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Ono M, Ito T. Hearing loss-related altered neuronal activity in the inferior colliculus. Hear Res 2024; 449:109033. [PMID: 38797036 DOI: 10.1016/j.heares.2024.109033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/01/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
Hearing loss is well known to cause plastic changes in the central auditory system and pathological changes such as tinnitus and hyperacusis. Impairment of inner ear functions is the main cause of hearing loss. In aged individuals, not only inner ear dysfunction but also senescence of the central nervous system is the cause of malfunction of the auditory system. In most cases of hearing loss, the activity of the auditory nerve is reduced, but that of the successive auditory centers is increased in a compensatory way. It has been reported that activity changes occur in the inferior colliculus (IC), a critical nexus of the auditory pathway. The IC integrates the inputs from the brainstem and drives the higher auditory centers. Since abnormal activity in the IC is likely to affect auditory perception, it is crucial to elucidate the neuronal mechanism to induce the activity changes of IC neurons with hearing loss. This review outlines recent findings on hearing-loss-induced plastic changes in the IC and brainstem auditory neuronal circuits and discusses what neuronal mechanisms underlie hearing-loss-induced changes in the activity of IC neurons. Considering the different causes of hearing loss, we discuss age-related hearing loss separately from other forms of hearing loss (non-age-related hearing loss). In general, the main plastic change of IC neurons caused by both age-related and non-age-related hearing loss is increased central gain. However, plastic changes in the IC caused by age-related hearing loss seem to be more complex than those caused by non-age-related hearing loss.
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Affiliation(s)
- Munenori Ono
- Department of Physiology, School of Medicine, Kanazawa Medical University, Uchinada, Ishikawa 920-0293, Japan.
| | - Tetsufumi Ito
- Systems Function and Morphology, University of Toyama, Toyama 930-0194, Japan.
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Elliott KL, Fritzsch B, Yamoah EN, Zine A. Age-Related Hearing Loss: Sensory and Neural Etiology and Their Interdependence. Front Aging Neurosci 2022; 14:814528. [PMID: 35250542 PMCID: PMC8891613 DOI: 10.3389/fnagi.2022.814528] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/03/2022] [Indexed: 12/19/2022] Open
Abstract
Age-related hearing loss (ARHL) is a common, increasing problem for older adults, affecting about 1 billion people by 2050. We aim to correlate the different reductions of hearing from cochlear hair cells (HCs), spiral ganglion neurons (SGNs), cochlear nuclei (CN), and superior olivary complex (SOC) with the analysis of various reasons for each one on the sensory deficit profiles. Outer HCs show a progressive loss in a basal-to-apical gradient, and inner HCs show a loss in a apex-to-base progression that results in ARHL at high frequencies after 70 years of age. In early neonates, SGNs innervation of cochlear HCs is maintained. Loss of SGNs results in a considerable decrease (~50% or more) of cochlear nuclei in neonates, though the loss is milder in older mice and humans. The dorsal cochlear nuclei (fusiform neurons) project directly to the inferior colliculi while most anterior cochlear nuclei reach the SOC. Reducing the number of neurons in the medial nucleus of the trapezoid body (MNTB) affects the interactions with the lateral superior olive to fine-tune ipsi- and contralateral projections that may remain normal in mice, possibly humans. The inferior colliculi receive direct cochlear fibers and second-order fibers from the superior olivary complex. Loss of the second-order fibers leads to hearing loss in mice and humans. Although ARHL may arise from many complex causes, HC degeneration remains the more significant problem of hearing restoration that would replace the cochlear implant. The review presents recent findings of older humans and mice with hearing loss.
