New insight into the bony labyrinth: A microcomputed tomography study

Surgical Considerations in Inner Ear Gene Therapy from Human Temporal Bone Anatomy

OBJECTIVE(S)

Recently directed methods of inner ear drug delivery underscore the necessity for understanding critical anatomical dimensions. This study examines anatomical measurements of the human middle and inner ear relevant for inner ear drug delivery studied with three different imaging modalities.

METHODS

Post-mortem human temporal bones were analyzed using human temporal bone histopathology (N = 24), micro computerized tomography (μCT; N = 4), and synchrotron radiation phase-contrast imaging (SR-PCI; N = 7). Nine measurements involving the oval and round windows were performed when relevant anatomical structures were visualized for subsequent age-controlled analysis, and comparisons were made between imaging methods.

RESULTS

Combined human temporal bone histopathology showed the mean distance to the saccule from the center of the stapes footplate (FP) was 2.07 ± 0.357 mm and the minimum distance was 1.23 mm. The mean distance from the round window membrane (RWM) to the osseous spiral lamina (OSL) was 1.75 ± 0.199 mm and the minimum distance was 1.43 mm. Instruments inserted up to 1 mm past the center of the FP are unlikely to cause saccular damage, provided there are no endolymphatic hydrops. Similarly, instruments inserted up to 1 mm through the RWM in the trajectory toward the OSL are unlikely to cause OSL damage.

CONCLUSION

The combined analyses of inner-ear dimensions of age-controlled groups and imaging modalities demonstrate critical dimensions of importance to consider when inserting delivery vehicles into the human cochlea.

LEVEL OF EVIDENCE

N/A Laryngoscope, 134:2879-2888, 2024.

Size and shape of the semicircular canal of the inner ear: A new marker of pig domestication?

Domestication has led to many changes in domestic animal biology, including their anatomy. The shape of the inner ear, part of the mammalian ear, has been found particularly relevant for discriminating domesticated species, their hybrids or differentiating the wild and domestic populations of a single species. Here we assessed the use of the size and shape of the semicircular canals (SCC) of the inner ear as a marker of pig domestication. We studied a total of 63 petrosal bones belonging to wild boar (Sus scrofa, two populations) and domestic pigs (extensively and intensively reared specimens) that were µCT-scanned and from which the size and the shape of the inner ear were quantified through geometric morphometrics, analyzing the 3D coordinates of 6 landmarks and 60 sliding semilandmarks localized on the SCC and the common crus. The domestic pigs have larger SCC than the wild boar from which they also strongly differ in shape (correct cross validation of 95.5%, confidence interval: 92.3%-98.1%). Strong shape differences were detected between the two populations of wild boar, as well as a sexual size dimorphism. All together the results highlight the taxonomic discriminant power of the SCC of the inner ear shape, and its relevance for domestication studies.

The Dizzy Child

Dizziness occurs in children with an estimated prevalence of 0.45% to 15.0%. Vestibular disorders in the pediatric population can impact gross motor function development, visual acuity, and contribute to psychological distress. Appropriate case history and focused direct examination can be helpful when determining the etiology of dizziness. Vestibular testing can be completed in children and guide management of suspected vestibular dysfunction. Vestibular dysfunction is commonly seen in patients with sensorineural hearing loss. Migraine disorders are the most common cause of dizziness in childhood. Etiologies of dizziness in children differ from those commonly seen in adults.

Sexing the bony labyrinth: A morphometric investigation in a subadult and adult Belgian identified sample

In forensic anthropology, sex estimation is a fundamental step in assessing individual biological profiles when analyzing human skeletons. Yet, current methods are not reliable enough to allow an accurate sex identification of highly fragmented, burnt, or subadult remains. This paper aims to investigate sexual dimorphism of the bony labyrinth on both identified subadult and adult individuals. The bony labyrinth is of particular interest for sex estimation since it is alleged to complete size and maturation pre-pubertally and is located inside the petrous part of the temporal bone which protects it from taphonomic processes. The study was performed on 93 CT scans of identified individuals from two Belgian osteological collections (19-20th century) and from current pediatric images (Erasme hospital, Brussels). Linear and angular measurements were taken on 2D slices of right bony labyrinths. Intra- and interobservers error measurements were calculated. Statistical tests were used to unravel any morphological variations between subadult and adult bony labyrinths and to highlight differences between females and males, separately in subadults and adults. Linear discriminant functions were established by cross-validation and tested on an independent sample from Belgium. Some measurements were significantly different between subadults and adults, and between females and males within both subadult and adult samples. Univariate functions achieved 72.7% in subadults and 68.4% in adults whereas multivariate equations increased accuracy respectively up to 84.9% and 78.4%. This study entails promising results to design a sex estimation method suitable for fragmented and/or subadult remains. Further metric approaches are needed to explore bony labyrinth sexual dimorphism.

