Effects of noise and quinine on the vessels of the stria vascularis: an image analysis study

Radiotherapy-associated Sensorineural Hearing Loss in Pediatric Oncology Patients

During the radiotherapeutic treatment of pediatric oncology patients, they would be at a latent risk of developing ionizing radiation-induced ototoxicity when the cochlea or auditory nerve is located within the radiation field. Sensorineural hearing loss (SNHL) is an irreversible late complication of radiotherapy, and its incidence depends on various factors such as the patient's hearing sensitivity, total radiation dose to the cochlea, radiotherapy fractionation regimen, age and chemoradiation. Importantly, this complication exhibits serious challenges to adult survivors of childhood cancer, as it has been linked to impairments in academic achievement, psychosocial development, independent living skills, and employment in the survivor population. Therefore, early detection and proper management can alleviate academic, speech, language, social, and psychological morbidity arising from hearing deficits. In the present review, we have addressed issues such as underlying mechanisms of radiation-induced SNHL, audiometric findings of pediatric cancer patients treated with radiotherapy, and management and protection measures against radiation-induced ototoxicity.

The Ototoxicity of Antimalarial Drugs-A State of the Art Review

This review summarizes current knowledge about the occurrence of hearing and balance disorders after antimalarial drugs treatment. It also examines the clinical applications of antimalarials, their mechanisms behind this ototoxicity and how it can be monitored. It includes studies with larger numbers of patients and those in which auditory function was assessed using audiological tests. Some antimalarials have been repurposed for other conditions like autoimmune disorders, rheumatic diseases, some viral diseases and cancers. While old antimalarial drugs, such as quinoline derivatives, are known to demonstrate ototoxicity, a number of new synthetic antimalarial agents particularly artemisinin derivatives, demonstrate unknown ototoxicity. Adverse audiovestibular effects vary depending on the medication itself, its dose and route of administration, as well as the drug combination, treated disease and individual predispositions of the patient. Dizziness was commonly reported, while vestibular symptoms, hearing loss and tinnitus were observed much less frequently, and most of these symptoms were reversible. As early identification of ototoxic hearing loss is critical to introducing possible alternative treatments with less ototoxic medications, therefore monitoring systems of those drugs ototoxic side effects are much needed.

Investigation of intact mouse cochleae using two-photon laser scanning microscopy

OBJECTIVES

The investigation of cochlear hair cells and lateral wall is a time-consuming and labor-intensive process. However, it is a mandatory experiment in audiology research. Here we suggest a novel method for investigating the inner ear microstructures from intact cochleae using two-photon laser scanning microscopy (TPLSM). This technique guarantees fewer artifacts and technical simplicity.

METHODS

Using TPLSM, we investigated the whole mount cochleae, decalcified cochleae, and cleared cochleae of wild type C57BL/6 mice. CX3CR1^+/GFP mice were used to investigate the feasibility of visualizing cellular structures in the cochlear spiral ligament. All samples were investigated without staining.

RESULTS

Endogenous fluorescence emission from the outer hair cells was strong enough to be distinguished from the other structures in all samples. From the single apical view, 50 and 90% of the whole hair cells of the decalcified cochleae and cleared cochleae, respectively, could be visualized without staining using TPLSM. Capillary structure of stria vascularis and spiral ligament could be visualized by endogenous fluorescence without staining.

CONCLUSION

We successfully investigated the hair cells and lateral wall of mouse cochleae using TPLSM without using staining or any destructive procedures. This method is easier, faster, and more reliable than conventional methods.

Toward Cochlear Therapies

Sensorineural hearing impairment is the most common sensory disorder and a major health and socio-economic issue in industrialized countries. It is primarily due to the degeneration of mechanosensory hair cells and spiral ganglion neurons in the cochlea via complex pathophysiological mechanisms. These occur following acute and/or chronic exposure to harmful extrinsic (e.g., ototoxic drugs, noise...) and intrinsic (e.g., aging, genetic) causative factors. No clinical therapies currently exist to rescue the dying sensorineural cells or regenerate these cells once lost. Recent studies have, however, provided renewed hope, with insights into the therapeutic targets allowing the prevention and treatment of ototoxic drug- and noise-induced, age-related hearing loss as well as cochlear cell degeneration. Moreover, genetic routes involving the replacement or corrective editing of mutant sequences or defected genes are showing promise, as are cell-replacement therapies to repair damaged cells for the future restoration of hearing in deaf people. This review begins by recapitulating our current understanding of the molecular pathways that underlie cochlear sensorineural damage, as well as the survival signaling pathways that can provide endogenous protection and tissue rescue. It then guides the reader through to the recent discoveries in pharmacological, gene and cell therapy research towards hearing protection and restoration as well as their potential clinical application.