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Affiliation(s)
- Karen L. Elliott
- Department of Biology, University of Iowa, Iowa City, IA, United States
| | - Bernd Fritzsch
- Department of Biology, University of Iowa, Iowa City, IA, United States
- *Correspondence: Bernd Fritzsch
| | - Ebenezer N. Yamoah
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, NV, United States
| | - Azel Zine
- LBN, Laboratory of Bioengineering and Nanoscience, University of Montpellier, Montpellier, France
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Vicencio-Jimenez S, Weinberg MM, Bucci-Mansilla G, Lauer AM. Olivocochlear Changes Associated With Aging Predominantly Affect the Medial Olivocochlear System. Front Neurosci 2021; 15:704805. [PMID: 34539335 PMCID: PMC8446540 DOI: 10.3389/fnins.2021.704805] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
Age-related hearing loss (ARHL) is a public health problem that has been associated with negative health outcomes ranging from increased frailty to an elevated risk of developing dementia. Significant gaps remain in our knowledge of the underlying central neural mechanisms, especially those related to the efferent auditory pathways. Thus, the aim of this study was to quantify and compare age-related alterations in the cholinergic olivocochlear efferent auditory neurons. We assessed, in young-adult and aged CBA mice, the number of cholinergic olivocochlear neurons, auditory brainstem response (ABR) thresholds in silence and in presence of background noise, and the expression of excitatory and inhibitory proteins in the ventral nucleus of the trapezoid body (VNTB) and in the lateral superior olive (LSO). In association with aging, we found a significant decrease in the number of medial olivocochlear (MOC) cholinergic neurons together with changes in the ratio of excitatory and inhibitory proteins in the VNTB. Furthermore, in old mice we identified a correlation between the number of MOC neurons and ABR thresholds in the presence of background noise. In contrast, the alterations observed in the lateral olivocochlear (LOC) system were less significant. The decrease in the number of LOC cells associated with aging was 2.7-fold lower than in MOC and in the absence of changes in the expression of excitatory and inhibitory proteins in the LSO. These differences suggest that aging alters the medial and lateral olivocochlear efferent pathways in a differential manner and that the changes observed may account for some of the symptoms seen in ARHL.
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Affiliation(s)
- Sergio Vicencio-Jimenez
- The Center for Hearing and Balance, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Madison M Weinberg
- The Center for Hearing and Balance, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Giuliana Bucci-Mansilla
- Laboratorio de Neurosistemas, Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Amanda M Lauer
- The Center for Hearing and Balance, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Ebbers L, Weber M, Nothwang HG. Activity-dependent formation of a vesicular inhibitory amino acid transporter gradient in the superior olivary complex of NMRI mice. BMC Neurosci 2017; 18:75. [PMID: 29073893 PMCID: PMC5659004 DOI: 10.1186/s12868-017-0393-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the mammalian superior olivary complex (SOC), synaptic inhibition contributes to the processing of binaural sound cues important for sound localization. Previous analyses demonstrated a tonotopic gradient for postsynaptic proteins mediating inhibitory neurotransmission in the lateral superior olive (LSO), a major nucleus of the SOC. To probe, whether a presynaptic molecular gradient exists as well, we investigated immunoreactivity against the vesicular inhibitory amino acid transporter (VIAAT) in the mouse auditory brainstem. RESULTS Immunoreactivity against VIAAT revealed a gradient in the LSO and the superior paraolivary nucleus (SPN) of NMRI mice, with high expression in the lateral, low frequency processing limb and low expression in the medial, high frequency processing limb of both nuclei. This orientation is opposite to the previously reported gradient of glycine receptors in the LSO. Other nuclei of the SOC showed a uniform distribution of VIAAT-immunoreactivity. No gradient was observed for the glycine transporter GlyT2 and the neuronal protein NeuN. Formation of the VIAAT gradient was developmentally regulated and occurred around hearing-onset between postnatal days 8 and 16. Congenital deaf Claudin14 -/- mice bred on an NMRI background showed a uniform VIAAT-immunoreactivity in the LSO, whereas cochlear ablation in NMRI mice after hearing-onset did not affect the gradient. Additional analysis of C57Bl6/J, 129/SvJ and CBA/J mice revealed a strain-specific formation of the gradient. CONCLUSIONS Our results identify an activity-regulated gradient of VIAAT in the SOC of NRMI mice. Its absence in other mouse strains adds a novel layer of strain-specific features in the auditory system, i.e. tonotopic organization of molecular gradients. This calls for caution when comparing data from different mouse strains frequently used in studies involving transgenic animals. The presence of strain-specific differences offers the possibility of genetic mapping to identify molecular factors involved in activity-dependent developmental processes in the auditory system. This would provide an important step forward concerning improved auditory rehabilitation in cases of congenital deafness.