Exploring the ontogenetic development of the inner ear in Aardvarks

The aardvark is the last living Tubulidentata, an order of afrotherian mammals. Afrotheria is supported strongly by molecular analyses, yet sparingly by morphological characters. Moreover, the biology of the aardvark remains incompletely known. The inner ear, and its ontogeny in particular, has not been studied in details yet, though it bears key ecomorphological characters and phylogenetical signal. The aim of this study is to decipher and discuss the ontogenetic development of the different areas of the inner ear of Orycteropus afer. We focused in particular on their relative size and morphological rates of development. Specimens were scanned with 3D imaging techniques. 3D and 2D geometric morphometrics coupled with qualitative descriptions of the petrosal ossification allowed us to evidence several stages through development. Based on our sample, the cochlea is the first structure of the inner ear to reach adult size, but it is the last one to acquire its adult morphology close to parturition. In contrast, after a delayed growth spurt, the semicircular canals reach their mature morphology before the cochlea, concomitantly with the increase of petrosal ossification. The ontogeny of the aardvark inner ear shows similarities with that of other species, but the apex of the cochlea presents some autapomorphies. This work constitutes a first step in the study of the ontogeny of this sensorial organ in Afrotheria.

Ratio of mitochondrial to nuclear DNA affects contamination estimates in ancient DNA analysis

In the last decade, ancient DNA research has grown rapidly and started to overcome several of its earlier limitations through Next-Generation-Sequencing (NGS). Among other advances, NGS allows direct estimation of sample contamination from modern DNA sources. First NGS-based approaches of estimating contamination measured heterozygosity. These measurements, however, could only be performed on haploid genomic regions, i.e. the mitochondrial genome or male X chromosomes, but provided no measures of contamination in the nuclear genome of females with their two X chromosomes. Instead, female nuclear contamination is routinely extrapolated from mitochondrial contamination estimates, but it remains unclear if this extrapolation is reliable and to what degree variation in mitochondrial to nuclear DNA ratios affects this extrapolation. We therefore analyzed ancient DNA from 317 samples of different skeletal elements from multiple sites, spanning a temporal range from 7,000 BP to 386 AD. We found that the mitochondrial to nuclear DNA (mt/nc) ratio negatively correlates with an increase in endogenous DNA content and strongly influenced mitochondrial and nuclear contamination estimates in males. The ratio of mt to nc contamination estimates remained stable for overall mt/nc ratios below 200, as found particularly often in petrous bones but less in other skeletal elements and became more variable above that ratio.

Development of ossification in the vertical semicircular canals: tomographic study

PURPOSE

To describe the ontogeny of vertical semicircular canals using computed tomography.

MATERIALS AND METHODS

We have studied 39 human fetuses aged between 17 and 38 weeks of development through multi-helicoidal CT.

RESULTS

The first signs of ossification in the semicircular canals, superior and posterior, are from 19 weeks of development, through two primary ossification centers in each canal, which will take part in the formation of the outer cover oriented towards the middle and posterior brain fossae, respectively. In this process it must be added the intervention of the common branch. Internal bone covers are formed by ossification of the fossa subarcuata in the superior semicircular canal, and from the compact center of the labyrinthine capsule into the posterior canal. The tomographic study has allowed us to demonstrate how ossification follows a variable rate, establishing a period between 21 and 26 weeks where there are completely closed canals with others still open to the brain fossae.

CONCLUSIONS

The tomographic study of the semicircular canals has enabled us to establish a critical period in its ossification that could explain the etiology of the congenital-type dehiscence.

