Schuknecht’s Crusade Against Myths in Otology

2016 ◽  
Author(s):  
Robert W. Baloh
Keyword(s):  
Inner Ear ◽  
Temporal Bone ◽  
Viral Infections ◽  
Endolymphatic Hydrops ◽  
Fibrous Tissue ◽  
Vestibular Neuritis ◽  
Shunt Surgery ◽  
Ear Diseases ◽  
Eighth Nerve ◽  
Human Temporal Bone

Like Joseph Toynbee, Harold Schuknecht believed that the only way to develop rational treatments for inner ear diseases was to understand the pathology of these diseases. Schuknecht used his human temporal bone studies to “refute the conceptual validity of several popular otologic therapies.” Probably the most controversial of these was the treatment of Ménière’s disease with endolymphatic shunt surgery. Schuknecht argued the concept that the endolymph sac can be drained to relieve endolymphatic hydrops is a pedantic notion at best. He studied numerous human temporal bone specimens of patients who had had shunts placed in the endolymphatic sac, and in every case the shunt devices were ensheathed in fibrous tissue. He debunked many other controversial treatments in otolaryngology. He argued that most cases of sudden deafness and acute vertigo (vestibular neuritis) were due to viral infections of the inner ear and eighth nerve, and that vascular treatments were inappropriate.

scholarly journals Stapedoplasty – Surgical Treatment of Hearing Loss Caused by Otosclerosis

2016 ◽  
Vol 1 (6) ◽  
pp. 126
Author(s):  
Jeļena Šaboviča ◽  
Renāta Klagiša
Keyword(s):  
Hearing Loss ◽  
Surgical Treatment ◽  
Inner Ear ◽  
Temporal Bone ◽  
Hearing Results ◽  
Functional Deficit ◽  
Human Temporal Bone

<p>Otosclerosis is a primary osteodystrophy which affects a localized area within the human temporal bone. Hearing loss is the most functional deficit caused by otosclerosis. However, tinnitus is frequently reported by otosclerotic patients, especially in those patients with inner ear involvement. The best therapy in achieving a significant improvement is surgery - stapedoplasty. Analysis of early hearing results (1 month after surgery) shows efficiency of surgical treatment and improvement in hearing.</p>

Experimental Viral Infections of the Inner Ear II. Simian Virus 40 Induced Tumors of the Temporal Bone

1979 ◽  
Vol 88 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Larry E. Davis ◽  
George T. Nager ◽  
Richard T. Johnson
Keyword(s):  
Inner Ear ◽  
Choroid Plexus ◽  
Temporal Bone ◽  
Viral Infections ◽  
Choroid Plexus Papilloma ◽  
Internal Auditory Canal ◽  
Simian Virus 40 ◽  
Simian Virus ◽  
Cochlear Aqueduct ◽  
Temporal Bones

Pathological and virological studies were performed on temporal bones of 23 hamsters which developed tumors subsequent to neonatal inoculation of simian virus 40 (SV40). Four to five months after viral inoculation, 22 hamsters developed undifferentiated sarcomas in the subcutaneous space adjacent to the temporal bone. Nine tumors invaded the temporal bone, occasionally extending to the subarachnoid space but not to the inner ear. Choroid plexus papillomas developed in four animals, with one tumor demonstrating invasion of the cochlear aqueduct, internal auditory canal, and cochlear modiolus. Cells grown from a sarcoma and a choroid plexus papilloma contained tumor antigen and established that the tumors were SV40 virus induced.

scholarly journals Volume-of-Interest Imaging of the Inner Ear in a Human Temporal Bone Specimen Using a Robot- Driven C-Arm Flat Panel Detector CT System

2011 ◽  
Vol 33 (10) ◽  
pp. E124-E128 ◽  
Author(s):  
D. Kolditz ◽  
T. Struffert ◽  
Y. Kyriakou ◽  
A. Bozzato ◽  
A. Dörfler ◽  
...  
Keyword(s):  
Inner Ear ◽  
Temporal Bone ◽  
Flat Panel ◽  
Bone Specimen ◽  
Flat Panel Detector ◽  
Volume Of Interest ◽  
Human Temporal Bone ◽  
Ct System

scholarly journals Gene Delivery into the Inner Ear and Its Clinical Implications for Hearing and Balance

