Temporal Bone Studies of the Human Peripheral Vestibular System

Tsuji, Kojiro; Velázquez-Villaseñor, L; Sd, Rauch; Rj, Glynn; Wall, Conrad; Sn, Merchant

doi:10.1177/00034894001090s504

Cited by 83 publications

(65 citation statements)

References 5 publications

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“…VN is a paresis of the vestibular nerve and the peripheral deafferentation in VN accompanies subsequent central compensation. Considering the pathophysiological mechanism of MD, which is thought to be endorgan dysfunction due to endolymphatic hydrops and the selective loss of type two hair cells [14,15], the peripheral dysfunction does not seem to be severe.…”

Section: Discussionmentioning

confidence: 99%

Clinical implication of ocular torsion in peripheral vestibulopathy

Choi

Kang

Rhee

et al. 2014

Eur Arch Otorhinolaryngol

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A (r = 0.749, P < 0.001). OT and UW were significantly dissociated with time (P < 0.001). For the 67 patients with MD, no correlation between the degree of OT and severity of UW was seen in MD group A. No significant dissociation change was revealed among the groups (P = 0.114). The OT abnormality is remarkable during the acute phase of VN, whereas it might not be remarkable immediately after a vertigo attack in MD. This finding can be used to differentiate MD and VN, especially when no definite hearing loss is seen or VN recurs.

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Section: Discussionmentioning

confidence: 99%

Clinical implication of ocular torsion in peripheral vestibulopathy

Choi

Kang

Rhee

et al. 2014

Eur Arch Otorhinolaryngol

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“…In humans, one study observed less decrease in HC density in the utricular macula compared to SCC crista after ITG injection for Ménière's disease in one patient (Ishiyama et al 2007). Other human temporal bone histopathology studies have also found relative sparing of otolithic maculae in cases of systemic aminoglycoside ototoxicity (Nadol 1981;Schuknecht 1993;Tsuji et al 2000). Proposed mechanisms of otolithic sparing include decreased HC sensitivity in the macula and/or regeneration or repair following injury (Baird et al 1993;Golub et al 2012;Carey et al 1996).…”

Section: Effects Of Intratympanic Gentamicin On the Labyrinthmentioning

confidence: 96%

Histopathologic Changes of the Inner ear in Rhesus Monkeys After Intratympanic Gentamicin Injection and Vestibular Prosthesis Electrode Array Implantation

Sun

Lehar

Dai

et al. 2015

JARO

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Bilateral vestibular deficiency (BVD) due to gentamicin ototoxicity can significantly impact quality of life and result in large socioeconomic burdens. Restoring sensation of head rotation using an implantable multichannel vestibular prosthesis (MVP) is a promising treatment approach that has been tested in animals and humans. However, uncertainty remains regarding the histopathologic effects of gentamicin ototoxicity alone or in combination with electrode implantation. Understanding these histological changes is important because selective MVP-driven stimulation of semicircular canals (SCCs) depends on persistence of primary afferent innervation in each SCC crista despite both the primary cause of BVD (e.g., ototoxic injury) and surgical trauma associated with MVP implantation. Retraction of primary afferents out of the cristae and back toward Scarpa's ganglion would render spatially selective stimulation difficult to achieve and could limit utility of an MVP that relies on electrodes implanted in the lumen of each ampulla. We investigated histopathologic changes of the inner ear associated with intratympanic gentamicin (ITG) injection and/or MVP electrode array implantation in 11 temporal bones from six rhesus macaque monkeys. Hematoxylin and eosin-stained 10-μm temporal bone sections were examined under light microscopy for four treatment groups: normal (three ears), ITG-only (two ears), MVP-only (two ears), and ITG + MVP (four ears). We estimated vestibular hair cell (HC) surface densities for each sensory neuroepithelium and compared findings across end organs and treatment groups. In ITG-only, MVP-only, and ITG + MVP ears, we observed decreased but persistent ampullary nerve fibers of SCC cristae despite ITG treatment and/or MVP electrode implantation. ITG-only and ITG + MVP ears exhibited neuroepithelial thinning and loss of type I HCs in the cristae but little effect on the maculae. MVP-only and ITG + MVP ears exhibited no signs of trauma to the cochlea or otolith end organs except in a single case of saccular injury due to over-insertion of the posterior SCC electrode. While implanted electrodes reached to within 50-760 μm of the target cristae and were usually ensheathed in a thin fibrotic capsule, dense fibrotic reaction and osteoneogenesis were each observed in only one of six electrode tracts examined. Consistent with physiologic studies that have demonstrated directionally appropriate vestibulo-ocular reflex responses to MVP electrical stimulation years after implantation in these animals, histologic findings in t h e p r e s e n t s t u d y i n d i c a t e t h a t a l t h o u g h intralabyrinthine MVP implantation causes some inner

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“…Regular afferents carry the output of type II hair cells or a mixture of type I and type II and likely encode low-frequency, low acceleration movement [44,45]. Tsuji et al reported that although MD affected the structure and function of type II hair cells, the density and number of type I hair cells appeared unchanged in patients with MD [46].…”

Section: Video Head Impulse Test (Vhit)mentioning

confidence: 99%

Electrophysiology in Ménière’s Disease

Lamounier¹

2017

Up to Date on Meniere's Disease

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Ménière's disease (MD) is a progressive inner ear disorder that affects at least 0.2% of the population in EUA. The symptoms triad of fluctuating hearing loss, tinnitus, and vertigo was described by Prosper Ménière for more than a century and its pathophysiology is still unknown. MD has a fluctuating course and in many cases, difficult clinical management. Progressive hearing loss and intense dizzying seizures becomes more frequent as the disease progresses. All of this increases the challenges of accurate identification and has probably led to the trial of several tests for identifying MD. The tests are useful tools to assist the otolaryngologist both in diagnosis and prognosis of MD. These tests includes audiometry, otoacustic emission (OAE), electrocochleography (EcochG), vestibular evoked myogenic potentials (VEMP), cochlear hydrops analysis masking procedure (CHAMP) and video head impulse test (vHIT).

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Temporal Bone Studies of the Human Peripheral Vestibular System

Cited by 83 publications

References 5 publications

Clinical implication of ocular torsion in peripheral vestibulopathy

Clinical implication of ocular torsion in peripheral vestibulopathy

Histopathologic Changes of the Inner ear in Rhesus Monkeys After Intratympanic Gentamicin Injection and Vestibular Prosthesis Electrode Array Implantation

Electrophysiology in Ménière’s Disease

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