Morphogenesis of the Middle Ear during Fetal Development as Observed Via Magnetic Resonance Imaging

Recently, our research group has utilized serial histological sections to investigate the morphogenesis of the middle ear, which corresponds to the period of middle ear ossicle (MEO) cartilage formation. However, research regarding middle ear development during the post-embryonic period has been limited. In the present study, we investigated morphogenesis of the middle ear in human fetuses with a crown-rump length (CRL) between 37 and 197 mm using high-resolution magnetic resonance imaging (MRI). Our findings indicated that the morphology of the MEOs is similar during fetal development and adulthood; further, growth of the MEOs nearly ceases once a CRL of 150 mm is attained. In each MEO, ossification spreads from a single center. The malleus and Meckel's cartilage could be discriminated in samples exhibiting a CRL of 145 mm based on differences in MRI signal intensity. In samples with a CRL of 86 mm, the tympanic cavity (TC) appeared as a thin yet distinct structure attached to the external auditory meatus at the convex surface. Only the handle of the malleus was covered by the TC, while the incus and stapes contacted the cavity at the region of articulation between the two ossicles only, even after a CRL of 145 mm had been attained. Thus, although the TC increased in both diameter and thickness, coverage did not extend across all three MEOs during the observation period. These data are expected to provide a useful standard for morphogenesis and may aid researchers in distinguishing between normal and abnormal development. Anat Rec, 301:757-764, 2018. © 2017 Wiley Periodicals Inc.

CT Scan Imaging of the Human Fetal Labyrinth: Case Series Data Throughout Gestation

OBJECTIVES

The inner ear in humans reaches its final configuration and its adult size during fetal life. According to the literature, this occurs between 18 and 25 weeks of amenorrhea (WA). Our goal is to clarify the course of inner ear size development.

METHODS

Using computed tomography (CT) scanner, we studied 13 measurements in the inner ear of a collection of 153 fetuses from 21 to 40 WA.

RESULTS

We found no side-related differences or sexual dimorphism in the measurements. Cochlear and vestibular bone measurements did not show growth from 21 to 40 WA, with the exception of the lateral semicircular canal (LSCC) bony island, which grows until 25 WA. Internal auditory canal (IAC) and cochlear aqueduct (CA) growth are correlated with gestational age. As our cochlear measurements are similar to those of infants and adults, in accordance with the literature we conclude that the cochlea has reached its adult size before 21 WA. The continuous growth of the IAC and CA is linked to petrous ossification that continues during fetal gestation and after birth.

CONCLUSION

We confirm that the cochlea reaches its adult size during the second trimester of fetal life.

Superior Canal Dehiscence Syndrome Affecting 3 Families

Importance

Superior canal dehiscence syndrome (SCDS) is an increasingly recognized cause of hearing loss and vestibular symptoms, but the etiology of this condition remains unknown.

Objective

To describe 7 cases of SCDS across 3 families.

Design, Setting, and Participants

This retrospective case series included 7 patients from 3 different families treated at a neurotology clinic at a tertiary academic medical center from 2010 to 2014. Patients were referred by other otolaryngologists or were self-referred. Each patient demonstrated unilateral or bilateral SCDS or near dehiscence.

Interventions

Clinical evaluation involved body mass index calculation, audiometry, cervical vestibular evoked myogenic potential testing, electrocochleography, and multiplanar computed tomographic (CT) scan of the temporal bones. Zygosity testing was performed on twin siblings.

Main Outcomes and Measures

The diagnosis of SCDS was made if bone was absent over the superior semicircular canal on 2 consecutive CT images, in addition to 1 physiologic sign consistent with labyrinthine dehiscence. Near dehiscence was defined as absent bone on only 1 CT image but with symptoms and at least 1 physiologic sign of labyrinthine dehiscence.

Results

A total of 7 patients (5 female and 2 male; age range, 8-49 years) from 3 families underwent evaluation. Family A consisted of 3 adult first-degree relatives, of whom 2 were diagnosed with SCDS and 1 with near dehiscence. Family B included a mother and her child, both of whom were diagnosed with unilateral SCDS. Family C consisted of adult monozygotic twins, each of whom was diagnosed with unilateral SCDS. For all cases, dehiscence was located at the arcuate eminence. Obesity alone did not explain the occurrence of SCDS because 5 of the 7 cases had a body mass index (calculated as weight in kilograms divided by height in meters squared) less than 30.0.

