Laser Doppler measurements of cochlear blood flow

The Otoprotective Effect of Ear Cryotherapy: Systematic Review and Future Perspectives

This systematic review investigates ear cooling and cryotherapy in the prevention and treatment of inner ear damage and disease, within the context of animal models and clinical studies. A literature search was carried out in the databases Pubmed and Cochrane Library. Ten studies were identified concerning the otoprotective properties of cryotherapy. Nine of these were rodent in vivo studies (mice, rats, gerbils, guinea pigs). One study involved human subjects and investigated cryotherapy in idiopathic sensorineural hearing loss. The studies were heterogeneous in their goals, methods, and the models used. Disorder models included ischemia and noise damage, ototoxicity (cisplatin and aminoglycoside), and CI-electrode insertion. All ten studies demonstrated significant cryotherapeutic otoprotection for their respective endpoints. No study revealed or expressly investigated otodestructive effects. While limited in number, all of the studies within the scope of the review demonstrated some degree of cryotherapeutic, otoprotective effect. These promising results support the conducting of further work to explore and refine the clinical applicability and impact of cryotherpeutics in otolaryngology.

Sympathetic Nervous System Regulation of Auditory Function

BACKGROUND

The auditory system processes how we hear and understand sounds within the environment. It comprises both peripheral and central structures. Sympathetic nervous system projections are present throughout the auditory system. The function of sympathetic fibers in the cochlea has not been studied extensively due to the limited number of direct projections in the auditory system. Nevertheless, research on adrenergic and noradrenergic regulation of the cochlea and central auditory system is growing. With the rapid development of neuroscience, auditory central regulation is an extant topic of focus in research on hearing.

SUMMARY

As such, understanding sympathetic nervous system regulation of auditory function is a growing topic of interest. Herein, we review the distribution and putative physiological and pathological roles of sympathetic nervous system projections in hearing. Key Messages: In the peripheral auditory system, the sympathetic nervous system regulates cochlear blood flow, modulates cochlear efferent fibers, affects hair cells, and influences the habenula region. In central auditory pathways, norepinephrine is essential for plasticity in the auditory cortex and affects auditory cortex activity. In pathological states, the sympathetic nervous system is associated with many hearing disorders. The mechanisms and pathways of sympathetic nervous system modulation of auditory function is still valuable for us to research and discuss.

Oral administration of an herbal medicine to prevent progressive hearing loss in a mouse model of diabetes

OBJECTIVE

Tsumura Suzuki Obese Diabetes (TSOD) mice exhibit early age-associated hearing loss. Histopathological analysis of these mice shows narrowing of capillaries in the stria vascularis and chronic reduction of blood flow in the cochlea. In this study, we investigated the effect of oral administration of a herbal medicine or calorie restriction on hearing in TSOD mice.

METHODS

TSOD mice were divided into 4 groups: CR (calorie restriction), BF and DS (treated with the herbal medicines, Bofutsushosan and Daisaikoto, respectively), and the control group. Body weight, blood glucose levels, and auditory brainstem responses (ABRs) were measured. The cochleae were excised and evaluated histopathologically.

RESULTS

Blood glucose levels were suppressed in the CR, BF, and DS groups. In addition, the elevation of ABR thresholds was inhibited in the CR, BF, and DS groups. Cochlear blood vessels remained wide in the three treatment groups compared with the control group. These results suggested that the administration of these herbal medicines improved glucose tolerance and yielded results similar to those on calorie restriction.

CONCLUSION

Oral administration of 2 herbal medicines can prevent hearing function disorder in a model mouse of diabetes. The results may clarify the possibility of clinical application.

Changes in cochlear blood flow in mice due to loud sound exposure measured with Doppler optical microangiography and laser Doppler flowmetry

In this work we determined the contributions of loud sound exposure (LSE) on cochlear blood flow (CoBF) in an in vivo anesthetized mouse model. A broadband noise system (20 kHz bandwidth) with an intensity of 119 dB SPL, was used for a period of one hour to produce a loud sound stimulus. Two techniques were used to study the changes in blood flow, a Doppler optical microangiography (DOMAG) system; which can measure the blood flow within individual cochlear vessels, and a laser Doppler flowmetry (LDF) system; which averages the blood flow within a volume (a hemisphere of ~1.5 mm radius) of tissue. Both systems determined that the blood flow within the cochlea is reduced due to the LSE stimulation.

Monitoring hypoxia induced changes in cochlear blood flow and hemoglobin concentration using a combined dual-wavelength laser speckle contrast imaging and Doppler optical microangiography system

A synchronized dual-wavelength laser speckle contrast imaging (DWLSCI) system and a Doppler optical microangiography (DOMAG) system was developed to determine several ischemic parameters in the cochlea due to a systemic hypoxic challenge. DWLSCI can obtain two-dimensional data, and was used to determine the relative changes in cochlear blood flow, and change in the concentrations of oxyhemoglobin (HbO), deoxyhemoglobin (Hb) and total hemoglobin (HbT) in mice. DOMAG can obtain three-dimensional data, and was used to determine the changes in cochlear blood flow with single vessel resolution. It was demonstrated that during a hypoxic challenge there was an increase in the concentrations of Hb, a decrease in the concentrations of HbO and cochlear blood flow, and a slight decrease in the concentration of HbT. Also, the rate of change in the concentrations of Hb and HbO was quantified during and after the hypoxic challenge. The ability to simultaneously measure these ischemic parameters with high spatio-temporal resolution will allow the detailed quantitative analysis of several hearing disorders, and will be useful for diagnosing and developing treatments.

Effects of hypoxia on cochlear blood flow in mice evaluated using Doppler optical microangiography

Reduced cochlear blood flow (CoBF) is a main contributor to hearing loss. Studying CoBF has remained a challenge due to the lack of available tools. Doppler optical microangiography (DOMAG), a method to quantify single-vessel absolute blood flow, and laser Doppler flowmetry (LDF), a method for measuring the relative blood flow within a large volume of tissue, were used for determining the changes in CoBF due to systemic hypoxia in mice. DOMAG determined the change in blood flow in the apical turn (AT) with single-vessel resolution, while LDF averaged the change in the blood flow within a large volume of the cochlea (hemisphere with ∼1 to 1.5 mm radius). Hypoxia was induced by decreasing the concentration of oxygen-inspired gas, so that the oxygen saturation was reduced from >95% to ∼80%. DOMAG determined that during hypoxia the blood flow in two areas of the AT near and far from the helicotrema were increased and decreased, respectively. The LDF detected a decrease in blood flow within a larger volume of the cochlea (several turns averaged together). Therefore, the use of DOMAG as a tool for studying cochlear blood flow due to its ability to determine absolute flow values with single-vessel resolution was proposed.

Betahistine exerts a dose-dependent effect on cochlear stria vascularis blood flow in guinea pigs in vivo

OBJECTIVE

Betahistine is a histamine H(1)-receptor agonist and H(3)-receptor antagonist that is administered to treat Menière's disease. Despite widespread use, its pharmacological mode of action has not been entirely elucidated. This study investigated the effect of betahistine on guinea pigs at dosages corresponding to clinically used doses for cochlear microcirculation.

