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.

scholarly journals Inner Ear Disease and Benign Paroxysmal Positional Vertigo: A Critical Review of Incidence, Clinical Characteristics, and Management

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
M. Riga ◽  
A. Bibas ◽  
J. Xenellis ◽  
S. Korres
Keyword(s):  
Inner Ear ◽  
Clinical Characteristics ◽  
Efficient Treatment ◽  
Ear Diseases ◽  
Integrated Diagnosis ◽  
Positional Vertigo ◽  
Inner Ear Disease ◽  
Comprehensive Search ◽  
Suspicion Index ◽  
Paroxysmal Positional Vertigo

Background. This study is a review of the incidence, clinical characteristics, and management of secondary BPPV. The different subtypes of secondary BPPV are compared to each other, as well as idiopathic BPPV. Furthermore, the study highlights the coexistence of BPPV with other inner ear pathologies.Methods. A comprehensive search for articles including in the abstract information on incidence, clinical characteristics, and management of secondary BPPV was conducted within the PubMed library.Results. Different referral patterns, different diagnostic criteria used for inner ear diseases, and different patient populations have led to greatly variable incidence results. The differences regarding clinical characteristics and treatment outcomes may support the hypothesis that idiopathic BPPV and the various subtypes of secondary BPPV do not share the exact same pathophysiological mechanisms.Conclusions. Secondary BPPV is often under-diagnosed, because dizziness may be atypical and attributed to the primary inner ear pathology. Reversely, a limited number of BPPV patients may not be subjected to a full examination and characterized as idiopathic, while other inner ear diseases are underdiagnosed. A higher suspicion index for the coexistence of BPPV with other inner ear pathologies, may lead to a more integrated diagnosis and consequently to a more efficient treatment of these patients.

scholarly journals Nanomedicine for Inner Ear Diseases: A Review of Recent In Vivo Studies

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Dong-Kee Kim
Keyword(s):  
Inner Ear ◽  
Animal Studies ◽  
Morphological Changes ◽  
In Vivo Studies ◽  
Ear Diseases ◽  
Age Related ◽  
Effective Delivery ◽  
Inner Ear Disease ◽  
Or Genes

Nanoparticles are promising therapeutic options for inner ear disease. In this report, we review in vivo animal studies in the otologic field using nanoparticles over the past 5 years. Many studies have used nanoparticles to deliver drugs, genes, and growth factors, and functional and morphological changes have been observed. The constituents of nanoparticles are also diversifying into various biocompatible materials, including poly(lactic-co-glycolic acid) (PLGA). The safe and effective delivery of drugs or genes in the inner ear will be a breakthrough for the treatment of inner ear diseases, including age-related hearing loss.

Intratympanic gadolinium magnetic resonance imaging supports the role of endolymphatic hydrops in the pathogenesis of immune-mediated inner-ear disease

2018 ◽  
Vol 132 (06) ◽  
pp. 554-559 ◽  
Author(s):  
D Lobo ◽  
M Tuñón ◽  
I Villarreal ◽  
B Brea ◽  
J R García-Berrocal
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Inner Ear ◽  
Endolymphatic Hydrops ◽  
Tertiary Care ◽  
Resonance Imaging ◽  
Virtual Absence ◽  
Imaging Result ◽  
Immune Mediated ◽  
Inner Ear Disease

AbstractObjectiveTo evaluate the presence of endolymphatic hydrops in patients with immune-mediated inner-ear disease.MethodsThe presence of endolymphatic hydrops was prospectively evaluated in 17 patients clinically diagnosed with secondary (n = 5) or primary (n = 12) immune-mediated inner-ear disease, who attended the ENT department of a tertiary care centre for evaluation or treatment over the previous year. All patients underwent magnetic resonance imaging of the temporal bone.ResultsIntratympanic gadolinium three-dimensional magnetic resonance imaging diagnosed hydrops in 11 of 12 patients with primary immune-mediated inner-ear disease (92 per cent). Of these, seven patients (64 per cent) presented only cochlear (n = 5) or predominantly cochlear (n = 2) hydrops. A positive magnetic resonance imaging result was observed in only one of five patients with secondary immune-mediated inner-ear disease (20 per cent).ConclusionThis study confirms the presence of endolymphatic hydrops in immune-mediated inner-ear disease patients. The virtual absence of hydrops in patients with secondary immune-mediated inner-ear disease is remarkable, although firm conclusions cannot be drawn; this should be explored in a multicentre study with a larger sample of patients. A different immune reaction without development of endolymphatic hydrops should not be ruled out in secondary immune-mediated inner-ear disease patients.