Conclusions and Relevance

Superior canal dehiscence syndrome is a rare, often unrecognized condition. This report of 3 multiplex families with SCDS provides evidence in support of a potential genetic contribution to the etiology. Symptomatic first-degree relatives of patients diagnosed with SCDS should be offered evaluation to improve detection of this disorder.

Inner ear ossification and mineralization kinetics in human embryonic development - microtomographic and histomorphological study

Little is known about middle and inner ear development during the second and third parts of human fetal life. Using ultra-high resolution Microcomputed Tomography coupled with bone histology, we performed the first quantitative middle and inner ear ossification/mineralization evaluation of fetuses between 17 and 39 weeks of gestational age. We show distinct ossification paces between ossicles, with a belated development of the stapes. A complete cochlear bony covering is observed within the time-frame of the onset of hearing, whereas distinct time courses of ossification for semicircular canal envelopes are observed in relation to the start of vestibular functions. The study evidences a spatio-temporal relationship between middle and inner ear structure development and the onset of hearing and balance, critical senses for the fetal adaptation to birth.

Influence of Sex and Age on Posterior Semicircular Canal Thickness

OBJECTIVE

The aim of this study is to determine whether sex and age influence posterior semicircular canal (PSC) thickness.

METHODS

This observational study was conducted in 3 tertiary hospitals. The minimal distance between the PSC and the posterior cranial fossa (PSC thickness) was estimated by thin-section multidetector row computed axial tomography (CAT) scan of the temporal bones. Nonselected consecutive patients of all ages (607 temporal bones) were considered.

RESULTS

A significant effect was only detected for sex (F = 5.418, p = 0.020); PSC thickness showed a higher mean value in women (mean difference ± SE: 0.224 ± 0.096 mm). A significant and negative r value was detected for males aged >45 years (-0.173, p = 0.026); in that group of patients, PSC thickness decreased as age increased (0.018 ± 0.008 mm/year). For females aged ≤45 years, a significant and positive r value was found (0.198, p = 0.022); in that group, PSC thickness increased as age increased (0.020 ± 0.008 mm/year).

CONCLUSIONS

PSC thickness did not significantly evolve with age in young males (≤45 years) but it decreased from age 45 years onwards. On the other hand, PCS thickness increased with age in women until the age of 45 years and it did not significantly change in older females.

Prenatal growth stages show the development of the ruminant bony labyrinth and petrosal bone

Foetuses are a source of scientific information to understand the development and evolution of anatomical structures. The bony labyrinth, surrounding the organ of balance and hearing, is a phylogenetically and ecologically informative structure for which still little concerning growth and shape variability is known in many groups of vertebrates. Except in humans, it is poorly known in many other placentals and its prenatal growth has almost never been studied. Ruminants are a diversified group of placentals and represent an interesting case study to understand the prenatal growth of the ear region. We computed tomography -scanned five cow foetuses and an adult petrosal bone (Bos taurus, Artiodactyla, Mammalia), and describe the bony labyrinth when already ossified. The foetuses encompass the second half of the 9.3-month-long gestation period of the cow. They were sampled at different ontogenetic stages to understand how and when the petrosal bone and bony labyrinth ossify in ruminants. The petrosal bone and bony labyrinth ossify within about 20 days in the fourth month of gestation. The bony labyrinth is already fully ossified at least in the 6th month, while only the cochlea, most of the vestibule and the common crus are already ossified at the beginning of the 4th month. The pars canalicularis of the petrosal thus ossifies at last. The size and volume of the bony labyrinth stay similar from the 6th month (possibly even from the 5th). From the end of the 4th month of gestation, a progressive lengthening of the cochlear aqueduct and endolymphatic sac occurs, culminating in the adult form and partly explaining the larger volume of the later. The inner ear in the cow ossifies quickly during the gestation period, being fully ossified around mid-gestation time, as in humans. The adult size and most of its volume are reached by mid-gestation time while the petrosal bone and skull still grow. A negative ontogenetic allometry between the bony labyrinth and the petrosal bone and skull is thus observed. It matches the evolutionary negative allometry of the structure observed in earlier studies. Few changes occur after ossification is achieved; only open structures (i.e. cochlear aqueduct and endolymphatic sac) continue to grow after birth and reflect size increase of the petrosal bone.