METHODS

Thirty healthy Dunkin-Hartley guinea pigs were randomly assigned to five groups to receive betahistine dihydrochloride in a dose of 1,000 mg/kg b. w. (milligram per kilogram body weight), 0.100 mg/kg b. w., 0.010 mg/kg b. w., 0.001 mg/kg b. w. in NaCl 0.9% or NaCl 0.9% alone as placebo. Cochlear blood flow and mean arterial pressure were continuously monitored by intravital fluorescence microscopy and invasive blood pressure measurements 3 minutes before and 15 minutes after administration of betahistine.

RESULTS

When betahistine was administered in a dose of 1.000 mg/kg b. w. cochlear blood flow was increased to a peak value of 1.340 arbitrary units (SD: 0.246; range: 0.933-1.546 arb. units) compared to baseline (p<0.05; Two Way Repeated Measures ANOVA/Bonferroni t-test). The lowest dosage of 0.001 mg/kg b. w. betahistine or NaCl 0.9% had the same effect as placebo. Nonlinear regression revealed that there was a sigmoid correlation between increase in blood flow and dosages.

CONCLUSIONS

Betahistine has a dose-dependent effect on the increase of blood flow in cochlear capillaries. The effects of the dosage range of betahistine on cochlear microcirculation corresponded well to clinically used single dosages to treat Menière's disease. Our data suggest that the improved effects of higher doses of betahistine in the treatment of Menière's disease might be due to a corresponding increase of cochlear blood flow.

Preventing hearing damage using topical dexamethasone during reversible cochlear ischemia: an animal model

HYPOTHESIS

Local application of dexamethasone to the round window (RW) niche prevents cochlear damage caused by local reversible ischemia.

BACKGROUND

Cochlear ischemia induced by internal auditory artery (IAA) compression/stretching is thought to cause postoperative sensory hearing loss after attempted hearing preservation removal of acoustic neuroma tumors. Dexamethasone administered to the RW niche traveling through the membrane to the cochlear fluids may prevent ischemic damage.

MATERIALS AND METHODS

Ten young albino rabbits were used for this study. Ischemic episodes were induced by compressing the IAA. Laser Doppler cochlear blood flow was measured using a probe positioned at the RW niche. Transtympanic electrocochleography was measured at 4, 8, and 12 kHz. In 5 test ears, dexamethasone was administered topically at the RW for approximately 50 minutes before the IAA compressions, whereas in 5 control ears, saline was applied in the same way. Each ear underwent one 10-minute IAA compression with a 60-minute postischemic period of transtympanic electrocochleography monitoring.

RESULTS

In both control- and dexamethasone-treated ears, ischemic episodes measured by Laser Doppler cochlear blood flow were comparable. Fifty minutes after IAA decompression, in dexamethasone-pretreated ears, cochlear microphonic and compound action potential amplitudes at all test frequencies were 10 to 15% less reduced than those in control ears. Compound action potential latencies in dexamethasone-pretreated ears resulted in shorter latency delay than in control ears.

CONCLUSION

The RW seems to be an efficacious route for the administration of dexamethasone into the inner ear. Dexamethasone showed a protective effect on cochlear function after local ischemia. Transtympanic electrocochleography was found to be a sufficient and effective tool in monitoring hearing.

Volumetric Imaging of Blood Flow within Cochlea in Gerbil in vivo

Changes in blood flow to the inner ear are thought to influence a number of cochlear diseases, including noise-induced hearing loss, sudden hearing loss, and Meniere's disease. Advances have been made in the areas of vital microscopic studies of micro-circulation, and the laser Doppler flowmetry. But none of these techniques can provide in vivo three-dimensional (3-D) mapping of microvascular perfusion within the cochlea. To overcome this limitation we have developed and used a method of optical microangiography (OMAG) that can generate 3-D angiograms within millimeter of tissue depths by analyzing the endogenous optical scattering signal obtained from an illuminated sample. We used OMAG to visualize the cochlear microcirculation of adult living gerbil through the intact cochlea, which would be difficult, if not impossible, by use of any other current techniques.

An animal model for the analysis of cochlear blood flow [corrected] disturbance and hearing threshold in vivo

Impairment of cochlear blood flow (CBF) is considered to be important in inner ear pathology. However, direct measurement of CBF is difficult and has not been investigated in combination with hearing function. Six guinea pigs were used to show feasibility of an animal model for the analysis of cochlear microcirculation by intravital microscopy in combination with investigation of the hearing threshold by brainstem response audiometry (ABR). By the application of sodium nitroprusside (SNP), CBF was increased over 30 min. Reproducibility of measurements was shown by retest measurements. Mean baseline velocity of CBF was 109 +/- 19 mum/s. Vessel diameters had a mean value of 9.4 +/- 2.7 mum. Mean hearing threshold was 19 +/- 6 dB. In response to SNP, CBF velocity increased significantly to 161 +/- 26 mum/s. Mean arterial pressure decreased significantly to 36 +/- 11 mmHg. After the end of the application, CBF velocity recovered to a minimum of 123 +/- 17 microm/s. Within the retest, CBF velocity significantly increased to a maximum of 160 +/- 31 microm/s. Second recovery of CBF velocity was 125 +/- 14 mum/s. Within the second retest, CBF increased significantly to 157 +/- 25 microm/s. ABR thresholds did not change significantly. The increase in blood flow velocity occurred in spite of substantial hypotension as induced by a vasodilator. This may explain the fact that ABR threshold remained unchanged reflecting a maintained blood supply in this part of the brain. This technique can be used to evaluate effects of treatments aimed at cochlear microcirculation in inner ear pathologies.

Ventral approach to rat inner ear preserves cochlear function

CONCLUSION

This technique enabled us to visualize the cochlea without causing damage.

OBJECTIVE

The mammalian inner ear is difficult to approach surgically. This is particularly true in the cases of the rat and mouse, which both have small cochleae. Rat and mouse research is particularly important because their genomes are well characterized, and significantly similar to that of the human. The aim of the present study was to develop a method of accessing the rat cochlea without affecting its function.

MATERIALS AND METHODS

In the ventral approach, a small hole was made for access to the scala tympani. Cochlear function was assessed through auditory brainstem response (ABR) threshold measurements.

RESULTS

The ventral approach enabled the direct visualization of the tympanic bulla. Thus, the tympanic bulla could be easily opened in a manner that was benign to cochlear function. There was no significant difference in ABR threshold before and after surgery.

A model of real time monitoring of the cochlear function during an induced local ischemia

The aim of this study was to investigate the utility of distortion product otoacoustic emissions (DPOAEs) in intraoperative monitoring (IM) of cochlear ischemic episodes in animals during internal auditory artery (IAA) compression. The IAA was exposed using the posterior fossa approach and then compressed for 3 and 5 min intervals to effect ischemia. DPOAE amplitudes and phases were measured at 4, 8, and 12 kHz geometric mean frequency (GMF). In each monitored ear, laser-Doppler cochlear blood flow (CBF) was measured. All IAA compressions resulted in rapid decrease of DPOAE amplitude and CBF, with simultaneous DPOAE phase increase. DPOAE phase changes were found to increase consistently within several seconds of IAA compression, while corresponding DPOAE amplitudes changed more slowly, with up to 30-40 s delays. Following IAA release, DPOAEs at 12 kHz GMF were characterized by longer delays in returning to baseline than those measured at lower frequencies. In some cases, CBF did not return to baseline. In this animal model, DPOAEs were found to be sensitive measures of cochlear function during transient cochlear ischemic episodes, suggesting the utility of DPOAE monitoring of auditory function during surgery of cerebello-pontine angle tumors.