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Affiliation(s)
- Lena Ebbers
- Neurogenetics Group, Center of Excellence Hearing4All, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, 26111 Oldenburg, Germany
| | - Maren Weber
- Neurogenetics Group, Center of Excellence Hearing4All, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, 26111 Oldenburg, Germany
| | - Hans Gerd Nothwang
- Neurogenetics Group, Center of Excellence Hearing4All, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, 26111 Oldenburg, Germany
- Research Center for Neurosensory Science, Carl von Ossietzky University Oldenburg, 26111 Oldenburg, Germany
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Laumen G, Tollin DJ, Beutelmann R, Klump GM. Aging effects on the binaural interaction component of the auditory brainstem response in the Mongolian gerbil: Effects of interaural time and level differences. Hear Res 2016; 337:46-58. [PMID: 27173973 PMCID: PMC4922418 DOI: 10.1016/j.heares.2016.04.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 04/06/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
The effect of interaural time difference (ITD) and interaural level difference (ILD) on wave 4 of the binaural and summed monaural auditory brainstem responses (ABRs) as well as on the DN1 component of the binaural interaction component (BIC) of the ABR in young and old Mongolian gerbils (Meriones unguiculatus) was investigated. Measurements were made at a fixed sound pressure level (SPL) and a fixed level above visually detected ABR threshold to compensate for individual hearing threshold differences. In both stimulation modes (fixed SPL and fixed level above visually detected ABR threshold) an effect of ITD on the latency and the amplitude of wave 4 as well as of the BIC was observed. With increasing absolute ITD values BIC latencies were increased and amplitudes were decreased. ILD had a much smaller effect on these measures. Old animals showed a reduced amplitude of the DN1 component. This difference was due to a smaller wave 4 in the summed monaural ABRs of old animals compared to young animals whereas wave 4 in the binaural-evoked ABR showed no age-related difference. In old animals the small amplitude of the DN1 component was correlated with small binaural-evoked wave 1 and wave 3 amplitudes. This suggests that the reduced peripheral input affects central binaural processing which is reflected in the BIC.
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Affiliation(s)
- Geneviève Laumen
- Cluster of Excellence Hearing4all, Animal Physiology and Behavior Group, Department for Neuroscience, School of Medicine and Health Sciences, Oldenburg University, 26111, Oldenburg, Germany.
| | - Daniel J Tollin
- Department of Physiology and Biophysics, School of Medicine, University of Colorado, Aurora, CO, 80045, USA.
| | - Rainer Beutelmann
- Cluster of Excellence Hearing4all, Animal Physiology and Behavior Group, Department for Neuroscience, School of Medicine and Health Sciences, Oldenburg University, 26111, Oldenburg, Germany.
| | - Georg M Klump
- Cluster of Excellence Hearing4all, Animal Physiology and Behavior Group, Department for Neuroscience, School of Medicine and Health Sciences, Oldenburg University, 26111, Oldenburg, Germany.
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Radtke-Schuller S, Seeler S, Grothe B. Restricted loss of olivocochlear but not vestibular efferent neurons in the senescent gerbil (Meriones unguiculatus). Front Aging Neurosci 2015; 7:4. [PMID: 25762929 PMCID: PMC4327622 DOI: 10.3389/fnagi.2015.00004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 01/11/2015] [Indexed: 11/19/2022] Open
Abstract
Degeneration of hearing and vertigo are symptoms of age-related auditory and vestibular disorders reflecting multifactorial changes in the peripheral and central nervous system whose interplay remains largely unknown. Originating bilaterally in the brain stem, vestibular and auditory efferent cholinergic projections exert feedback control on the peripheral sensory organs, and modulate sensory processing. We studied age-related changes in the auditory and vestibular efferent systems by evaluating number of cholinergic efferent neurons in young adult and aged gerbils, and in cholinergic trigeminal neurons serving as a control for efferents not related to the inner ear. We observed a significant loss of olivocochlear (OC) neurons in aged compared to young adult animals, whereas the overall number of lateral superior olive (LSO) cells was not reduced in aging. Although the loss of lateral and medial olivocochlear (MOC) neurons was uniform and equal on both sides of the brain, there were frequency-related differences within the lateral olivocochlear (LOC) neurons, where the decline was larger in the medial limb of the superior olivary nucleus (high frequency representation) than in the lateral limb (middle-to-low frequency representation). In contrast, neither the number of vestibular efferent neurons, nor the population of motor trigeminal neurons were significantly reduced in the aged animals. These observations suggest differential effects of aging on the respective cholinergic efferent brainstem systems.