Oxidative Stress and Inflammation Induced by Environmental and Psychological Stressors: A Biomarker Perspective

SIGNIFICANCE

The environment can elicit biological responses such as oxidative stress (OS) and inflammation as a consequence of chemical, physical, or psychological changes. As population studies are essential for establishing these environment-organism interactions, biomarkers of OS or inflammation are critical in formulating mechanistic hypotheses. Recent Advances: By using examples of stress induced by various mechanisms, we focus on the biomarkers that have been used to assess OS and inflammation in these conditions. We discuss the difference between biomarkers that are the result of a chemical reaction (such as lipid peroxides or oxidized proteins that are a result of the reaction of molecules with reactive oxygen species) and those that represent the biological response to stress, such as the transcription factor NRF2 or inflammation and inflammatory cytokines.

CRITICAL ISSUES

The high-throughput and holistic approaches to biomarker discovery used extensively in large-scale molecular epidemiological exposome are also discussed in the context of human exposure to environmental stressors.

FUTURE DIRECTIONS

We propose to consider the role of biomarkers as signs and to distinguish between signs that are just indicators of biological processes and proxies that one can interact with and modify the disease process. Antioxid. Redox Signal. 28, 852-872.

Molecular regulation of auditory hair cell death and approaches to protect sensory receptor cells and/or stimulate repair following acoustic trauma

Loss of auditory sensory hair cells (HCs) is the most common cause of hearing loss. This review addresses the signaling pathways that are involved in the programmed and necrotic cell death of auditory HCs that occur in response to ototoxic and traumatic stressor events. The roles of inflammatory processes, oxidative stress, mitochondrial damage, cell death receptors, members of the mitogen-activated protein kinase (MAPK) signal pathway and pro- and anti-cell death members of the Bcl-2 family are explored. The molecular interaction of these signal pathways that initiates the loss of auditory HCs following acoustic trauma is covered and possible therapeutic interventions that may protect these sensory HCs from loss via apoptotic or non-apoptotic cell death are explored.

Overexpression of X-linked inhibitor of apoptosis protein protects against noise-induced hearing loss in mice

Apoptosis is responsible for cochlear cell death induced by noise. Here, we show that transgenic (TG) mice that overexpress X-linked inhibitor of apoptosis protein (XIAP) under control of the ubiquitin promoter display reduced hearing loss and cochlear damage induced by acoustic overstimulation (125 dB sound pressure level, 6 h) compared with wild-type (WT) littermates. Hearing status was evaluated using the auditory brainstem response (ABR), whereas cochlear damage was assessed by counts of surviving hair cells (HCs) and spiral ganglion neurons (SGNs) as well as their fibers to HCs. Significantly smaller threshold shifts were found for TG mice than WT littermates. Correspondingly, the TG mice also showed a reduced loss of HCs, SGNs and their fibers to HCs. HC loss was limited to the basal end of the cochlea that detects high frequency sound. In contrast, the ABRs demonstrated a loss of hearing sensitivity across the entire frequency range tested (2-32 kHz) indicating that the hearing loss could not be fully attributed to HC loss alone. The TG mice displayed superior hearing sensitivity over this whole range, suggesting that XIAP overexpression reduces noise-induced hearing loss not only by protecting HCs but also other components of the cochlea.

Unique responses of auditory cortex networks in vitro to low concentrations of quinine

The anti-malarial drug quinine has several side effects including tinnitus. The aim of the study was to determine if cultured auditory networks growing on microelectrode arrays exhibited unique dynamic states when exposed to quinine. Eight auditory cortex networks (ACN), eight frontal cortex networks (FCN), and five inferior colliculus networks (ICN) were used in this study. Response of ACNs to quinine was biphasic, with an excitatory phase followed by inhibition. FCNs and ICNs revealed only inhibitory responses. The concentrations at which the spike rate was inhibited by 50% (IC50 mean +/- SE) were 42.5 +/- 3.9, 28.7 +/- 4.8 and 23.9 +/- 2.1 microM for ACNs, FCNs, and ICNs, respectively. Quinine increased the regularity and coordination of bursting in all three tissues. The increased burst pattern regularity of ICNs coupled with the excitatory responses seen only in ACNs between 1 and 10 microM show a unique susceptibility of auditory tissues to quinine that may be related to the underlying mechanism that triggers tinnitus-like activity.

Reporting results in ossiculoplasty

OBJECTIVE

To review and modify past methods of reporting ossiculoplasty results, improve analysis, standardize presentation formats, and achieve greater veracity of the reported outcomes.

STUDY DESIGN

A review of past and present evaluation methods.

BACKGROUND

Past ossiculoplasty evaluation methods have been often poorly comparable, based on questionable methodology, and frequently failed to adequately verify the results described. Guidelines set by the American Academy in 1995 to improve matters appear unsatisfactory in several respects.

METHODS

Past evaluation techniques and the Academy modifications are examined for areas that may be subject to modification and improvement, particularly the choice of audiologic frequencies, the calculation of the air-bone gap, and the description of the pathologic findings within the caseload itself.

FINDINGS

Some audiologic measures and disease evaluations are potentially inaccurate or inadequate. The Academy frequency selections may be flawed. Insufficient emphasis is given to the evaluation of case pathologic findings, which is the major factor pertinent in series comparisons and preoperative case prognostication.