Simultaneous measurement of electrocochleography and cochlear blood flow during cochlear hypoxia in rabbits

In this study, a new monitoring system is developed to measure cochlear blood flow (CBF) and electrocochleography (ECochG) during transient ischemic episodes of the cochlea. A newly designed otic probe was used for the simultaneous recordings of laser-Doppler CBF and ECochG directly from the round window (RW). The probe enabled the recording of high amplitude compound action potentials (CAP) and cochlear microphonics (CM) with few averages. Experiments were conducted on rabbits to generate episodes of cochlear ischemia by using timed compressions of the internal auditory artery (IAA). The computer monitoring system extracted and measured CAP and CM components from ECochG in real-time. Results indicate that CM and CAP generally followed CBF during compressions and releases of IAA. Both CBF values and CAP amplitudes showed an overshoot following the reperfusion. CAP amplitude measures were found to be very sensitive to ischemia showing very rapid amplitude, latency and morphological changes. CM amplitude decreased more slowly than the CAP and CBF. Simultaneous recordings of CBF and ECochG using the otic probe provide a valuable neuromonitoring tool to investigate the dynamic behavior of the cochlea during ischemia.

Neuromonitoring of cochlea and auditory nerve with multiple extracted parameters during induced hypoxia and nerve manipulation

A system capable of comprehensive and detailed monitoring of the cochlea and the auditory nerve during intraoperative surgery was developed. The cochlear blood flow (CBF) and the electrocochleogram (ECochGm) were recorded at the round window (RW) niche using a specially designed otic probe. The ECochGm was further processed to obtain cochlear microphonics (CM) and compound action potentials (CAP). The amplitude and phase of the CM were used to quantify the activity of outer hair cells (OHC); CAP amplitude and latency were used to describe the auditory nerve and the synaptic activity of the inner hair cells (IHC). In addition, concurrent monitoring with a second electrophysiological channel was achieved by recording compound nerve action potential (CNAP) obtained directly from the auditory nerve. Stimulation paradigms, instrumentation and signal processing methods were developed to extract and differentiate the activity of the OHC and the IHC in response to three different frequencies. Narrow band acoustical stimuli elicited CM signals indicating mainly nonlinear operation of the mechano-electrical transduction of the OHCs. Special envelope detectors were developed and applied to the ECochGm to extract the CM fundamental component and its harmonics in real time. The system was extensively validated in experimental animal surgeries by performing nerve compressions and manipulations.

Cochlear blood flow modifications induced by anaesthetic drugs in middle ear surgery: comparison between sevoflurane and propofol

OBJECTIVE

Because it is necessary to maintain controlled hypotension during middle ear surgery in order to avoid bleeding and as it is known that cochlear blood flow (CBF) is related to blood pressure (BP), it is useful to evaluate CBF modifications induced by anaesthetics in order to prevent cochlear damage. The aim of this paper is to evaluate, using laser Doppler flowmetry, which anaesthetic drug, out of sevoflurane and propofol, has the smallest effect on CBF.

MATERIAL AND METHODS

Twenty consenting adult patients scheduled for myringoplasty under general anaesthesia for simple tympanic membrane perforation were studied. Patients were divided into two groups: the first group was treated with sevoflurane and the second with propofol. For the first group, CBF measurement was carried out on three different occasions: (i) at a basal low drug dosage; (ii) having increased the drug dosage to a higher level; and (iii) having reduced the drug dosage to the basal low level again. For the second group, CBF measurement was carried out on three different occasions: (i) 10 min after injecting a bolus of propofol; (ii) immediately after a second propofol injection; and (iii) 10 min after a third injection of propofol. A probe was placed over the promontory in order to measure CBF levels.

RESULTS

In the subjects treated with sevoflurane, after having increased the drug dosage, BP decreased significantly while CBF did not change significantly. In the subjects treated with propofol we recorded a significant reduction in BP, as well as a decrease in CBF.

CONCLUSION

The results obtained show that sevoflurane has a hypotensive effect without modifying CBF, while propofol, although having a similar effect on BP to sevoflurane, has less of a protective effect on inner ear microcirculation.

Bilateral superior cervical sympathectomy and noise-induced, permanent threshold shift in guinea pigs

The rich sympathetic innervation to the cochlea suggests its potential control of cochlear blood flow and activity during noise exposure, as part of the general and local stress sympathetic reaction evoked by noise. In a previous study, superior cervical sympathectomy prior to sound exposure in guinea pigs in an awake state, resulted in reduced temporary threshold shift. The present study was conducted to explore whether this potential protection would also be manifested in conditions producing permanent threshold shift (PTS). Thirty-six guinea pigs, divided into four groups of nine guinea pigs each, were sound exposed for 2 h in an awake state. Eighteen guinea pigs underwent superior cervical sympathectomy prior to sound exposure. Auditory brainstem thresholds were recorded prior to sound exposure, and then at 24 h, 1 and 6 weeks post-exposure. Results indicated a reduced PTS at 122 dB sound pressure level (SPL) exposure, suggesting a protective effect of the sympathectomy. However, at 125 dB SPL exposure, the protective effect was reduced.

Mechanisms of Photoinduced Cochlear Ischemia in the Guinea Pig

An experimental model of cochlear ischemia using the photosensitization reaction of rose bengal (RB) is reported. Ischemia was induced by the systemic administration of RB solution and localized irradiation of the cochlea with a green light of specific wavelength for RB activation. After the RB solution was administered, the cochlear blood flow was temporarily increased and then decreased, and the latency of wave I of the auditory brainstem response increased and the amplitude of wave I decreased after RB injection and finally wave I disappeared completely. A histological study revealed thrombus formation in the vessels of the irradiated cochlea not only in the stria vascularis and the spiral ligament, but also in the modiolus. L-Histidine, a scavenger of singlet oxygen (1O2) and hydroxyl radical (.OH), significantly prolonged cochlear dysfunction, but D-mannitol, a specific scavenger of.OH did not, suggesting that 1O2 has an important role in this reaction.

Quantitative analysis of rat inner ear blood flow using the iodo[(14)C]antipyrine technique

A number of different qualitative and quantitative techniques have been used to measure inner ear blood flow and all have required that the animal be anesthetized. It is well known that anesthesia can cause a variety of circulatory as well as other systemic changes. In this study, we have employed a technique commonly used for quantifying brain blood flow, the iodo[(14)C]antipyrine technique ([(14)C]IAP). Unlike other techniques, [(14)C]IAP can be used in unanesthetized animals under conditions that are nearly normal, it is non-invasive, it can be used reliably in regions of low local blood flow, and data can be acquired from both the periphery and central nervous system. Results show that blood flow to the lateral wall of the basal turn of the cochlea (387 +/- 19 microl/g/min) is significantly higher (P<0.001) than that of the utricular macula (189 +/- 23 microl/g/min), horizontal (186 +/- 22 microl/g/min), superior (185 +/- 22 microl/g/min), or posterior canal crista (185 +/- 25 microl/g/min). Surprisingly, blood flow to all of the vestibular end-organs is remarkably similar. The use of this technique should allow pharmacological experimentation on inner ear blood flow without the unknown complications of anesthesia or invasive procedures.

Local vestibular blood flow and systemic vascular responses to natural vestibular stimulation in the Mongolian gerbil

HYPOTHESIS

Natural stimulation of the vestibular end organs will produce alterations in the local vestibular microvascular blood flow.

