Three-dimensional ultrastructure of the endolymphatic sac

The subcellular structures of the epithelial cells of the guinea pig endolymphatic sac were studied. By using a newly developed scanning electron microscopy technique, the intracellular organelles could be studied three-dimensionally and the topographic relationships analyzed. The light epithelial cell has an extensive network of endoplasmic reticulum which is characteristically arranged in a baso-apical direction. The connections between the inner surface of the plasmalemma and the endoplasmic reticulum were observed, as were connections between the Golgi complex and the endoplasmic reticulum. Our findings support the hypothesis that the endoplasmic reticulum might form transcellular channels through which the cell can transport water and ions from the lumen of the endolymphatic sac out into the subepithelial tissue. The dark epithelial cells seen in particular contained the smooth type of endoplasmic reticulum. Lysosomes were also observed in the dark cells, indicating that these cells probably have more of a secretory function.

Human endolymphatic sac: morphologic evidence of immunologic function

The ultrastructure of ten normal human endolymphatic sacs (ES), fixed immediately after death and obtained at autopsy, was observed by transmission electron microscopy. The roles of the epithelium, subepithelial space, vasculature, and ES leukocytes were morphologically studied to evaluate possible immunologic functions of the human ES. In addition, five intraosseous ES biopsies from patients undergoing translabyrinthine acoustic neuroma resection were studied using the immunoperoxidase technique to identify specific leukocyte subpopulations. Evidence of phagocytic activity included the presence of phagocytic epithelial cells, monocytes, macrophages, and polymorphonuclear leukocytes. Immune surveillance was suggested by intraepithelial and subepithelial T-lymphocytes, numerous fenestrated blood vessels, and the presence of a homogeneously staining substance within the lumina of ES epithelial tubules. No B-lymphocytes were found. The findings support the existence of a local immune system of the normal human inner ear.

Effects of high intensity pure tone stimulation on the endolymphatic sac. Correlations between cochlear morphology and endolymphatic sac response

A systematic study of the effects of acoustic overstimulation on the endolymphatic sac (ES) in the guinea pig was performed. The ES was studied with light and transmission electron microscopy after exposure of the animals to a 3.85 kHz pure tone of 108 dB SPL or 120 dB SPL for 22.5 min (sound energy 9.4 and 150 Pa2 X h, respectively). The damage pattern in the organ of Corti was studied after various post-exposure times with SEM and correlated with the morphological characteristics of the ES in the same ear. This was made possible by using a modified technique for histological processing. In ears with induced structural abnormalities to the organ of Corti, the ES displayed few morphological changes without obvious signs of accumulation of cell debris within the lumen. Initially an increase in the amount of freely floating cells was found which persisted for at least 24 h. The role of the ES for disposal and digestion of locally produced degeneration products within the cochlea after acoustically generated structural damage is discussed.

Ultrastructure of the endolymphatic sac in the mongolian gerbil

We describe our findings in an ultrastructural study of the endolymphatic sac of the mongolian gerbil. In conjunction with its specific renal physiology, enabling this animal to withstand long-term water deprivation, we have used our findings to hypothesize the existence of a local monitoring system within the endolymphatic space. The presence of elastic tissue in the subepithelial space of the endolymphatic sac could explain the mechanism through which this structure equilibrates endolymphatic pressure changes. Finally, we propose that a secretion of water-retaining macromolecules may act through osmotic forces to modulate inner ear fluid.

The endolymphatic sac in a mouse mutant with cochleo-saccular degeneration. Electrophysiological and ultrastructural correlations

The response of the endolymphatic sac to a disturbance in endolymph homeostasis was investigated by examining the sac in a mouse mutant, viable dominant spotting, which is known to exhibit primary strial dysfunction and cochleo-saccular degeneration. The function of the vascular stria was assessed by measuring the endocochlear potential and the sacs were then studied by light and transmission electron microscopy. The endolymphatic sac was found to be morphologically abnormal in these mutants, the main abnormality being the presence of granular epithelial cells, which showed clear histological signs of secretory activity. A stainable precipitate, believed to be secreted by the granular cells, was observed in the lumen of the endolymphatic sac in the mutants. The findings strengthen the view that the sac is involved in the regulation of endolymph volume and pressure.

A freeze-fracture study of receptor axons and Schwann cells in the human olfactory mucosa

Electron micrographs of freeze-fracture replicas from the human olfactory mucosa were analysed regarding the structure of the axons of the olfactory receptor cells. In the lamina propria, numerous axons were generally invested with one Schwann cell. The ensheathed axons were often found in close contact with one another. Membrane specializations were not found at these sites, nor were tightening membrane junctions observed in the mesaxons. The Schwann cell plasmalemma exhibited caveolae, whose neck was surrounded by uniformly sized intramembranous particles evenly distributed over the axolemmal fracture planes. There was a marked difference in particle density between the P face (about 850/micron 2) and the E face (about 180/micron 2).

