8% of patients during audiological examination indicates involvement in the process of the inner ear, hence all patients with CSOM, regardless of the duration and stage of the inflammatory process, should conduct a comprehensive vestibulometric examination to determine vestibular status, the degree of involvement of inner ear structures , prognosis, choice of treatment tactics and prevention of complications.

Cochlear and Vestibular Lesions in Capsular Otosclerosis as Seen in Microdissection

1978 ◽  
Vol 87 (2_suppl2) ◽  
pp. 1-40 ◽  
Author(s):  
Lars-Göran Johnsson ◽  
Joseph E. Hawkins ◽  
Fred H. Linthicum
Keyword(s):  
Hair Cells ◽  
Round Window ◽  
Organ Of Corti ◽  
Otic Capsule ◽  
Scala Tympani ◽  
Toxic Factor ◽  
Basal Turn ◽  
Vestibular Pathology ◽  
Temporal Bones ◽  
State Of Activity

In 24 temporal bones from patients with otosclerosis prepared by the method of microdissection and surface preparations, otosclerotic foci could be clearly seen during removal of the otic capsule. The state of activity of each focus was estimated on the basis of its consistency and vascularity. Small anterior foci constituted the most common form of involvement of the otic capsule. All were judged to be inactive, and none of them appeared to have caused obvious sensorineural degeneration. No cases of “pure cochlear otosclerosis” were seen. Sensorineural degeneration was associated with large anterior foci which reached the upper basal turn. One specimen displayed a circumscribed sensorineural degeneration in the upper basal turn, with an almost exact correspondence between the location and extent of the cochlear lesion and the site of invasion by the otosclerotic process in the bone and endosteum bordering on scala media and scala tympani. It is postulated that a toxic factor had diffused from the focus and acted directly on the organ of Corti. When multiple foci were present they were usually poorly defined. The otosclerotic process involved the round window, with new lamellar bone formation in the scala tympani of the lower half of the basal turn. The most extensive sensorineural degeneration in the entire material was seen in this group. One specimen also had severe cochlear hydrops. In three specimens large shunts were observed to connect the otosclerotic foci with the cochlear vasculature, which was severely dilated. Where otosclerosis involved the endosteum of the scala tympani, loss of vessels was observed. One specimen with extensive active capsular otosclerosis had severe sensorineural degeneration of the vestibular system. Vestibular pathology in fenestrated ears is also described. In a specimen from a patient with no caloric reaction, numerous hair cells were present in the macular organs.

S239 – Labyrinthine Changes in Otitis Media

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P155-P155
Author(s):  
Shruti Siddharth Joglekar ◽  
Armin Farajzadeh Deroee ◽  
Norimasa Morita ◽  
Sebahattin Cureoglu ◽  
Schachern Patricia ◽  
...  
Keyword(s):  
Inner Ear ◽  
Otitis Media ◽  
Stria Vascularis ◽  
Chronic Otitis Media ◽  
Inflammatory Cells ◽  
Spiral Ligament ◽  
Histopathologic Study ◽  
Significant Difference ◽  
Temporal Bones ◽  
Inflammatory Changes

Objectives Otitis media causes labyrinthine changes and subsequent sensorineural hearing loss. The aim of this histopathologic study was to evaluate the extension of inflammation to the inner ear and its effects. Methods Out of 614 temporal bones with otitis media, 47 (30 cases) with chronic and 35 (21 cases) with purulent were selected for histopathologic study. Subjects with a history of acoustic trauma, head trauma, ototoxic drugs and other otologic and systemic diseases affecting the inner ear were excluded. The pattern of labyrinthine inflammation was classified as localized purulent, localized serous, generalized seropurulent and generalized serous. Inner ear findings were compared to age-matched controls. Results 19% of temporal bones with chronic and 9% of temporal bones with purulent otitis media showed labyrinthine inflammatory changes. In chronic otitis media, inflammatory changes were: 56% localized purulent; 22% localized serous; 11% generalized seropurulent; and 11% generalized serous. Inflammatory changes in temporal bones with purulent otitis media included: 67% localized purulent; and 33% generalized seropurulent. Pathological findings included: serofibrinous precipitates and inflammatory cells in the scala tympani of basal turn and cochlear aqueduct; significant decrease in area of stria vascularis (p = 0.033); and loss of hair cells in the organs of Corti. No significant difference was found in area of spiral ligament area or number of fibrocytes in diseased and control bones. Conclusions Middle ear/inner ear interaction in otitis media can result in labyrinthine inflammation and cochlear damage. Early diagnosis and treatment of otitis media is important in preventing inner ear damage.