Molecules ◽  
2018 ◽  
Vol 23 (10) ◽  
pp. 2507 ◽  
Author(s):  
Sho Kanzaki
Keyword(s):  
Stem Cells ◽  
Hair Cell ◽  
Inner Ear ◽  
Viral Infections ◽  
Endolymphatic Hydrops ◽  
Topical Administration ◽  
Acoustic Trauma ◽  
Sensory Cells ◽  
Road Map ◽  
Cell Proliferation And Differentiation

The inner ear contains many types of cell, including sensory hair cells and neurons. If these cells are damaged, they do not regenerate. Inner ear disorders have various etiologies. Some are related to aging or are idiopathic, as in sudden deafness. Others occur due to acoustic trauma, exposure to ototoxic drugs, viral infections, immune responses, or endolymphatic hydrops (Meniere’s disease). For these disorders, inner ear regeneration therapy is expected to be a feasible alternative to cochlear implants for hearing recovery. Recently, the mechanisms underlying inner ear regeneration have been gradually clarified. Inner ear cell progenitors or stem cells have been identified. Factors necessary for regeneration have also been elucidated from the mechanism of hair cell generation. Inducing differentiation of endogenous stem cells or inner ear stem cell transplantation is expected. In this paper, we discuss recent approaches to hair cell proliferation and differentiation for inner ear regeneration. We discuss the future road map for clinical application. The therapies mentioned above require topical administration of transgenes or drug onto progenitors of sensory cells. Developing efficient and safe modes of administration is clinically important. In this regard, we also discuss our development of an inner ear endoscope to facilitate topical administration.

Comparison of duration of deafness and tumour invasion to the inner ear from metastatic tumours of the internal auditory canal: human temporal bone pathology

2002 ◽  
Vol 116 (4) ◽  
pp. 256-260 ◽  
Author(s):  
Shinichi Nishimura ◽  
Kimitaka Kaga ◽  
Toshihiro Tsuzuku ◽  
Yukiko Iino
Keyword(s):  
Inner Ear ◽  
Temporal Bone ◽  
Internal Auditory Canal ◽  
Metastatic Tumour ◽  
Tumour Invasion ◽  
Bone Pathology ◽  
Neural Invasion ◽  
Histopathological Findings ◽  
Human Temporal Bone

Four cases (seven ears) of metastatic tumour of the internal auditory canal were studied. The histopathological findings confirmed that the inner ear invasion of the tumour follows a unique course, as reported in the literature. Relationship between duration of deafness and extent of tumour invasion in the inner ear is discussed. It is suggested that the deafness could occur via neural invasion or compression near the ductus spiralis foraminosus.

scholarly journals Validation of inner ear MRI in patients with Ménière’s disease by comparing endolymphatic hydrops from histopathologic specimens

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Young Sang Cho ◽  
Jong Sei Kim ◽  
Min Bum Kim ◽  
Sung Min Koh ◽  
Chang Hee Lee ◽  
...  
Keyword(s):  
Inner Ear ◽  
Temporal Bone ◽  
Semicircular Canal ◽  
Endolymphatic Hydrops ◽  
Semicircular Canals ◽  
Meniere’S Disease ◽  
Ménière’S Disease ◽  
Affected Side ◽  
Mri Scans ◽  
Temporal Bones

AbstractIntravenous gadolinium-enhanced inner-ear magnetic resonance imaging (IV-Gd inner-ear MRI) has been used to visualize endolymphatic hydrops (EH) in clinical diagnosis of Ménière’s disease (MD). However, lack of histological validation has led to several concerns regarding how best to interpret the resulting images. Here, we compared hydropic changes in temporal bone specimens with the results of IV-Gd inner-ear MRI in patients with MD. Histopathologic images of temporal bones from 37 patients with MD and 10 healthy controls were collected from the National Temporal Bone Bank of the Massachusetts Eye and Ear Infirmary in the United States. The EH ratios in the vestibule and cochlea were calculated from temporal bones using the methods used for IV-Gd inner-ear MRI, and the degree to which the saccular and utricular hydrops contributed to vestibular hydrops was measured. The presence of hydropic change in each semicircular canal was assessed using temporal bone images and compared with IV-Gd inner-ear MRI scans of 74 patients with MD. Based on human temporal bone imagery, the EH ratios in the cochlea and the vestibule on the affected side were 0.314 and 0.757, respectively. In the healthy control group, the ratio was 0.064 for the cochlea and 0.289 for the vestibule; these values were significantly different from those for the affected side of MD patients. The values for the affected ear were similar to the ratios from the IV-Gd inner-ear MRI scans in MD patients. In the vestibule, saccular hydrops were more common than utricular hydrops. The average EH ratios in the saccule and utricle were 0.513 and 0.242, respectively. No significant hydropic change from each of three semicircular canals was evident in temporal bone histopathology. However, herniation of otolithic organs (saccule or utricle) into the lateral semicircular canal was found in 44.4% of the patients, with saccular herniation (24.8%) more common than utricular herniation (16.7%). Although IV-Gd inner-ear MRI might not reflect fully the results of actual histopathology due to the limited resolution of MRI and image-processing techniques, the measured EH ratios from temporal bone specimens and IV-Gd inner-ear MRI scans were similar. Hydropic change in the three semicircular canals was not significant at either the ampullated or nonampullated end. Canal invasion of vestibular hydrops seen on MRI also appeared in temporal bone histopathology, and saccular invasion was dominant.