BACKGROUND

The vestibular and cardiovascular systems require a coordinated interaction to maintain organ perfusion during rapid positional and postural changes. However, the detailed relationship of these systems is not well understood. There have been no previous descriptions of local vestibular blood flow (VBF) during natural stimulation (NS) conditions.

METHODS

In vivo VBF and systemic blood pressure (BP) in the Mongolian gerbil during natural stimulation. Using laser Doppler flowmetry, the authors obtained continuous measures of local VBF in both anesthetized and alert gerbils during sinusoidal rotational stimuli. Simultaneous recordings of systemic BP were collected from the contralateral common carotid artery.

RESULTS

The anesthetized gerbils showed stable VBF and BP during all vestibular stimuli. By contrast, alert subjects demonstrated a significant response to natural stimulation. The VBF increased 28% over baseline, and systemic BP increased 8% during a 45-second, 0.133-Hz sinusoid. Decreases in BP of 8% and 5%, respectively, were seen with a 0.10 and 0.20 Hz, 360-second stimulus. A corresponding determination of VBF during the extended stimulus conditions was not technically possible.

CONCLUSIONS

To the authors' knowledge, these are the first in vivo descriptions of vestibular blood flow during natural stimulation. In the alert animals, VBF increased in response to NS. This increase in flow does not appear to be directly dependent on systemic blood pressure changes and indicates that the vestibular microvasculature is closely regulated.

The influence of noise on blood flow in the basilar artery (BA) - measurements with transcranial color-coded duplex sonography (TCCD)

Acoustic stimuli are being reported as a cause of changes in resistance in the basilar artery (BA). It was the aim of this study to investigate this effect under standardized conditions dependent upon the intensity of the evoking stimulus. Twenty healthy subjects with normal hearing (male/female 14/6; mean age 26.4 years) were exposed to 'pink noise' for periods of 2 min at 75, 85 and 95 dB(A). Parallel to this, the Doppler spectrum of the BA and both the Pourcelot resistance index and the Gosling pulsatility index were measured by means of transcranial color-coded Doppler sonography. In comparison with the base value (at rest) a significant increase in resistance was noted during noise exposure. The noise-induced resistance changes could be interpreted as a consequence of changes in activity of the various centers of the auditory pathway and cerebral function. Further animal experiments may prove the connection between BA blood flow and resistance and their changes depending on different acoustic stimuli or different hearing pathophysiology.

A model of cochlear function assessment during reversible ischemia in the Mongolian gerbil

An in vivo model in the Mongolian gerbil is used to assess the auditory changes during reversible cochlear ischemia. This model allows the recordings of cochlear potentials (microphonics, summating potential and compound action potential) and otoacoustic emissions (cubic difference tones, CDTs), together with laser Doppler cochlear blood flow (CBF) measurements, over reversible cochlear ischemia. Ischemia is achieved by compression of the eighth nerve complex at the porus of the internal acoustical meatus, whereas the compression release allows the reperfusion to occur. While CBF monitoring permits to objectively determine the degree of ischemia and reperfusion, the combined analysis of cochlear potentials and CDTs makes it possible to point out the preferential site of main functional damage within the cochlea, i.e., outer hair cells (OHCs), inner hair cells, or ganglia cells. At least three ischemia-reperfusion sequences can be used on one side, and sometimes both ears can serve for experiments. This model could be applicable for testing drugs with alleged protective effects against cochlear ischemia and/or reperfusion, in treated vs. non-treated animals.

Vulnerability of the gerbil cochlea to sound exposure during reversible ischemia

Cochlear ischemia induces a sensorineural hearing loss, in part through a fast functional impairment of outer hair cellls. Assuming that the cochlea is rendered fragile during ischemia and reperfusion and that stimulation itself can jeopardize its functional recovery, we used a model of reversible selective cochlear ischemia in Mongolian gerbils to establish what type of sound exposure can be deleterious during and immediately after reversible ischemia. Several groups of gerbils were used, with different ischemia durations and levels of sound exposure. Control groups were only exposed to tones at 80 and 90 dB SPL during 30 min, while other groups underwent complete and fully reversible blockage of the labyrinthine artery, during 5.5 or 8 min, and were exposed to 60 or 80 dB SPL tones during 30 min. The amount of ischemia and reperfusion was measured by means of laser Doppler velocimetry, whereas outer hair cells' function was continuously monitored through distortion-product otoacoustic emissions (DPOAEs). The losses of DPOAE levels after 8 min transient ischemia and 60 dB SPL exposure were as large as those induced by 80 dB SPL exposures combined with 5.5 min ischemia, or 90 dB SPL exposures without ischemia, with a maximum loss around 25-30 dB, half an octave above the stimulus frequency. These results give evidence for an extremely high cochlear vulnerability to low-level sound exposure when associated with reversible ischemia. This vulnerability may have important clinical consequences in patients with cochlear circulatory disturbances.

Measuring the cochlear blood flow and distortion-product otoacoustic emissions during reversible cochlear ischemia: a rabbit model

Impairment to the cochlear blood flow likely induces many types of sensorineural hearing loss. Models using several small laboratory animals have been described in the literature that permit the simultaneous monitoring of the cochlear blood flow with laser-Doppler flowmetry and cochlear function using evoked responses. However, these models have not permitted a direct application of the resulting knowledge to the human condition, primarily due to differences in the translucence of the otic capsule between species. In the present study, to approximate conditions relevant to the human patient, the rabbit was utilized to develop a procedure in which laser-Doppler flowmetry could be used to measure the cochlear blood flow in an animal with an opaque otic capsule. At the same time, the cochlear function was monitored non-invasively using distortion-product otoacoustic emissions. In this manner, a laser-Doppler probe was positioned in the round window niche and the cochlear function measured using distortion-product otoacoustic emissions during a systematic series of ischemic episodes. Cochlear ischemia was produced by deliberately compressing the eighth nerve complex at the porus of the internal acoustic meatus, for periods lasting from 1-3 min, while cochlear blood flow and distortion-product otoacoustic emission measures were obtained simultaneously before, during and following the occlusion. Results demonstrated that the cochlear blood flow sharply decreased within 1 s after compression onset, whereas distortion-product otoacoustic emissions showed obstruction-induced changes after a delay of several seconds, provided that the blood flow decreased, at least 40%. Similarly, upon release of the compression, the cochlear blood flow began to recover within 1 s, whereas the recovery of the corresponding distortion-product otoacoustic emissions was slightly delayed. Although not apparent in the distortion-product otoacoustic emission recovery time course, the cochlear blood flow consistently overshot its initial baseline value during the recovery process. Thus, although cochlear ischemia produced changes in the distortion-product otoacoustic emission activity that generally followed the resulting alterations in the cochlear blood flow, the detailed relationship between the two measures was complex.

