The findings of our study suggest that the decrease in the number of vestibular sensory cells and dark cells could be the cause of the clinical symptoms of imbalance of some patients with chronic otitis media.

Objective To measure the volume of the endolymph drainage system in temporal bone specimens with Meniere’s disease, as compared with specimens with endolymphatic hydrops without vestibular symptoms and with nondiseased specimens Study Design Comparative human temporal bone analysis Methods We generated 3-dimensional models of the vestibular aqueduct, endolymphatic sinus and duct, and intratemporal portion of the endolymphatic sac and calculated the volume of those structures. We also measured the internal and external aperture of the vestibular aqueduct, as well as the opening (if present) of the utriculoendolymphatic (Bast’s) valve and compared the measurements in our 3 study groups. Results The volume of the vestibular aqueduct and of the endolymphatic sinus, duct, and intratemporal endolymphatic sac was significantly lower in the Meniere’s disease group than in the endolymphatic hydrops group (P<0.05). The external aperture of the vestibular aqueduct was also smaller in the Meniere’s disease group. Bast’s valve was open only in some specimens in the Meniere’s disease group. Conclusion In temporal bones with Meniere’s disease, the volume of the vestibular aqueduct, endolymphatic duct, and intratemporal endolymphatic sac was lower, and the external aperture of the vestibular aqueduct was smaller as compared with bones from donors who had endolymphatic hydrops without vestibular symptoms and with nondiseased bones. The open status of the Bast’s valve in the Meniere’s group could be secondary to higher retrograde endolymph pressures caused by smaller drainage systems. These anatomic findings could correlate with the reason that some patients with hydrops develop clinical symptoms, while others do not.

Objectives To determine if peripheral vestibular otopathology is present in human temporal bones with otosclerosis. Study Design Comparative human temporal bone study Methods Seventy-four human temporal bones from 46 subjects with otosclerosis (mean age of 61±18 years) and 20 within histologically normal limits from 17 subjects (mean age of 59±14 years) were included in this study. Temporal bones with otosclerosis were divided into those with and without endosteal involvement. Using differential interference contrast microscopy at 1008x magnification, type I and type II vestibular hair cell counts were performed on each vestibular sense organ in which the neuroepithelia was oriented perpendicular to the plane of section. The organ-specific cell densities (cells/0.01 mm2 surface area) were compared between the groups with and without endosteal involvement and also compared to counts in the non- otosclerosis control group using Student’s t-test. Results Mean type I and type II hair cell densities of all vestibular structures in the group with endosteal involvement were significantly lower compared to the group without endosteal involvement. Mean type I and type II hair cell densities of all vestibular structures in the group with endosteal involvement were also significantly lower compared to the control group but were not in the group without endosteal involvement compared to the control group. Conclusion Endosteal involvement of otosclerotic foci is associated with damage to the vestibular sensory neuroepithelia that may contribute to the vestibular symptoms in otosclerosis.

NA Laryngoscope, 126:E369-E374, 2016.

In acute and recurrent otitis media, fibrin and neutrophil extracellular traps (NETs) are part of the host inflammatory response to bacterial infection. In the early stages of otitis media the host defense system uses fibrin to entrap bacteria, and NETs function to eliminate bacteria. In chronic otitis media, fibrin and NETs appear to persist.