[Trial of Micro CT Scanner SKYSCAN1176 for the Imaging of the Guinea Pig Cochlea in vivo]

The usefulness of the micro CT scanner system SKYSCAN1176 was evaluated for the study of the guinea pig cochlea. Each slice of the section was 9 μm and we were able to identify each ossicles, modiolus, upper, middle, and basal turn of the cochlea. This scanner enables us to observe inner ear structure repeatedly in vivo.

Semicircular canal angulation during fetal life: a computed tomography study of 54 human fetuses

OBJECTIVE

In humans, the inner ear reaches its final configuration and adult size during fetal life. According to the literature, this occurs between 18 and 25 weeks of amenorrhea (WA). The ossification of the otic capsule is believed to arrest any further configuration change. There have, however, been some observations of slight changes in the orientation of the semicircular canals (SCCs) occurring later in fetal life. The present study aim was to examine changes of angulations between bony SCCs during fetal life.

PATIENTS

Fifty-four human fetuses aged 22 to 40 WA.

INTERVENTION

Computed tomography scanner.

MAIN OUTCOME MEASURE

SCC angulation (in degrees) studied with Amira software.

RESULTS

We found mean angles between the lateral SCC and anterior SCC, the lateral SCC and posterior SCC, and the anterior SCC and posterior SCC of 88.67, 92.60, and 90.19 degrees, respectively. Inter-SCC angles did not change significantly between the different age groups (22 WA, 24 WA, 26 WA, 29-31 WA, 34-36 WA, 38-40 WA). There was no difference of angulation between males and females and no intraobserver or interobserver variability.

CONCLUSION

The absence of correlation of SCC angles with age in our sample of fetuses indicates that the three-dimensional configuration of the SCC has already reached its adult form at 22 WA. As often described in the literature, these angles are close to orthogonality, probably reflecting an optimal vestibular function configuration.

Frequency of Otitis Media Based on Otoendoscopic Evaluation in Preterm Infants

Objective

This study was conducted to determine the frequency of otitis media in preterm neonates using otoendoscopy and tympanometry.

Study Design

Prospective study.

Setting

Wayne State University, Hutzel Women’s Hospital Neonatal Intensive Care Unit.

Subjects and Methods

Eighty-six preterm infants were included (gestational age <36 weeks). Otoendoscopy and tympanometry were performed to detect the presence of otitis media. Kappa statistic and logistic regression were used for statistical analysis.

Results

Otoendoscopy was performed in 85 patients. The frequency of otoendoscopy-diagnosed otitis media was 72.9% (62/85). Tympanometry could be performed on 69.76% of the ears. There was 73.5% agreement between the findings of tympanometry and those of otoendoscopy. The association between the presence of otitis media and gestational age at birth was statistically significant. The lower the gestational age, the higher the frequency of otoendoscopy-diagnosed otitis media ( P = .001).

Conclusion

Otoendoscopically diagnosed otitis media is frequent in preterm neonates. There was agreement between the results of tympanometry and those of otoendoscopy. The frequency of otitis media increased with lower gestational age.

The human semicircular canals orientation is more similar to the bonobos than to the chimpanzees

For some traits, the human genome is more closely related to either the bonobo or the chimpanzee genome than they are to each other. Therefore, it becomes crucial to understand whether and how morphostructural differences between humans, chimpanzees and bonobos reflect the well known phylogeny. Here we comparatively investigated intra and extra labyrinthine semicircular canals orientation using 260 computed tomography scans of extant humans (Homo sapiens), bonobos (Pan paniscus) and chimpanzees (Pan troglodytes). Humans and bonobos proved more similarities between themselves than with chimpanzees. This finding did not fit with the well established chimpanzee – bonobo monophyly. One hypothesis was convergent evolution in which bonobos and humans produce independently similar phenotypes possibly in response to similar selective pressures that may be associated with postural adaptations. Another possibility was convergence following a “random walk” (Brownian motion) evolutionary model. A more parsimonious explanation was that the bonobo-human labyrinthine shared morphology more closely retained the ancestral condition with chimpanzees being subsequently derived. Finally, these results might be a consequence of genetic diversity and incomplete lineage sorting. The remarkable symmetry of the Semicircular Canals was the second major finding of this article with possible applications in taphonomy. It has the potential to investigate altered fossils, inferring the probability of post-mortem deformation which can lead to difficulties in understanding taxonomic variation, phylogenetic relationships, and functional morphology.