Human endolymphatic duct: possible mechanisms of endolymph outflow

The ultrastructure of the normal human endolymphatic duct (ED) was observed by transmission electron microscopy. The role of the epithelium, the various regions of the subepithelial space, and vasculature in the resorption of endolymph was morphologically studied in order to generate testable hypotheses of human ED function. These hypothetical mechanisms of endolymph outflow at the level of the ED are a passive transcellular movement of water across the epithelium, driven by an osmotic gradient created by a subepithelial organic matrix; an active transcellular ion exchange with a passive transepithelial outflow of water, which stresses the importance of the dilated lateral intercellular spaces; and an active transcellular vacuolar endolymph outflow, whereby high molecular weight substances are removed by the ED. These mechanisms may be useful in designing experimental studies of the ED and in interpretation of retrospective light microscopic and transmission electron microscopic studies of patients with Meniere's disease.

Effect of labyrinthectomy on the endolymphatic sac. A histological, ultrastructural and computer-aided morphometric investigation in the mouse

A time sequence study of the effect of hemilabyrinthectomy on the endolymphatic sac was performed in mice. Light and transmission electron microscopy of the sac showed significant morphological changes of the epithelial lining and adjacent structures. Initially (2 and 4 days post-labyrinthectomy) the sac lumen was collapsed, but later (7 days post-labyrinthectomy) it was dilated or 'ballooned' and filled with a darkly staining homogeneous substance. This substance, which has been identified histochemically as a proteoglycan, appeared to be secreted from the epithelium of the endolymphatic sac. This finding suggests that the endolymphatic sac may be capable both of absorbing and of secreting endolymph.

The ultrastructure of the human antral mucosa as demonstrated by freeze-fracturing

The fine structure of the normal mucous membrane in the human maxillary sinus was investigated by means of the freeze-fracture technique. Special interest was directed to membrane structures in the epithelial cells. The morphology of tight junctions could be analysed. According to morphological criteria these junctions might be classified as "very tight". So called ciliary necklaces were well distinguishable. Their morphology seemed to be in concordance with the structure reported in other mammalian respiratory epithelia. Abluminally the epithelial cells frequently displayed abundant caveolae or micropinocytotic vesicles. The present investigation was performed as a preface to later studies on pathologically altered antral mucosa.

Basal lamina pathology of the utricle and endolymphatic duct in Ménière's disease

Labyrinthectomy was performed in a patient with a 4-year history of Ménière's disease. The utricle and the proximal portion of the endolymphatic duct were studied using light and electron microscopy. The epithelium varied in height from squamous to columnar. The basal lamina lining the columnar epithelial cells showed marked thickening which was visible in the light microscope. Electron microscopy revealed that the basal lamina had a fibrillar structure. The basal lamina of adjacent blood vessels also showed pathologic thickening with similar fibrillar texture. The significance of basal lamina thickening in association with Ménière's disease is discussed.

Human endolymphatic duct. An ultrastructural study

The fine structure of the human endolymphatic duct was observed by transmission electron microscopy. Well-preserved specimens were obtained after fixation of inner ear tissue by perilymphatic perfusion. The morphologic findings seemed to be in accordance with earlier propositions that the human endolymphatic duct may be involved in endolymph resorption. The duct was found to contain otoconialike bodies, suggesting that the endolymphatic duct and sac in man may also play a role in the turnover of macular otoconia.

Membrane structures in the pulp-dentin border zone. A freeze-fracture study of demineralized human teeth

The membrane morphology of cells in the pulp-dentin border zone in human teeth was scrutinized by means of the freeze-fracture technique. The tissue was fractured and replicated after mild demineralization in Na-EDTA. This procedure did not seem to influence the preservation of the tissue significantly. The odontoblastic cell bodies and their long processes lying within the predentinal and dentinal tubules were exposed. The technique made it possible to analyze the structural features of the apical part of the odontoblastic layer, including the 'terminal bar' region. This area exhibited large, irregularly shaped gap junctions. In some regions clusters of many small membranous pits or caveolae apparently representing pinocytotic vesicles were seen. The odontoblastic process displayed membrane protuberances projecting outward and abutting the inner tubular wall. In the predentinal and the adjacent dentinal regions, fine-caliber fibers (approximately 0.1-0.4 micron in diameter), presumably nerves, appeared in intimate relationship with the odontoblastic cell processes. At these sites the cell membrane displayed aggregations of membrane-associated particles, presumably gap junctions.