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Affiliation(s)
- Susanne Radtke-Schuller
- Division of Neurobiology, Department Biology II, Ludwig-Maximilians-University Munich, Germany ; IFB German Center for Vertigo and Balance Disorders Munich, Germany
| | - Sabine Seeler
- Division of Neurobiology, Department Biology II, Ludwig-Maximilians-University Munich, Germany
| | - Benedikt Grothe
- Division of Neurobiology, Department Biology II, Ludwig-Maximilians-University Munich, Germany ; IFB German Center for Vertigo and Balance Disorders Munich, Germany
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Comparing the inferior colliculus of young and old gerbils (Meriones unguiculatus) with an emphasis on GABA. Exp Gerontol 2014; 57:155-62. [DOI: 10.1016/j.exger.2014.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 05/22/2014] [Accepted: 05/28/2014] [Indexed: 11/23/2022]
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Gerbils. THE LABORATORY RABBIT, GUINEA PIG, HAMSTER, AND OTHER RODENTS 2012. [PMCID: PMC7158315 DOI: 10.1016/b978-0-12-380920-9.00052-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
The gerbil is usually nonaggressive and is one of the easiest rodents to maintain and handle. Its disposition, curious nature, relative freedom from naturally occurring infectious diseases, and adaptability to its environment have contributed to its popularity as a laboratory animal. Gerbils are found in deserts and semiarid geographical regions of the world. The Mongolian gerbils that are available today originated from 20 pairs of captured animals that were maintained in 1935 in a closed, random-bred colony at the Kitasato Institute in Japan. Gerbils have several unique anatomical and physiological features. Mature gerbils are smaller than rats, but larger than mice. Mongolian gerbils are attracted to saliva and use salivary cues to discriminate between siblings and nonsiblings, and females use oral cues in the selection of sociosexual partners. Gerbils have been used as experimental models in a number of areas of biomedical research. Gerbils are excellent subjects for laboratory animal research as they are susceptible to bacterial, viral, and parasitic pathogens that affect humans and other species. Gerbils may have spontaneous seizures secondary to stress such as handling, cage change, abrupt noises, or changes in the environment. Cystic ovaries are seen commonly in female gerbils over 1 year of age. Gerbils have unique characteristics, which make them appropriate for a number of animal models. Classically, gerbils have been used in research involving stroke, parasitology, infectious diseases, epilepsy, brain development and behavior, and hearing.
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Morphology of the malleus handle and the comparison of different prostheses for malleostapedotomy. Otol Neurotol 2010; 30:1175-85. [PMID: 19300298 DOI: 10.1097/mao.0b013e31819e6361] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To assess malleus morphology to characterize optimal sites for prosthesis attachment in malleostapedotomy and to examine attachment, position, and depth of penetration in the vestibule of the 3 most used prostheses. METHODS Ten mallei were processed for histologic examination with the light microscope. Using digitized video images of the histologic slices, the diameters, circumference, and shape of the specimen were determined. Implantation of 3 prostheses (Gyrus Nitinol piston, Storz titanium stapes piston, and Kurz malleovestibulopexy piston), was performed in 3 temporal bones for a total of 27 implantations. RESULTS The cross-section of the malleus just distal to the lateral process shows an inclined oval shape with a mean minimum diameter of 0.84 +/- 0.10 mm, a mean maximum diameter of 1.02 +/- 0.23 mm, and a mean circumference of 3.23 +/- 0.49 mm. The quality of attachment to the malleus, the position of the prosthesis piston, and the depth of penetration were reliable for the Storz titanium stapes piston, satisfactory though variable for the Gyrus Nitinol piston and poor for the Kurz malleovestibulopexy piston as judged by contact with the malleus surface and predictability of insertion depth into the vestibule. CONCLUSION The oval and inferoanteriorly inclined shape of the malleus distal to the lateral process requires the use of a prosthesis capable of molding itself to its surface for reliable attachment. To achieve the correct perpendicular position of the piston as it relates to the stapedotomy opening, individualized adaptation of the prosthesis shaft and loop to the anterior position of the malleus should be made in situ.
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Caspary DM, Ling L, Turner JG, Hughes LF. Inhibitory neurotransmission, plasticity and aging in the mammalian central auditory system. ACTA ACUST UNITED AC 2008; 211:1781-91. [PMID: 18490394 DOI: 10.1242/jeb.013581] [Citation(s) in RCA: 353] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Aging and acoustic trauma may result in partial peripheral deafferentation in the central auditory pathway of the mammalian brain. In accord with homeostatic plasticity, loss of sensory input results in a change in pre- and postsynaptic GABAergic and glycinergic inhibitory neurotransmission. As seen in development, age-related changes may be activity dependent. Age-related presynaptic changes in the cochlear nucleus include reduced glycine levels, while in the auditory midbrain and cortex, GABA synthesis and release are altered. Presumably, in response to age-related decreases in presynaptic release of inhibitory neurotransmitters, there are age-related postsynaptic subunit changes in the composition of the glycine (GlyR) and GABA(A) (GABA(A)R) receptors. Age-related changes in the subunit makeup of inhibitory pentameric receptor constructs result in altered pharmacological and physiological responses consistent with a net down-regulation of functional inhibition. Age-related functional changes associated with glycine neurotransmission in dorsal cochlear nucleus (DCN) include altered intensity and temporal coding by DCN projection neurons. Loss of synaptic inhibition in the superior olivary complex (SOC) and the inferior colliculus (IC) likely affect the ability of aged animals to localize sounds in their natural environment. Age-related postsynaptic GABA(A)R changes in IC and primary auditory cortex (A1) involve changes in the subunit makeup of GABA(A)Rs. In turn, these changes cause age-related changes in the pharmacology and response properties of neurons in IC and A1 circuits, which collectively may affect temporal processing and response reliability. Findings of age-related inhibitory changes within mammalian auditory circuits are similar to age and deafferentation plasticity changes observed in other sensory systems. Although few studies have examined sensory aging in the wild, these age-related changes would likely compromise an animal's ability to avoid predation or to be a successful predator in their natural environment.