Comparative Measurements of Cochlear Apparatus

1968 ◽  
Vol 11 (2) ◽  
pp. 229-235 ◽  
Author(s):  
Makoto Igarashi ◽  
Robert G. Mahon ◽  
Shizuo Konishi
Keyword(s):  
Cross Section ◽  
Basilar Membrane ◽  
Stria Vascularis ◽  
The Other ◽  
Tectorial Membrane ◽  
Spiral Ligament ◽  
Scala Tympani ◽  
Basal Turn ◽  
Temporal Bones ◽  
Scala Vestibuli

Micromeasurements of horizontal midmodiolar sections of temporal bones were performed to obtain the dimensions of the different cochlear partitions in the squirrel monkey, the cat, and the rat. The width of the basilar membrane and the tectorial membrane were larger in the apical turn than in the basal turn in all three species. The thickness of the spiral ligament, the width of Reissner’s membrane, and the width of the stria vascularis were larger in the basal turn than in the apical turn. The cross-section areas of scala vestibuli and scala tympani in the three species were larger in the basal turn than in the other turns.

scholarly journals A novel cochlear measurement that predicts inner-ear malformation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tawfiq Khurayzi ◽  
Fida Almuhawas ◽  
Abdulrahman Alsanosi ◽  
Yassin Abdelsamad ◽  
Úna Doyle ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Inner Ear ◽  
Type I ◽  
Basal Turn ◽  
Type Iii ◽  
A Value ◽  
Inner Ear Malformation ◽  
C Value ◽  
Temporal Bones ◽  
Value Measurement

AbstractThe A-value used in cochlear duct length (CDL) estimation does not take malformed cochleae into consideration. The objective was to determine the A-value reported in the literature, to assess the accuracy of the A-value measurement and to evaluate a novel cochlear measurement in distinguishing malformed cochlea. High resolution Computer Tomography images in the oblique coronal plane/cochlear view of 74 human temporal bones were analyzed. The A-value and novel C-value measurement were evaluated as predictors of inner ear malformation type. The proximity of the facial nerve to the basal turn was evaluated subjectively. 26 publications report on the A-value; but they do not distinguish normal vs. malformed cochleae. The A-values of the normal cochleae compared to the cochleae with cochlear hypoplasia, incomplete partition (IP) type I, -type II, and -type III were significantly different. The A-value does not predict the C-value. The C-values of the normal cochleae compared to the cochleae with IP type I and IP type III were significantly different. The proximity of the facial nerve to the basal turn did not relate to the type of malformation. The A-value is different in normal vs. malformed cochleae. The novel C-value could be used to predict malformed anatomy, although it does not distinguish all malformation types.

Sensorineural Hearing Loss after Otitis Media with Effusion and Subacute Mastoiditis after Viral Infections of the Upper Respiratory Tract: A Comparative Study of Conservative and Surgical Treatment

2016 ◽  
Vol 95 (9) ◽  
pp. E18-E27 ◽  
Author(s):  
Thomas Wilhelm ◽  
Tim Stelzer ◽  
Rudolf Hagen
Keyword(s):  
Hearing Loss ◽  
Surgical Treatment ◽  
Sensorineural Hearing Loss ◽  
Inner Ear ◽  
Otitis Media ◽  
Viral Infections ◽  
Otitis Media With Effusion ◽  
Sensorineural Hearing ◽  
Upper Respiratory Tract ◽  
Temporal Bones

Involvement of the middle ear after viral infections of the upper airways may lead to serous otitis media with effusion in the absence of bacterial infection. This can be accompanied by a concomitant shading of the mastoid air cells, which could manifest as a reduced opacity on computed tomography (CT) in the absence of a history of chronic mastoiditis or acute inflammatory signs. This can lead to a subsequent impairment of inner ear function. CT scans reveal an extended pneumatization of the temporal bones in affected patients. Inner ear hearing impairment can probably be attributed to a concomitant labyrinthine reaction—the so-called toxic inner ear lesion. If no remission occurs within 5 days after initial conservative treatment (paracentesis or hemorrheologic infusions), surgical treatment with a mastoidectomy can accelerate hearing restoration. We conducted a retrospective, nonrandomized study of short- and long-term hearing outcomes in patients with a toxic inner ear lesion who had been treated with conservative measures alone (CONS group) or with surgery (SURG group) in a tertiary care referral center. Our study group was made up of 52 consecutively presenting patients (57 ears) who had been seen over a 10-year period; there were 20 patients (21 ears) in the CONS group and 32 patients (36 ears) in the SURG group. Initially, 15 CONS patients (75%) and 18 SURG patients (56%) complained of dizziness or a balance disorder. The initial averaged sensorineural hearing loss (over 0.5, 1.0, 2.0, and 3.0 kHz) was 32.4 ± 15.6 dB in the CONS group and 35.4 ± 12.0 dB in the SURG group. At follow-up (mean: 31.7 mo), the SURG group experienced a significantly greater improvement in hearing (p = 0.025). We conclude that patients with viral otitis media and concomitant noninflammatory mastoiditis with impairment of inner ear function (sensorineural hearing loss) experience a better hearing outcome when a mastoidectomy is performed during primary treatment.

Fabry's disease

1972 ◽  
Vol 105 (5) ◽  
pp. 774-774
Author(s):  
A. Chaitin
Keyword(s):  
Fabry’S Disease ◽  
Fabry's Disease
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