Membrane junctions between odontoblasts and associated cells. A freeze-fracture study of the human odontoblastic cell layer with special reference to its nerve supply

The relationship between odontoblasts and adjacent cell structures within the odontoblastic cell layer was analyzed by means of the freeze-fracturing technique. Two principal forms of interodontoblastic cell structures were found. The first was tubular or thread-like in appearance, having a general diameter around 0.1-1.0 micron. From morphological criteria these were believed to represent small, unmyelinated nerve fibers. The second type of cell structure found between odontoblasts was more irregular and heterogeneous in outline, and often lamellar or branched. These slender formations sometimes proved to constitute cellular projections from adjacent odontoblasts or neighboring, subodontoblastic fibroblasts. Both the nerve-like fibers and the irregular branched cells between the odontoblasts showed morphological contact areas with odontoblastic cell bodies. At these sites the intracellular distances were reduced, and characteristic gap junctional complexes occurred. Nerve ending specialization or membrane structures indicating the presence of chemical synapses on the odontoblastic cell surface were not observed.

The blood capillaries in the subodontoblastic region of the human dental pulp, as demonstrated by freeze-fracturing

The microvasculature of the subodontoblastic region in the human dental pulp was studied, using freeze-fracturing. This technique allows an analysis of the fine structure of the vascular endothelium with special reference to the membrane structure. The blood capillaries were noted to be of the non-fenestrated or continuous type, although a few fenestrated vessels were observed. The endothelial plasmalemma often exhibited bundles of fibrillar structures, presumably myofilaments. There was a relatively large number of micropinocytotic vesicles and the interendothelial spaces were closed juxtaluminally by tight junctions (zonulae occludentes). The junctions appeared mostly as two to four strands, seen as ridges or grooves on the cell membrane. Thin-walled, irregular, tissue channels lacking the typical, blood-vessel configuration were disclosed. These vessels were believed to represent lymphatics.

The role of the endolymphatic sac in statoconial formation and degradation

In the present investigation we studied the morphology o the endolymphatic sac in guinea pig fetuses (age 20-, 30-, 45-, 60-days-old and newborns). Twenty-day and 30-days-old guinea pig fetuses often displayed small prismatic or hexagonally shaped granules, presumably representing miniature otoconia. The granules appeared freely in the lumen of the endolymphatic sac as well as incorporated in the cytoplasm of the freely floating cells or macrophages. The origin of these "sac otoconia' as well as the possible role of the endolymphatic sac in statoconis turnover and metabolism is discussed.

The fenestrated blood vessels of the endolymphatic sac. A freeze-fracture and transmission electron microscopic study

The fenestrated blood vessels surrounding the endolymphatic sac in guinea pigs were investigated with the help of freeze-fracturing. The technique exposes the structure and distribution of vascular pores as well as interendothelial bridges or tight junctions between vascular endothelial cells. It is possible to get a three-dimensional comprehension of the vascular structure which can be compared with that of conventional transmission electron microscopy (TEM). Discontinuity in the junctional elements as seen in some endothelial layers and the high number of fenestrations organized in geometric patterns, as well as the abundant, randomly distributed micropinocytotic vesicles seem to bear out the theory that the endolymphatic sac is one of the most metabolically active parts of the inner ear and may be involved in the turnover of endolymph.

The ultrastructure of the human endolymphatic duct

The fine structure of the human endolymphatic duct as observed at transmission electron microscopy (TEM) is described. After fixation of inner ears by perilymphatic perfusion adequately preserved tissue specimens were obtained. Our morphological findings seem to be in accordance with the earlier proposition that the human endolymphatic duct may be involved in endolymph resorption. The duct was found to contain otoconia-like bodies, suggesting that the endolymphatic duct and sac, may play a role in the turnover of macular otoconia.

Membrane junctions in the subodontoblastic region. A freeze-fracture study of the human dental pulp

The morphology of the subodontoblastic region in the human dental pulp was analysed using the freeze-fracturing technique. Multiple areas of focal intercellular junctions were found between subodontoblastic fibroblasts (or Höhl's cells). The connections were of the gap junction type. Similar junctions were observed between subodontoblastic cells and small-calibre (0.10-0.20 microns) fibres, presumably nerves. Tight junctions were not observed.