Sexual dimorphism of the bony labyrinth: a new age-independent method

Currently in physical anthropology there is a need for reliable methods of sex estimation for immature individuals and highly fragmented remains. This study develops a sex estimation technique from discriminant function analysis of the bony labyrinth as it matures before puberty and can survive taphonomic conditions that would destroy most other skeletal material. The bony labyrinth contains the organs of hearing and balance. For this reason biologists and paleoanthropologists have undertaken research in this area to understand evolutionary changes in locomotion. Prior studies have found clear differences between species, but within-species variation has not been satisfactorily investigated. 3D segmentations of the left and right labyrinths of 94 individuals from a Cretan collection were generated and measured. Mean measurements of height, width, size, and shape indices were analyzed for sexual dimorphism, bilateral asymmetry, and measurement error. Significant sexual dimorphism was detected for several measurements. For sex estimation, the single best variable was the radius of curvature of the posterior semicircular canal, which achieved 76% accuracy. Two multivariate functions increased accuracy to 84%. Although these equations are less accurate than equations for complete long bones and crania, they appear to be as accurate as or better than other techniques for sexing immature individuals and temporal bones.

Three-dimensional histological specimen preparation for accurate imaging and spatial reconstruction of the middle and inner ear

PURPOSE

This paper presents a highly accurate cross-sectional preparation technique. The research aim was to develop an adequate imaging modality for both soft and bony tissue structures featuring high contrast and high resolution. Therefore, the advancement of an already existing micro-grinding procedure was pursued. The central objectives were to preserve spatial relations and to ensure the accurate three-dimensional reconstruction of histological sections.

METHODS

Twelve human temporal bone specimens including middle and inner ear structures were utilized. They were embedded in epoxy resin, then dissected by serial grinding and finally digitalized. The actual abrasion of each grinding slice was measured using a tactile length gauge with an accuracy of one micrometre. The cross-sectional images were aligned with the aid of artificial markers and by applying a feature-based, custom-made auto-registration algorithm. To determine the accuracy of the overall reconstruction procedure, a well-known reference object was used for comparison. To ensure the compatibility of the histological data with conventional clinical image data, the image stacks were finally converted into the DICOM standard.

RESULTS

The image fusion of data from temporal bone specimens' and from non-destructive flat-panel-based volume computed tomography confirmed the spatial accuracy achieved by the procedure, as did the evaluation using the reference object.

CONCLUSION

This systematic and easy-to-follow preparation technique enables the three-dimensional (3D) histological reconstruction of complex soft and bony tissue structures. It facilitates the creation of detailed and spatially correct 3D anatomical models. Such models are of great benefit for image-based segmentation and planning in the field of computer-assisted surgery as well as in finite element analysis. In the context of human inner ear surgery, three-dimensional histology will improve the experimental evaluation and determination of intra-cochlear trauma after the insertion of an electrode array of a cochlear implant system.

Prevalence of radiographic semicircular canal dehiscence in very young children: an evaluation using high-resolution computed tomography of the temporal bones

BACKGROUND

Previous studies suggest that semicircular canal dehiscences (SCDs) have a developmental origin.

OBJECTIVE

We hypothesized that if SCDs originate during development, incidence of radiographic SCDs in young children will be higher than in adults.

MATERIALS AND METHODS

Thirty-four temporal bone HRCTs of children younger than 2 years and 40 temporal bone HRCTs of patients older than 18 years were reformatted and re-evaluated for presence of SCD or canal thinning. Results were compared with indications for HRCT and clinical information.

RESULTS

SCDs were detected in 27.3% of children younger than 2 years of age (superior, 13.8%; posterior, 20%) and in 3% of adults (P  < 0.004). Of children with one radiographic dehiscence, 55.6% had multiple and 44% had bilateral SCDs on HRCT. No lateral canal SCDs were present. Thinning of bone overlying the semicircular canals was found in 44% of children younger than 2 years and 2.5% of adults (P < 0.0001).

CONCLUSION

SCDs are more common on HRCTs of very young children. This supports the hypothesis that SCDs originate from discontinuation of bone deposition/maturation. However, SCDs on imaging do not necessarily correlate with canal dehiscence syndrome and should therefore be interpreted carefully.