A Study of Neurotransmitters in Human Inner Ear: Preservation of Human Temporal Bone and Value of Organ Donation for Inner Ear Research

1994 ◽  
Vol 114 (3) ◽  
pp. 245-253 ◽  
Author(s):  
Wei-Jia Kong ◽  
Gisela Egg ◽  
Burkhard Hussl ◽  
Michaela Seyr ◽  
Anneliese Schrott-fischer
Keyword(s):  
Organ Donation ◽  
Inner Ear ◽  
Temporal Bone ◽  
Human Temporal Bone ◽  
Human Inner Ear

Rapid-prototyped temporal bone and inner-ear models replicated by adjusting computed tomography thresholds

2007 ◽  
Vol 121 (11) ◽  
pp. 1025-1028 ◽  
Author(s):  
M Suzuki ◽  
A Hagiwara ◽  
Y Ogawa ◽  
H Ono
Keyword(s):  
Computed Tomography ◽  
Inner Ear ◽  
Temporal Bone ◽  
Selective Laser Sintering ◽  
Three Dimensional ◽  
Threshold Value ◽  
Surgical Instruments ◽  
Dimensional Structure ◽  
Three Dimensional Model ◽  
Human Temporal Bone

AbstractPurpose:This study aimed to investigate the validity of adjusting computed tomography thresholds in order to replicate a temporal bone model suitable for dissection training and education.Materials and methods:A simulated three-dimensional model of a human temporal bone was prototyped using selective laser sintering. The powder layers were laser-fused, based on detailed computed tomography data, and accumulated to create a three-dimensional structure. The computed tomography threshold value of the stapes was modified on standard triangular language file in order to replicate the stapes. The intensity value was determined to select the fluid lumen of the inner ear and the bone surface, in order to replicate the inner ear.Results:The model could be shaved, using surgical instruments, in the same manner as during real surgery. The stapes could be reproduced, making this model even more realistic than a previous version. The inner ear was recreated, along with the surrounding bony wall and the ossicles.Conclusion:This model facilitates dissection training and easy understanding of the relation between the labyrinth and the surrounding structures.

Mechanism of Immune Complex—Mediated Inner Ear Diseases

1992 ◽  
Vol 101 (10_suppl) ◽  
pp. 72-77 ◽  
Author(s):  
Tamotsu Harada ◽  
Mitsuhito Sano ◽  
Satoshi Ogino ◽  
Masafumi Sakagami ◽  
Toru Matsunaga
Keyword(s):  
Inner Ear ◽  
Endolymphatic Hydrops ◽  
Stria Vascularis ◽  
Capillary Endothelium ◽  
Tracer Method ◽  
Ear Diseases ◽  
Inner Ear Disease ◽  
Foot Pad ◽  
The Relationship ◽  
Ig G

Tissues of the stria vascularis of normal rabbits were collected as cochlear antigen and injected into the foot pad of guinea pigs. The mechanism of development of endolymphatic hydrops was studied by the tracer method. Damage to the capillary endothelium and an increase in vascular permeability were found in the stria vascularis. Therefore, we studied patients with a raised level of immunoglobulin (Ig) G—class circulating immune complexes (CICs). Hearing loss was found in 3 of 22 patients with significantly elevated IgG CIC levels (13.6%). The relationship between inner ear disease and the presence of CIC was considered to be very significant. The possible mechanism of CIC-mediated inner ear diseases is discussed.

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