Otoconia degradation

During certain stages of mammalian inner ear development, small crystallized bodies which resemble otoconia may be found in the endolymphatic sac. In order to examine whether the endolymphatic sac plays any part in the process of degradation and dissolution of otoconia, we made an electron-microscopic examination on the endolymphatic sac of fetuses and adult guinea pigs injected with streptomycin sulfate (SM). In 30-day-old fetal guinea pigs we found miniature otoconium-like bodies (OLBs) in the endolymphatic sac and a giant OLB in the endolymphatic duct. In adult animals we found no otoconia in the endolymphatic sac following SM intoxication. However, the results suggested that both the dark cells of the utricle, as well as the non-sensory epithelium of the saccule, may be engaged in the absorption and dissolution of otoconia.

Temporal bone characteristics in Meniere's disease

The petrous portion of the temporal bone in patients with Meniere's disease differs from that of healthy individuals mainly in its lack of periaqueductal pneumatization and its consequently short and narrow vestibular aqueduct. Diminished pneumatization may have an impact upon the tomographic reproducibility of the aqueduct. A total lack of periaqueductal pneumatization is prevalent in long-standing Meniere's disease. Tomography may serve as a tool by providing a basis for the choice of surgical procedure. Roentgenologic and histologic studies have indicated that the pars rugosa of the endolymphatic sac in normals mainly is housed inside the distal part of the vestibular aqueduct. In patients with Meniere's disease, the sac might be located outside the aqueduct and therefore deprived of the functions of the loose and highly vascular tissue normally surrounding it within the aqueduct. This might influence the total vascular supply of the sac, thereby interfering with its resorptive and immunodefensive functions.

Immunodefence of the inner ear? Lymphocyte-macrophage interaction in the endolymphatic sac

Owing to their proximity to areas exposed to infection, the sensory organs of the inner ear are probably dependent on an efficient antimicrobial defence. The longitudinal flow of endolymph to the endolymphatic sac may be of major importance in this context. Substances entering the ear can be automatically carried to the distal part of the endolymphatic duct, where lymphoid cells are present and endolymphatic phagocytosis occurs. In the intermediate part of the epithelium of the sac morphological signs marking the incoming substances are present. A vigorous interaction between lymphocytes and macrophages, similar to that observed in antigen-activated lymphoid tissue, may be seen. The sac is here surrounded by a rich network of lymphatic capillaries and blood vessels.

The vascular supply of the endolymphatic sac

The vascular anatomy of the endolymphatic sac in guinea pigs was examined following intravascular injection of silicone rubber (Microfil). Methacrylate resin of low viscosity (Mercox) was used to obtain vascular corrosion casts for scanning electron microscopy, which allowed more accurate differentiation between arteries and veins. The extensive vascular system around the sac comprises both arteries and veins, as well as lymphatic vessels. The arterial supply is derived mainly from the posterior meningeal artery in the posterior cranial fossa. In some cases a small artery also leads to the sac from the posterior vestibular artery in the labyrinth (in 7 of the 35 animals investigated). It courses together with the vein of the vestibular aqueduct along the walls of the endolymphatic duct. The blood is drained over the intermediate portion of the endolymphatic sac, which becomes lodged in a rich meshwork of capillaries, venules, veins and a few small arteries. A few venous trunks from both sac walls fuse with the vein of the vestibular aqueduct, which drains blood from the vestibule to the sigmoid sinus. Scanning electron microscopy also revealed numerous anastomosing vessels within bone channels with adjacent bone marrow sinusoids, which also probably contribute to the vascular supply of the endolymphatic sac.

Lymphocyte-macrophage activity in the endolymphatic sac. An ultrastructural study of the rugose endolymphatic sac in the guinea pig

The irregular epithelial layer which delimits the intermediate part of the endolymphatic sac, and the surrounding perisaccular tissue, were examined morphologically in the guinea pig by transmission electron microscopy. Specialized areas of the epithelium which have previously been designated as "non-vascularized epithelial processes" (NVP) were constantly observed. These proliferative areas showed a close topographical relation to the free luminal cells and contained an abundance of lymphoid cells. Lymphocytes and macrophages were intimately associated with each other in a manner similar to that seen in these two types of cells in antigen-stimulated lymphoid tissues. There was a marked degeneration and phagocytosis of cells. The richly vascularized perisaccular tissue was rich in plasma cells, monocytes, mast cells and lymphocytes. The latter could be seen to migrate through the endothelial cells in the thin post-capillary venules into the sac tissue. The authors consider that the endolymphatic sac plays a role as an immunological defence organ for the internal ear. A hypothetical model concerning circulation and turnover of certain of the free intraluminal cells in presented.

