Design and Analysis of Posterior Semicircular Canal BPPV Diagnostic Test Based on Physical Simulation

To discusses and analyzes how to realize the design of posterior semicircular canal BPPV diagnostic maneuver. First, measure the spatial attitude of the human semicircular canal, establish a BPPV virtual simulation platform, then analyze the key positions of the maneuver, and finally design a new diagnostic maneuver according to the demand, and perform physical simulation verification. The average value of the unit normal vector of the right posterior semicircular plane is [ 0.660, 0.702, 0.266], after rotate -46.8 ° around Z axis and 15.4 ° around Y axis, it parallel to the X axis. After that, when the tilt back angle reaches 70 °, the free otoconia in the left utricle will fall into the common crus; when bend forward 53.3°, the unit normal vector of the crista ampullaris plane of the posterior semicircular canal to the XY plane; when bend forward angle reaches 30°, the otoconia slides to the opening of the ampulla; when bend forward angle reaches 70°, the otoconia slides to the bottom of the crista ampullaris. The shallow pitching Yang maneuver is designed as turn head 45° to the one side, bend forward 45°, tilt back 90°, and bend forward 90°. The deep pitching Yang maneuver is designed as bend forward 90°, turn head 45° to one side, tilt back 135°, and bend forward 90°. A new posterior semicircular BPPV diagnostic test is designed to make the induced nystagmus have the characteristics of long latency, reversal, and repeatability, will not cause the inhibitory stimulation of the contralateral superior semicircular canal, and has good operation fault tolerance, which is of great value for clinical and scientific research.

Novel cell types and developmental lineages revealed by single-cell RNA-seq analysis of the mouse crista ampullaris

This study provides transcriptomic characterization of the cells of the crista ampullaris, sensory structures at the base of the semicircular canals that are critical for vestibular function. We performed single cell RNA-seq on ampullae microdissected from E16, E18, P3 and P7 mice. Cluster analysis identified the hair cells, support cells and glia of the crista as well as dark cells and other nonsensory epithelial cells of the ampulla, mesenchymal cells, vascular cells, macrophages and melanocytes. Cluster-specific expression of genes predicted their spatially restricted domains of gene expression in the crista and ampulla. Analysis of cellular proportions across developmental time showed dynamics in cellular composition. The new cell types revealed by single cell RNA-seq could be important for understanding crista function and the markers identified in this study will enable the examination of their dynamics during development and disease.

Simulation study of BPPV fatigability

To analyze the mechanism and clinical significance of BPPV fatigability and discuss how to eliminate BPPV fatigability. A physical simulation model of BPPV was developed to analyze the effects of the Dix-Hallpike test and different angles of bowing maneuver on otolith positions. Dix-Hallpike test can keep the otoliths in the lower arm of the posterior semicircular canal away from the ampulla. The otoliths located in the lower arm of the posterior semicircular canal, slide closed to the ampulla while tilting the head forward more than 30 degrees; slide to the bottom of the crista ampullaris while tilting the head forward more than 60 degrees. The otoliths located in the short arm of the posterior semicircular canal leave the short arm and enter the utricle while tilting the head forward more than 120 degrees. It is recommended that tilting the head forward at least 60° so that the nystagmus induced by repeated Dix-Hallpike tests is consistent with long latency and fatigability is eliminated,which will be an important basis for the diagnosis of BPPV.

Histopathologic Evaluation of Intralabyrinthine Schwannoma

<b><i>Objectives:</i></b> The aim of this study is to perform a histopathologic analysis of temporal bones with an intralabyrinthine schwannoma (ILS) in order to characterize its extension. <b><i>Methods:</i></b> Archival temporal bones with a diagnosis of sporadic schwannoma were identified. Both symptomatic and occult nonoperated ILS were included for further analysis. <b><i>Results:</i></b> A total of 6 ILS were identified, with 4 intracochlear and 2 intravestibular schwannomas. All intracochlear schwannomas involved the osseous spiral lamina, with 2 extending into the modiolus. The intravestibular schwannomas were limited to the vestibule, but growth into the bone next to the crista of the lateral semicircular canal was observed in 1 patient. <b><i>Conclusions:</i></b> Complete removal of an ILS may require partial removal of the modiolus or bone surrounding the crista ampullaris as an ILS may extend into these structures, risking damage of the neuronal structures. Due to the slow growth of the ILS, it remains unclear if a complete resection is required with the risk of destroying neural structures hindering hearing rehabilitation with a cochlear implant.

Expression and Localization of BDNF/TrkB System in the Zebrafish Inner Ear

Brain-derived neurotrophic factor (BDNF), a member of the neurotrophin family, is involved in multiple and fundamental functions of the central and peripheral nervous systems including sensory organs. Despite recent advances in knowledge on the functional significance of BDNF and TrkB in the regulation of the acoustic system of mammals, the localization of BDNF/TrkB system in the inner ear of zebrafish during development, is not well known. Therefore, the goal of the present study is to analyze the age-dependent changes using RT-PCR, Western Blot and single and double immunofluorescence of the BDNF and its specific receptor in the zebrafish inner ear. The results showed the mRNA expression and the cell localization of BDNF and TrkB in the hair cells of the crista ampullaris and in the neuroepithelium of the utricle, saccule and macula lagena, analyzed at different ages. Our results demonstrate that the BDNF/TrkB system is present in the sensory cells of the inner ear, during whole life. Therefore, this system might play a key role in the development and maintenance of the hair cells in adults, suggesting that the zebrafish inner ear represents an interesting model to study the involvement of the neurotrophins in the biology of sensory cells

Vestibular end organ injury induced by middle ear treatment with ferric chloride in rats

Sensorineural hearing loss, ataxia, pyramidal signs, and vestibular deficits characterize superficial siderosis of the central nervous system. This study investigated changes in vestibular function, free radical formation, and phosphorylated cJun expression in the vestibular end organs after middle ear treatment with a ferric chloride (FeCl3) solution. A single injection of 70% FeCl3 solution into the unilateral middle ear cavity caused static vestibular symptoms, such as spontaneous nystagmus and head tilt. Asymmetric expression of c-Fos protein was observed in the bilateral vestibular nuclei and prepositus hypoglossal nuclei within 6 h after injection. Histopathologic examinations revealed partial hair cell loss, degeneration of the supporting stroma, and terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells in the neuroepithelial layer of the crista ampullaris in FeCl3-treated animals. 5-(And-6)-chloromethyl-2′,7′-dichlorodihydrofluorescein diacetate, acetyl ester and diaminofluorescein–2 diacetate fluorescence and immunoreactivity for nitrotyrosine increased markedly in the sensory neuroepithelial layer and nerve bundles of the crista ampullaris after 2 h. Strong immunoreactivity for phospho-cJun and cJun was observed in the type I hair cells of the crista ampullaris 120 h after injection. Thus, a single short-term treatment with a high concentration of FeCl3 in the unilateral middle ear cavity can induce activation of intracellular signals for cJun protein and oxidative stress through the formation of reactive oxygen species and nitric oxide in vestibular sensory receptors, resulting in vestibular dysfunction. These results suggest that activation of intracellular signals for cJun protein and oxidative stress may be a key component of the pathogenesis of vestibular deficits in patients with superficial siderosis.