Betahistine increases vestibular blood flow

Betahistine is used for treatment of several vestibular disorders. Despite the accepted use of this histamine-like substance, its mechanism of action is not well understood. The purpose of this study was to assess the possibility that one of the activities of betahistine is increasing blood flow in the peripheral vestibular end organs. Using a novel surgical approach, we identified the posterior semicircular canal ampulla of guinea pigs and placed a laser Doppler probe in position to obtain blood flow measurements from the posterior semicircular canal ampulla. Blood pressure, heart rate, and vestibular blood flow were continuously recorded. Concentration-response curves were obtained for betahistine (2.5, 5, 7.5, and 10 mg/kg) and control-vehicle (0.15 mol/L NaCl) infusions. A separate group of subjects was pretreated with the competitive selective H3 agonist, thioperimide maleate, before betahistine treatment. Increases in vestibular blood flow and decreases in blood pressure were observed in response to betahistine infusions. Pretreatment with thioperamide maleate abolished these changes at low doses of betahistine and attenuated the responses at higher doses of betahistine. These results show that betahistine administration induces increases in vestibular blood flow. These findings support the potential use of betahistine for treatment of vestibular disorders, which may be caused by compromised circulation.

The effect of mannitol upon cochlear dysfunction induced by transient local anoxia

Transient local anoxia of the cochlea was induced by pressing the labyrinthine artery, and compound action potential (CAP) or endocochlear potential (EP) was measured before and after transient local anoxia ranging from 5 to 60 min using 106 albino guinea pigs. The complete interruption of the cochlear blood flow by this procedure and its full restoration after releasing the pressure on the artery was confirmed by a laser-Doppler flowmeter. The anoxia of less than 10 min induced no post-anoxic cochlear dysfunction, whereas the anoxia of a longer duration induced an irreversible dysfunction of the cochlea. It was evident that the post-anoxic recovery of the CAP threshold was worse as the anoxia period was prolonged, and CAP was almost completely abolished after 60-min anoxia. In animals which were administered mannitol intravenously just after the restoration of the cochlear blood circulation, the recovery of the CAP threshold was significantly better than that in the control animals, when the animals were subjected to local anoxia of 15- to 30-min duration. No beneficial effect, however, was observed in the 60-min anoxia group. In conclusion, local anoxia of 10 min or longer caused cochlear dysfunction, which was partially but significantly alleviated by mannitol.

Local effects of nitric oxide on vestibular blood flow in the Mongolian gerbil

There is a paucity of studies regarding the regulation of vestibular blood flow (VBF), despite the possibility that vascular alterations may contribute to specific vestibulopathies. The current experiments used the Mongolian gerbil as an animal model since it provides easy surgical access to the vestibular end-organs and has been previously used for physiologic studies involving inner ear function. VBF changes were measured in the posterior semicircular canal using laser Doppler flowmetry following round window membrane (RWM) application of the nitric oxide donor 1, 3-propanediamine-N-[4-1-(3-aminopropyl)-2-hydroxy-2-nitrosohydrazi no] butyl (spermine NONOate; SPNO) as a vasodilator. The specificity of the responses induced was tested via pretreatment with an NO scavenger, 2-(4-Carboxyphenyl)-4,4,5,5-tetramethylimidazonline-1-oxyl-3-oxide (carboxy-PTIO; cPTIO). cPTIO, SPNO, vehicle (control) or cPTIO/SPNO were applied to the RWM, during which blood pressure and VBF were monitored for baseline, treatment, and recovery conditions. Results showed concentration-dependent increases in flow, probably resulting from NO's vasodilatory action on local vasculature. cPTIO pretreatment was found to attenuate SPNO-induced VBF increases. These findings support a role of NO in maintaining the vestibular microcirculation.

The optical properties of the cochlear bone

The transmittance, reflectance and the angular dependence of coherent light at wavelengths of 632.8 and 750 nm in the cochlear bone in guinea pigs were measured by a single integrating sphere and a goniometer. The strict one-dimensional transport theory was applied to calculate the absorption and scattering coefficients. The Henyey-Greenstein phase function was applied to determine the anisotropy factor g, from the goniometer measurements. A linear inverse correlation was found between the calculated g and sample thickness. We found that the cochlear bone in guinea pigs strongly scatters light in the forward direction. Its absorption and scattering coefficients are much larger than those of dermis. Delrin has a similar optical absorption property to human dermis tissue.

In vivo vestibular blood flow in the Mongolian gerbil: angiotensin III-provoked changes in systemic and local factors

The current literature contains little information on vestibular end organ blood flow. The absence of an accepted model, difficulties applying dynamic in vivo measurement techniques and the inaccessibility of the inner ear organs contribute to the shortage of experimental findings. The purpose of the current study is to introduce the gerbil as a viable model for the in vivo study of vestibular blood flow dynamics. The potent vasoactive peptide, angiotensin III (AIII), was used to provoke blood pressure and blood flow changes. The results of this study demonstrate that viable blood flow measures may be obtained from the vestibule of the gerbil. Dose-dependent changes in blood pressure and vestibular blood flow were observed in response to high concentrations of AIII. Pretreatment with the receptor antagonist, sarthran, attenuated both blood pressure and blood flow increases in response to subsequent AIII infusions. The gerbil model offers the advantages of easily accessible and identifiable peripheral vestibular organs, as well as responsive local blood flow. Investigations using this model may provide information on the regulation of blood flow during presentation with a variety of stimulus modalities. Information from such studies may lead to development of strategies for treatment of vestibulopathies suspected to be of vascular origins.

Nitric oxide synthase and contractile protein in the rat cochlear lateral wall: possible role of nitric oxide in regulation of strial blood flow

The present study demonstrated by histochemical and immunohistochemical methods that NADPH diaphorase reactivity, endothelial nitric oxide synthase (eNOS)-like immunoreactivity, and tropomyosin-like immunoreactivity, were located within the rat cochlear lateral wall. Both NADPH diaphorase reactivity and eNOS-like immunoreactivity were found mainly in the endothelium of the strial capillaries (ESC) and that of the vessels of the spiral ligament (ESL). These reaction products appeared to be somewhat more common in the ESC than in the ESL. On the other hand, tropomyosin-like immunoreactivity was localized in tissues outside the endothelium and its intensity was greater in the ESL than in the ESC. These findings suggest that nitric oxide (NO) produced by eNOS may play a role in regulating the blood flow of the cochlear lateral wall. In addition, NADPH diaphorase reactivity, eNOS-like immunoreactivity, and tropomyosin-like immunoreactivity showed different patterns of distribution between ESC and ESL. This suggests that in these two sites blood circulation is controlled by NO through two different mechanisms that are suitable for regulating strial blood flow.

A reversible ischemia model in gerbil cochlea

A completely reversible cochlear-ischemia animal model was developed, and an initial study of ischemia/reperfusion-induced cochlear function change is presented. The bulla of the anesthetized gerbil was opened through a ventral approach and the anterior inferior cerebellar artery and its branches were exposed. Cochlear blood flow (CBF) from the basal turn of the cochlea was monitored with a laser Doppler flowmeter. An electrically isolated microclamp was used to occlude the labyrinthine artery (LA). During LA clamping, the cubic distortion product (DP) was continuously recorded. The LA was repeatedly clamped for different durations in all animals, and CBF consistently showed full recovery after clamp release. No obvious change in vessel diameter or flow pattern was observed under a stereomicroscope. Mean blood pressure did not show significant change during clamping. Immediately upon LA clamping, CBF decreased rapidly nearly to zero. After clamp release, CBF demonstrated an immediate rapid increase, followed by a secondary gradual recovery to baseline. CBF recovery patterns were clamp duration-related. Within a few seconds of occlusion, DP decreased and reached a minimum of approximately 24% of the initial level in less that 30 s. Following reperfusion of the cochlea, DP gradually increased, decreased again, then slowly recovered. Time delay between CBF reperfusion and the first increase of DP was proportional to clamping duration, and the increased amplitudes demonstrated a negative relationship to clamp duration. We assume that the first decrease in DP during clamping was caused by ischemia in the cochlea; the second decrease, during the cochlear reperfusion, could be a form of reperfusion-induced change in cochlear function. This ischemia/reperfusion model in gerbil cochlea demonstrates excellent repeatability and reversibility. Since DP and other measurements can be used to dynamically monitor cochlear or hair cell functions, this model is useful in studies of auditory physiology and pathophysiology.