The electrical potential difference and impedance between CSF and blood in unanesthetized man

The electrical potential difference (PD) between cerebrospinal fluid (CSF) and blood has been studied extensively in animals. To obtain data from man the PD and impedance were recorded from the lumbar subarachnoid space of thirteen unanaesthetized patients with a presumably normal blood--brain barrier. The spontaneous PD ranged from 1 mV to 5 mV, CSF positive to blood. Hyperventilation and CO2-inhalation changed the PD with a mean slope of deltaPD/deltapHa of --4.16 mV/pH. The CSF-blood PD in unanaesthetized man is similar in direction to that found in dogs, goats and rats, but its sensitivity to change in arterial pH may be less.

Human cochlear aqueduct and its accessory canals

The anatomy of the adult human cochlear aqueduct and its surrounding structures, and their normal variations at tomography, microdissection and plastic molding are described. The mean length of the aqueduct is 12.9 mm and the mean width of its funnel-shaped external aperture 4.2 mm. The mean width of the narrowest portion is 0.14 mm. No difference in aqueductal width was found between the youngest and oldest age groups. Complete bony obstruction was revealed at microdissection in 3 out of 82 specimens. In the remaining 79 the entire aqueduct was patent. The aqueduct usually runs parallel to the internal auditory canal when seen from above, and the AP projection is therefore most suitable for tomography. At tomography the entire aqueduct was visualized in 60% of the specimens. The isthmic portion was not visible in 40%. Major reasons for nonvisualization of the entire aqueduct are: 1) a luminal width less than 0.1 mm, 2) a high jugular fossa, 3) a posteriorly directed aqueductal convexity (10%), and 4) bony obliteration (4)%). Accessory canals close to and often wider than the aqueduct may complicate tomographic evaluation of the aqueductal patency. Nonvisualization of the aqueduct at tomography does not necessarily indicate nonpatency.

Dynamics of upper urinary tract. I. An electrophysiologic in vivo study of renal pelvis in pigs: method and normal pattern

Under halothane anesthesia, peroperative electromyography of the pelvis and ureter together with intrapelvic pressure and urine flow were recorded in 11 pigs; the electromyography was by bipolar extracellular leads. Pressure waves of low amplitude, synchronous with action potentials from leads placed most proximally in the pelvis, preceded action potentials registered by distally placed leads. Transmission of the action potentials from the pelvis to the ureter took place with a constant transmission velocity but the transmission ratio varied from 1:1 to 6:1. Ureteral electric activity was time-related to the urine bolus. The transmission velocity was smaller in the pelvis than in the ureter and seemed to accelerate caudally. Thus, there is electromyographic evidence that the renal pelvis controls ureteric activity and that this pacemaker function is mediated high up, most proximally, in the renal pelvis.

Urethral pressure profile in prostatic surgery

Urethral pressure profile measurements were performed in 45 men suffering from micturation disturbances with the aim of evaluating the diagnostic aid of the procedure as compared to conventional urodynamic evaluation. The urethral pressure profile seems to be of value in visualizing the diseases of the prostate and the bladder neck, but it is of no definite aid except for postprostatectomy incontinence.

The surgical anatomy of the endolymphatic sac

The endolymphatic sac (ELS) and vestibular aqueduct (VA), which play a notable role in the pathogenesis of endolymphatic hydrops and Meniere disease, were identified in all anatomic and tomographic materials. More than 100 temporal bones were used for microdissection, tomography, and plastic molds. Normal subjects and Meniere disease patients were studied tomographically (N = 63) and observed during ELS surgery (N=49). In Meniere disease there is, with increassing duration of diseases, a decrease in the periaqueductal and opercular air cell pneumatization, with a concomitant shorter and straighter VA. This correlates with a decreased ELS luminal patency, and a more inferiorly positioned ELS. These factors help to explain both the difficulties of visualizing the VA by tomography in Meniere disease as well as the occasional difficulties reported by others in satisfactorily identifying the ELS at sac surgery. All observations are made from the surgeon's viewpoint to enhance clinical identification of the ELS.

Incomplete ureteral duplication. Electromyographic and manometric investigation

Studies were made peroperatively in a patient with incomplete ureteral duplication. Bipolar extracellular EMG-leads were taken from both pelvices, both ureteral segments and from the common ureter. Simultaneously pressure measurements were made in the pelvices. Function of the two pelvi-ureteral units were shown to be autonomous. Simultaneous action potentials and pressure waves were observed in each pelvis. Not every pelvic impulse was transmitted to the corresponding ureter, but when transmission did occur, the conduction rate was constant. Impulses from both ureteral branches were conducted distally to the common ureteral trunk, but impulses from the dilated segment had not the same quality (amplitude) as those from the non-dilated segment. Antiperistalsis was not observed. There was a measurable pressure difference between the two segments.