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Affiliation(s)
- Donald M Caspary
- Southern Illinois University School of Medicine, Springfield, IL 62794, USA.
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Maier JK, Kindermann T, Grothe B, Klump GM. Effects of omni-directional noise-exposure during hearing onset and age on auditory spatial resolution in the Mongolian gerbil (Meriones unguiculatus) -- a behavioral approach. Brain Res 2008; 1220:47-57. [PMID: 18343357 DOI: 10.1016/j.brainres.2008.01.083] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2007] [Revised: 01/18/2008] [Accepted: 01/19/2008] [Indexed: 10/22/2022]
Abstract
Inhibitory inputs to the binaural brainstem nuclei medial and lateral superior olives (MSO and LSO, respectively) are thought to be important for sound localization in mammals. Here, we investigate whether aged gerbils that typically exhibit degenerative changes in auditory nuclei providing inhibition to MSO and LSO show diminished localization ability. We also tested the localization ability in gerbils reared in omni-directional white noise during hearing onset, a treatment that affects the adjustment of inhibitory inputs to MSO neurons possibly resulting in weakened sensitivity to interaural time difference. Localization ability of both groups was compared to that of young gerbils raised under control conditions. Stimuli had a duration of 125 ms and were pure tones of 0.5, 1, 2, 4 and 8 kHz, 300-Hz-bands of noise centered at 0.5, 2 and 8 kHz or broad-band noise. Gerbils trained in a two-alternative-forced-choice procedure indicated if sounds were presented from the left or from the right by choosing the respective response compartment of a Y-shaped experimental setup. The minimum resolvable angle (MRA) was calculated as the minimum angle between two loudspeaker locations that a gerbil was able to discriminate. MRAs for aged gerbils were higher compared to controls, whereas MRAs of noise-reared gerbils did not differ from those of the control group. Results are discussed with respect to the progressive degeneration affecting the gerbil's auditory system, changes in the anatomical arrangement of inhibitory inputs on binaural neurons in the MSO, and hearing thresholds.
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Affiliation(s)
- Julia K Maier
- Zoophysiology and Behaviour Group, Institute for Biology and Environmental Sciences, Carl von Ossietzky University Oldenburg, Carl von Ossietzky Street 9-11, 26129 Oldenburg, Germany
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Kwok P, Fisch U, Gleich O, Achhammer K, Strutz J. Stapes surgery: the diameter of the long process of the incus. Otol Neurotol 2008; 27:469-77. [PMID: 16791037 DOI: 10.1097/01.mao.0000224081.85473.9b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS The aim of this study was to examine the long process of the incus in respect of its shape and its dimensions at the site of the attachment of a stapes prosthesis. BACKGROUND One of the complications in stapes surgery is the erosion of the long process of the incus at the site of the attachment of the prosthesis, resulting in a fluctuating conductive hearing loss. Knowing the dimensions of the attachment site of the prosthesis at the long process of the incus will make it possible to optimize the size of the prosthesis loop. METHODS The incus was obtained from 11 patients who had undergone middle ear surgery for hearing improvement or cholesteatoma removal. The ossicles were kept in 4% paraformaldehyde and were processed for histological examination after decalcification in ethylenediamine tetra-acetic acid. The 5-microm slices were stained with toluidine blue and examined in the light microscope. Using digitized video images of the histological slices, the diameters, circumference, and surface of the specimens were determined. RESULTS The diameter of the long process of the incus at 1.4+/-0.28 mm from the tip, which is the average site of prosthesis attachment, showed an oval shape with a minimum diameter of 0.66+/-0.05 mm, a maximum diameter of 0.81+/-0.1 mm, and a circumference of 2.46+/-0.23 mm. CONCLUSION The loop of a stapes prosthesis should have the following dimensions: diameter 0.9 mm, loop length of 2.2 mm, and opening of loop 0.7 mm. However, the material of the prosthesis and its malleability are also important factors.
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Affiliation(s)
- Pingling Kwok
- ENT-Department, University of Regensburg, Regensburg, Germany, and ORL-Zentrum, Hirslanden Klinik, Zürich, Switzerland.
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