Atrial natriuretic peptide participates in the regulation of vestibular blood flow

Atrial natriuretic peptide (ANP) is a cardiac hormone which exerts natriuretic, diuretic and vasorelaxant effects. Among the many organs and vascular beds populated with ANP receptors (Genest and Cantin, 1988) are the vestibular and auditory organs of the inner ear (Lamprecht and Meyer zum Gottesberge, 1988). The purpose of the current study was to assess the potential influence of ANP on vestibular blood flow in the guinea pig. The inner ear was exposed with a posterior-lateral approach medially through the mastoid cortex. The laser Doppler probe was placed adjacent to the ampulla of the posterior semicircular canal. Baseline measurements of mean blood pressure (BP), heart rate (HR) and vestibular blood flow were established. ANP dissolved in physiologic saline was infused intravenously at concentrations of 15, 150 or 300 ng/kg/min at 10 microliters/min for 30 min. Measurements were recorded during the infusion and for a recovery period of 65 min. The control group was treated equivalently and infused with 0.15 M NaCl. Baseline BP and HR for all animals were 40.1 +/- 6.67 and 190 +/- 15.7, respectively. BP, HR and vestibular blood flow remained stable during the baseline, control and recovery conditions of saline infused subjects. Infusion of ANP (15 ng/kg/min) induced a mild elevation of BP followed by a small decrease in pressure during the post-infusion period. Vestibular blood flow showed a decrease to approximately 20% below baseline during infusion and stabilized at this level during the recovery period. Infusion of higher concentrations of ANP (150 and 300 ng/kg/min) induced a similar pattern of BP change in a dose-dependent manner. Vestibular blood flow, however, evidenced significant elevations during the post-infusion periods for both concentrations. These increases (22% and 26%, for 150 and 300 ng/kg/min, respectively) were significantly different from vestibular blood flow changes in the saline and low dose groups. The HR remained stable for baseline, infusion and recovery periods for each of the ANP infused subjects. This investigation demonstrates the systemic and local effects of ANP suggest a possible role for ANP in local regulation of vestibular blood flow.

Effect of focal cochlear vascular lesion on endocochlear potential in guinea pigs

The alteration endocochlear potential (EP) in response to total cochlear ischemia induced by various experimental manipulations has been studied. However, the effect of restricted areal damage to the microvessels (restricted to small area in the lateral wall of a cochlear turn) on the EP value is still unknown. In the current investigation we adopted a photochemical method to produce a focal (i.e., restricted area) microvessel injury in the lateral wall of the guinea pig cochlea and examined the effect of these insults on EP recorded in the same region. The small area of the microvessel lesion (small fenestra: approximately 0.2 x 0.4 mm2) induced by photoactivation did not yield significant EP changes, suggesting that damage to such a small area of microcirculation in the lateral wall of the cochlea has no statistically significant effects on EP values. In subjects with a large area of the microvessel lesion (large fenestra: approximately 0.2 x 0.8 mm2), a decrease in the EP value (mean +/- SEM 7.9 +/- 0.8 mV) was noted. However, the control group animals with a large fenestra but without microvessel lesion also displayed a decrease (8.6 +/- 0.8 mV) in EP. In the current study we were unable to differentiate whether the EP changes in animals with the large fenestra microvessel lesions were caused by the cochlear blood flow decrease or by the surgical preparation. However, the results of this study indicated if the EP value was affected by the large area of the microvessel lesion, the level of decrease would not be large. That is, the EP decrease was less than the EP change in the control group (mean: 8.6 mV). Considering the dependence of EP on blood flow, the data of this study suggest that compensatory mechanisms in the cochlea may maintain the EP following a focal lesion in the lateral wall of the cochlea. This study also indicates that the photochemical method provides a reliable approach to produce the animal model with the focal microvessel lesion in the lateral wall of the cochlea.

Autoregulation of cochlear blood flow in young and aged mice

Autoregulation is the capacity of an organ system to maintain organ blood flow constant in response to changes in arterial blood pressure (BP). The current study was carried out to investigate the effect of age on autoregulation of cochlear blood flow (CBF) in mice. CBF was measured using a laser-Doppler flowmeter while BP was increased by angiotensin II injections and decreased by exsanguination in 2-month-old, 10-month-old and 18-month-old CBA mice. Autoregulation of CBF was significantly weaker in the 2-month-old mice when compared to the older mice. Although CBF autoregulation was weaker in the 18-month-old mice compared to the 10-month-old mice, this difference was not statistically significant. These results suggest that autoregulation changes with maturation and age. Findings are discussed in relationship to the possible development of presbycusis.

Cochlear blood flow and labyrinthine pressure: effects of glycerol on the inner ear

Changes in cochlear blood circulation (CoBC) and perilymphatic pressure (Pp) after administration of physiological saline and 50% glycerol (12 ml/kg) were measured simultaneously in guinea pigs to examine the influence of glycerol on CoBC and Pp. The CoBC was measured by the laser-Doppler method. Although neither CoBC nor Pp changed after administration of physiological saline, glycerol produced a marked increase in CoBC and a slight decrease in Pp in 11 of 15 animals. However, the increase in CoBC was transient; CoBC reached a peak as soon as 30 min after glycerol administration and then returned rapidly to its initial value within 1 h after administration, although the Pp was still decreasing. Therefore, the response of CoBC to glycerol does not seem to be directly related to hyperosmolarity due to glycerol administration.

Effect of topical application of nitroglycerin on cochlear blood flow

PURPOSE

To investigate whether topical application of the vasodilator nitroglycerin would increase cochlear blood flow without adversely affecting inner ear function.

MATERIALS AND METHODS

The effect of topical application of nitroglycerin to the round window membrane on cochlear blood flow was measured in 33 guinea pigs with a laser Doppler flowmeter. Endocochlear potential, as an indicator of inner ear function, was recorded by a glass microelectrode inserted through the round window membrane in a second series of 27 guinea pigs. Blood pressure was also monitored in both experiments.

RESULTS

Low doses (0.0001 to 1 microgram) of nitroglycerin induced an increase in cochlear blood flow with no change in blood pressure. The cochlear blood flow was maximally increased by approximately 50%. A high dose (50 micrograms) of nitroglycerin induced a significant decrease in blood pressure but did not significantly affect endocochlear potential.

CONCLUSIONS

Topical application of nitroglycerin may be useful in increasing cochlear blood flow in various inner ear diseases.