Morphologic Effects of Glycerol and Urea on Cochlear Tissues of the Chinchilla

1988 ◽  
Vol 97 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Charles G. Wright ◽  
David H. Lee ◽  
William L. Meyerhoff ◽  
Peter S. Roland
Keyword(s):  
Inner Ear ◽  
Hair Cells ◽  
Endolymphatic Hydrops ◽  
Stria Vascularis ◽  
Metabolic Stress ◽  
Mechanisms Of Action ◽  
Outer Hair Cells ◽  
Ultrastructural Changes ◽  
Spiral Ligament ◽  
Subcutaneous Injections

Glycerol and urea are used as test agents in confirming the diagnosis of endolymphatic hydrops. Although both substances act as osmotic diuretics, recent evidence suggests that they may have differing physiologic effects on the inner ear. This study was designed to compare the morphologic effects of urea and glycerol on cochlear tissues, using the chinchilla as an experimental model. Animals were given subcutaneous injections of glycerol (2 g/kg) or urea (1.2 g/kg) over periods of 3 hours, 4 days, or 1 week. Both agents were found to produce ultrastructural changes, including spiral ligament vacuolization, intracellular alterations of the stria vascularis, and increased numbers of Hensen's bodies in outer hair cells. These alterations appeared indicative of metabolic stress, but not toxicity. The morphologic findings provided no evidence that glycerol and urea affect the inner ear by fundamentally different mechanisms of action.

scholarly journals The Relationship between Inner Ear Disease and the Presence of Immune Complex

1993 ◽  
Vol 52 (Suppl-9) ◽  
pp. 55-59
Author(s):  
Tamotsu Harada ◽  
Takeshi Kubo ◽  
Toru Matsunaga
Keyword(s):  
Inner Ear ◽  
Immune Complex ◽  
Inner Ear Disease ◽  
The Relationship

Otopathologic Changes in the Cochlea following Head Injury without Temporal Bone Fracture

2018 ◽  
Vol 159 (3) ◽  
pp. 526-534 ◽  
Author(s):  
Reuven Ishai ◽  
Renata M. Knoll ◽  
Jenny X. Chen ◽  
Kevin Wong ◽  
Katherine L. Reinshagen ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Head Injury ◽  
Inner Ear ◽  
Temporal Bone ◽  
Hair Cells ◽  
Endolymphatic Hydrops ◽  
Stria Vascularis ◽  
Temporal Bone Fracture ◽  
Severe Loss ◽  
History Of

Objective Hearing loss following temporal bone (TB) fracture may result from direct transection of the middle and inner ear. The pathophysiology of hearing loss due to head injury without TB fracture, however, is not well understood. Few reports describe otopathologic findings. Herein, we investigate the pathologic findings of patients who sustained a head injury without evidence of a TB fracture. Study Design Otopathology study. Setting Otopathology laboratory. Subjects Subjects with a history of head injury without TB fracture. Methods The TBs of patients with head injury were evaluated by light microscopy. Inner ear anatomy was evaluated, including counts of spiral ganglion cells (SGCs), hair cells, pillar cells, atrophy of the stria vascularis, and the presence of endolymphatic hydrops. SGC counts were compared with those of historical age-matched controls. Results All cases (N = 6 TBs) had evidence of inner ear pathology. Of the 6 cases, 2 (33%) had severe loss of hair cells in all 3 turns of the cochlea, and 4 (67%) cases demonstrated moderate to severe loss at the basal turn of the cochlea. Four cases had scattered atrophy of the stria vascularis, and 3 (50%) had cochlear hydrops. The number of total SGCs was decreased, with an average 53% loss (range, 25%-79%) as compared with controls. The SGC count loss was evenly distributed along Rosenthal’s canal. Conclusions Patients with a history of head injury without TB fracture demonstrate inner ear pathology. Further studies are necessary to determine if otopathology findings are directly attributable to trauma.

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.

Experimental Autoimmune Inner Ear Disease: An Electrocochleographic and Histophysiologic Study

2000 ◽  
Vol 109 (5) ◽  
pp. 457-466 ◽  
Author(s):  
Henk Bouman ◽  
John C. M. J. de Groot ◽  
Sjaak F. L. Klis ◽  
Guido F. Smoorenburg ◽  
Frits Meeuwsen ◽  
...  
Keyword(s):  
Inner Ear ◽  
Structural Changes ◽  
Endolymphatic Hydrops ◽  
Compound Action Potential ◽  
Electron Microscopic ◽  
Molecular Weights ◽  
Summating Potential ◽  
Immune Mediated ◽  
Electrophysiological Responses ◽  
Inner Ear Disease

Systemic immunization with swine inner ear antigens in complete Freund's adjuvant induces functional disturbances in the cochlea. Morphometric data indicate that an endolymphatic hydrops develops within 2 weeks. It diminishes 6 weeks after immunization. A progressive decrease in the compound action potential amplitude is observed from 2 to 6 weeks after immunization. Enhancement of the amplitude of the summating potential is present without a clear overall correlation to the presence of endolymphatic hydrops. The amplitude of the cochlear microphonics shows no significant changes after immunization. Western blot analysis of the sera performed 2 and 6 weeks after immunization shows enhanced reactivity at 68,50,45, and 27 kd molecular weights, as compared to controls. The same spectrum of cross-reacting antibodies is believed to be instrumental in immune-mediated sensorineural hearing loss in patients. Apparently, cross-reacting antibodies and released mediators disturb cochlear homeostasis, resulting in the observed changes in the electrophysiological responses. However, these changes are not clearly related to structural changes at the light and electron microscopic levels.

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