Effect of leukotriene inhibitor on cochlear blood flow in salicylate ototoxicity

Our previous studies showed that salicylate ototoxicity is associated with decreased levels of vasodilating prostaglandins (PGs) and increased vasoconstricting leukotrienes (LTs) in the perilymph and reduced cochlear blood flow (CoBF). The purpose of this study was to test the hypothesis that leukotriene inhibitor prevents salicylate ototoxicity by preventing abnormal elevation of LT levels in the inner ear, thus averting a decrease in CoBF resulting from abnormal levels of arachidonic acid metabolites in the inner ear. Ototoxicity was induced in chinchillas by either local round window membrane (RWM) application or systemic treatment with salicylate both with and without pretreatment with leukotriene inhibitor (Sch 37224). A moderate reduction in CoBF was documented with both local RWM and systemic treatment with salicylate. Salicylate induced hearing loss and reduction in CoBF were prevented by pretreatment with a leukotriene inhibitor. This study suggests that leukotriene inhibitor prevents salicylate ototoxicity by averting a decrease in CoBF mediated by abnormal levels of arachidonic acid metabolites in the inner ear.

Studies of inner ear blood flow in animals and human beings

This article reviews current studies on inner ear blood flow, discusses their relevance to the maintenance of normal homeostasis of the inner ear, reports for the first time clear changes in fundamental properties of cochlear blood flow in the chronic hydropic ear, and describes the potential of applying laser Doppler flowmetry technology to the measurement of inner ear blood flow in human beings. Studies of the guinea pig in which perfusion pressure is varied demonstrate a broad range of autoregulatory capabilities of the inner ear vasculature. Gain factors range from 0.76 and higher for recovery for less than 1 minute of modified perfusion pressure. This is significantly greater than reports obtained for brain autoregulation. In a series of four investigations of cochlear blood flow in the hydropic ear in guinea pigs, a decreased responsiveness to electrical stimulation and direct stimulation of the superior cervical ganglia was found, indicating a change in sympathetic control of cochlear tone. Reduced vasomotion was observed, and autoregulatory capabilities were reduced. In human investigations, changes in cochlear blood flow were demonstrated with direct electrical stimulation of the round window and warm water irrigation of the ear canal, but not with carbogen breathing. Increased cochlear blood flow was observed with increased systemic blood pressure, and a remarkable decrease in cochlear blood flow was observed with the application of 1:10,000 epinephrine to the round window. These observations indicate the potential for development of laser Doppler flowmetry technology in the diagnosis and treatment of inner ear vascular disorders, and the animal investigations suggest that changes may occur in the chronic hydropic ear that compromise autoregulation and thus increase the sensitivity of the hydropic ear to other stress factors. Treatments can be found to modify such changes in vascular tone.

Cochlear blood flow measured by averaged laser Doppler flowmetry (ALDF)

This report describes a new approach to estimate the hydromechanical properties of a vascular system. Averaged laser Doppler flowmetry (ALDF) was developed by averaging the flux signal of a laser Doppler flowmeter (LDF) synchronized to the heart cycle. The usefulness of this method was verified by manipulation of the cochlear microvasculature. Twelve pigmented guinea pigs under pentobarbital/fentanyl anesthesia were used. The cochlea was surgically exposed and the LDF probe placed on the bony surface of the first turn to monitor cochlear blood flow (CBF). The LDF flux signal (0.2 s time constant) was sampled by an A/D board at 2 kHz for 255 ms and averaged with synchronization to the heart beat. The mean blood flow, peak to peak amplitude, and time (phase) delay of pulsatile flow were measured from the averaged signal. According to a transmission line model of the vascular system, under a given perfusion pressure, mean flow reflects resistance while amplitude and time delay of the pulsatile flow are related to the reactance component of the impedance of the vascular system. During the formation of photochemically-induced thrombosis in the cochlear microvasculature, there was a dramatic mean flux decrease (90.1 +/- 3.4% from baseline (BL), N = 6). Additionally, a time-dependent decrease in amplitude and time delay of pulsatile flow were indicated by ALDF. These results suggest a large increase in vascular resistance and significant decrease in compliance.(ABSTRACT TRUNCATED AT 250 WORDS)

Lipid peroxidation inhibitor attenuates noise-induced temporary threshold shifts

The purpose of this study was to investigate the protective effects of U74389F (Upjohn Co. Kalamazoo, MI), a 21-aminosteroid/lipid peroxidation inhibitor, and a member of the lazaroid drug class, on temporary threshold shifts in animals exposed to prolonged noise stimulation. Animals treated with U74389F and exposed to noise showed attenuated cochlear action potential threshold (CAP) shifts and cochlear microphonic (CM) when compared to non-drug treated noise-exposed subjects. These data suggest that inhibition of FOR induced lipid peroxidation is an important mechanism in noise-induced asymptotic temporary threshold shifts.

Possible involvement of capsaicin-sensitive sensory nerves in the regulation of cochlear blood flow in the guinea pig

Capsaicin-induced microcirculatory changes in the cochlea of anaesthetized guinea pigs were examined by laser-Doppler flowmetry. Close intraarterial capsaicin infusion into the anterior inferior cerebral artery at doses of 10-50 pmol/min was followed by dose-dependent vasodilatation. Capsaicin infused in a dose of 150-200 pmol/min or above resulted in vasoconstriction in the region examined. Topical capsaicin administration into the cochlea (50-150 pmol) resulted in very moderate vasodilation with a latency of 1-2 min. Perivascular capsaicin application onto the anterior inferior cerebellar artery elicited an elevated blood flow in the cochlea, too. It is concluded that the release of vasoactive substances from capsaicin-sensitive nerve fibres in the inner ear of the guinea pig may play a role in the control of the local microcirculation. These nerves may also be involved in the neurogenic inflammatory processes in the region.

The cochlear blood flow: a comparison between the laser Doppler and the microsphere surface methods

Since the introduction in the early 1980s, of the laser Doppler (LD) method for measuring cochlear blood flow (CBF) it has been debated whether the measured changes reflect the total or regional blood flow and whether the method per se influences the CBF. In order to answer those questions, the effect of one vasodilating drug, sodium nitroprusside, was investigated after topical application on the round window membrane (RWM) with respect to its influence on CBF. Two different techniques, the microspheres surface method and the LD method, were used. Untreated animals and animals which received saline or nicotine acid on the RWM were used as controls. The effects on CBF and blood pressure (BP) were continuously registered with LD. When a maximal flow had stabilized, 6 x 10(6) microspheres were injected into the left side of the heart. After the microspheres had been distributed within the body, the animals were killed. Both cochleae were microdissected and the microspheres counted turn by turn in the lateral wall. The number of spheres in the two ears was compared and the difference was recorded as the increase caused by the drug. The percentage change in CBF measured using the LD was compared with that obtained by using the microsphere surface method (MSM). No change in CBF measured by the two techniques was registered in the untreated animals, or after saline or nicotinic acid, while sodium nitroprusside induced a substantial increase in CBF. The mean percentage change of CBF measured with the LD method was compared with the calculated mean percentage change of microspheres for all turns in the cochlea, and in the first turn. Student's t-test and the linear correlation coefficient were calculated.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of posture, hypotension and locally applied vasoconstriction on the middle ear microcirculation in anaesthetized humans

Studies by laser-Doppler flowmetry of middle ear microcirculation changes induced by physical and chemical stimuli in the animal have only recently been made. This prospective study, performed in humans, was designed to compare the effects of a postural manoeuvre (headup tilt 30 degrees), hypotension and locally applied vasoconstriction on middle ear blood flow during anaesthesia. Circulatory changes provoked by a headup tilt of 30 degrees, and successive intravenous boluses of potent vasodilators, were compared with circulatory changes provoked by locally applied adrenaline, in ten healthy patients in good physical states undergoing middle ear surgical repair. Heart rate and direct arterial pressure were continuously recorded via a radial artery cannula. Middle ear blood flow was continuously recorded via a laser-Doppler probe placed on the promontorium cavi tympani. Metabolic parameters (partial pressure of O2 and CO2 in arterial blood, pH, arterial lactate concentrations) and arterial concentrations of propofol were measured just before and just after the experiment. Headup tilt did not modify heart rate, mean arterial pressure or middle ear blood flow. Vasodilators (nicardipine, nitroprusside, nitroglycerin) provoked a fall in arterial pressure (P < 0.0001, P < 0.0001, P < 0.019, respectively), but did not induce any significant variations in heart rate; variations occurred in middle ear blood flow (P > 0.05, not significant) which were different according to patients and agents. Locally applied adrenaline provoked a fall in the middle ear blood flow (P < 0.0012), with no effect on heart rate and arterial pressure. There were no significant changes in metabolic values, or propofol serum concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Endolymphatic sac blood flow versus cochlear blood flow following intravenous administration of isosorbide in guinea pigs

Endolymphatic sac (ES) blood flow (ESBF) and cochlear blood flow (CBF) were measured in different groups of guinea pigs by laser-Doppler flowmetry (Advance Laser Flowmeter, Model ALF 2100) after the intravenous administration of 70% isosorbide (1.6 ml/kg). The measurements were made under general anesthesia with intraperitoneal pentobarbital sodium. Respiration was controlled by a respirator after tracheotomy, and blood pressure was monitored through the femoral artery (Gould Statham P23 ID Pressure Transducer). For ESBF measurements, a probe was placed on the right ES after entering the posterior cranial fossa via the dorsal approach. For CBF measurements, a probe was placed on the basal turn of the right cochlea via the ventral approach. Isosorbide was administered intravenously through the jugular vein for 60 s. Both ESBF and CBF increased immediately after administration, reached a peak within 3-6 min and decreased gradually to their initial baseline levels in 11-15 min. Both blood flow changes almost always corresponded to systemic blood pressure changes, although a slight delay was observed in blood pressure compared to the blood flow. The magnitude of the CBF response tended to be greater than that of the ESBF response (p < 0.1). This may result from the anatomical differences in the two blood supplies, i.e., from the vertebral artery (CBF) and the external carotid artery (ESBF).

The protective effects of allopurinol and superoxide dismutase on noise-induced cochlear damage

Several studies have demonstrated that noise exposure may result in local vasoconstriction of cochlear vessels. The subsequent decrease in cochlear blood flow may lead to hypoxia and predispose to the formation of free oxygen radicals (FORs). If hypoxia occurs in response to noise exposure, then drugs that scavenge or block the formation of FORs should protect the cochlea from damage resulting from hypoxic or ischemic events as well as noise trauma. Rats were exposed to 60 hours of continuous broad-band noise (90 dB SPL) and treated with superoxide dismutase-polyethylene glycol (SOD-PEG), allopurinol, or a control vehicle. Exposure to noise resulted in significant threshold shifts at each frequency tested (3, 8, 12, and 18 kHz) as measured by tone burst-evoked compound action potentials and cochlear microphonics recorded from the round window. Both of these thresholds in drug-treated animals were attenuated compared with animals exposed to noise alone. These findings show that SOD-PEG and allopurinol may preserve cochlear sensitivity associated with noise exposure. This suggests that noise-induced damage to the cochlea may be related to the activity of FORs.

Substance P increases cochlear blood flow without changing cochlear electrophysiology in rats

Carotid artery infusions of substance P yielded reductions in systemic blood pressure and elevations in cochlear blood flow (CoBF), measured via laser Doppler flowmeter, with no alterations in cochlear action potentials or cochlear microphonics in Wistar-Kyoto rats. Additionally, direct micro-infusions of substance P into the anterior inferior cerebellar artery, which contributes to the local vascular perfusion of the cochlea, yielded elevations in CoBF with no changes in systemic blood pressure. Pretreatment with a specific substance P receptor antagonist, ([D-Pro2,D-Trp7,9]SP) via the carotid artery or the anterior inferior cerebellar artery, diminished subsequent substance P-induced vascular responses. These results suggest that endogenous substance P, like other vasoactive peptides, may interact with a substance P-specific receptor population in the cochlea and may therefore participate in the ongoing regulation of CoBF. These findings also support the premise that vasodilatory hormones, along with vasoconstrictive agents, may be involved in the autoregulation of CoBF.

Acute effects of cocaine on cochlear function

The effects of a single administration of cocaine on the cochlea was evaluated by measuring amplitude-intensity functions of the N1 response of the auditory nerve. Amplitude-intensity functions of the N1 response to tone-pips of 500 Hz, 1, 2, 4 and 8 kHz were obtained before and after intraperitoneal injection of either saline, 3 mg/kg or 25 mg/kg of cocaine. N1 amplitudes were decreased after the administration of cocaine and this reduction was found to be dose dependent. The influence of cocaine on cochlear blood flow (CBF) was examined in order to test the possibility that cocaine induced reductions in CBF underlie these electro-physiological changes. Corresponding decreases in cochlear blood flow after cocaine exposure were observed.

Laser-Doppler measurements and electrocochleography during ischemia of the guinea pig cochlea: implications for hearing preservation in acoustic neuroma surgery

Interruption of cochlear blood flow has been implicated as one of the causes of the sensorineural hearing loss that may occur during acoustic neuroma surgery. With the guinea pig as an animal model for cerebellopontine angle surgery, laser-Doppler measurements were used to estimate the cochlear blood flow changes caused by compression of the eighth nerve complex. With compression, the laser-Doppler measurements decreased abruptly; somewhat later, the electrocochleographic potentials declined. When compression was released, laser-Doppler measurements usually returned immediately, followed later by return of the electrical potentials. Some of these potentials, including the compound action potential of the auditory nerve, often became transiently larger than their precompression values. Interposing bone between the laser-Doppler probe and the otic capsule, so that the total bone thickness approximated the thickness of the human otic capsule, decreased the laser-Doppler measurement, but changes caused by compression were still apparent. Thus, although the human otic capsule is much thicker than the guinea pig capsule, it may still be possible to make laser-Doppler estimates of human cochlear blood flow. Laser-Doppler monitoring during acoustic neuroma surgery may be beneficial, because it could give earlier warning of ischemia than is currently available from electrocochleographic monitoring, thereby enabling earlier corrective action. Electrocochleography complements laser-Doppler measurements by indicating the physiologic state of the cochlea.

Discovery of a distinct binding site for angiotensin II (3-8), a putative angiotensin IV receptor

We report here the discovery of a unique and novel angiotensin binding site and peptide system based upon the C-terminal 3-8 hexapeptide fragment of angiotensin II (NH3(+)-Val-Tyr-Ile-His-Pro-Phe-COO-) (AII(3-8) (AIV)). This fragment binds saturably, reversibly, specifically, and with high affinity to membrane-binding sites in a variety of tissues and from many species. The binding site is pharmacologically distinct from the classic angiotensin receptors (AT1 or AT2) displaying low affinity for the known agonists (AII and AIII) and antagonist (Sar1,Ile8-AII). Although a definitive function has not been assigned to this system in many of the tissues in which it resides, AIV's interaction with endothelial cells may involve a role in endothelial cell-dependent vasodilation. Consequent to this action, AIV is a potent stimulator of renal cortical blood flow.