CONCLUSIONS

Further in-depth analysis of reporting methods is overdue. The matter is one of an international measure standard and should be subject to a global discussion, written and oral, to produce an adequately researched and formulated consensus. This in turn may provide the clinical and theoretical tools by which this troubled area can be more effectively analyzed.

Effects of nimodipine on quinine ototoxicity

The compound action potential (CAP) in response to a click train stimulus was recorded at the round window of guinea pigs. Administration of quinine hydrochloride (200 mg/kg) significantly elevated the CAP thresholds by 5 to 25 dB (p < .05), and the CAP waveform elicited by the click train stimulus was abnormal. The amplitude of the CAP elicited by the second click was bigger than that elicited by the first click. These changes may be caused by an abnormally broadened N1 response to the first click in the click train. In contrast, CAP waveforms elicited by the second and subsequent clicks appeared normal. After administration of nimodipine (2 mg/kg), the CAP thresholds and waveforms elicited by the click train stimulus were unchanged. Simultaneous administration of both quinine (200 mg/kg) and nimodipine (2 mg/kg) resulted in the same electrophysiological changes as those induced by quinine alone. These results suggest that nimodipine prevents neither the deterioration in the CAP nor the abnormal properties in the response to a click train stimulus.

Quinine affects the response properties of compound action potentials elicited by periodic click trains

The effects of systemically applied quinine on the compound action potential (CAP) were investigated in 5 guinea pigs. A dose of 200 mg/kg body weight of quinine hydrochloride was administered intramuscularly, and CAPs were recorded at the round window before and after administration. The CAP thresholds of the animals were elevated by 5 to 25 dB approximately 30 minutes after administration, and thresholds recovered in some animals during the experimental session. The CAP waveform elicited by the click train stimulus was abnormal after administration of quinine. The amplitude of the CAPs elicited by the second click was larger than that of those elicited by the first click. These changes may be induced by an abnormally broadened N1 response to the first click in the click train following quinine administration. In contrast, the CAP waveforms elicited by the second click and by the following clicks in the click train appeared normal.

Surgical repair of bone defects of the ear canal wall with flexible hydroxylapatite sheets: a pilot study

OBJECTIVE

Evaluation of suitability of flexible composite sheets (hydroxylapatite and polymer) for outer ear canal (OEC) wall reconstruction in tympanoplasty.

STUDY DESIGN

Prospective, open label pilot study.

SETTING

University and regional hospital.

PATIENTS

Forty-two randomly selected patients with chronic otitis media (n = 20) and cholesteatoma (n = 22) among 356 patients admitted between 1996 and 1997.

INTERVENTIONS

Eradication of disease through a partial or total canal wall down mastoidectomy; immediate reconstruction of canal wall with flexible composite sheet (hydroxylapatite and polymer) and connective tissue graft.

OUTCOME MEASURES

Anatomic integrity of the OEC and neotympanum, extrusion rate, complications.

RESULTS

At minimum follow-up of 24 months: recurrent cholesteatoma (n = 0), residual cholesteatoma (n = 3/22) (13.6%) in the mesotympanum (none behind the hydroxylapatite sheet or in the attic or antrum). The neotympanum was intact in 38 ears (90.4%), reperforated in 2, and severely retracted and lateralized in 1, respectively. Anatomic integrity of the OEC was obtained in 37 (88%) of 42 patients; stenosis or membranous synechiae were observed in 5 ears and treated in the office. Extrusion of the hydroxylapatite sheet occurred in 7 patients (16.6%) because of purulent otorrhea and granulation tissue formation. Surgical revision achieved complete epithelialization of the rebuilt canal wall in 33 ears (78.6%).

CONCLUSIONS

A dry, disease-free ear and normal anatomy may be expected 2 years postoperatively in more than three-fourths of the patients treated using the described surgical technique. Complete protection with a connective tissue graft is essential to avoid extrusion of the implant. The failure rate is significantly higher if otorrhea is present at the time of the operation.

Hearing results of ossiculoplasty in Austin-Kartush group A patients

OBJECTIVE

To compare hearing results in patients who underwent ossiculoplasty for Austin-Kartush group A impairments (incus erosion, malleus handle present, stapes superstructure present) with the results in patients with an intact ossicular chain who required only myringoplasty. The literature on hearing results of ossiculoplasty with different types of prostheses and different techniques is reviewed.

PATIENTS AND STUDY DESIGN

This study retrospectively reviews a series of 181 consecutive ossiculoplasties and 204 consecutive myringoplasties.

SETTING

The study was carried out partly at a private practice and partly in an academic tertiary referral center.

MAIN OUTCOME MEASURES

This study complies with levels 1 and 2 of the guidelines recommended by the American Academy of Otolaryngology--Head and Neck Surgery (1995).

RESULTS

When success was defined as a postoperative air-bone gap within 10 dB, the success rate was higher for myringoplasty (81%) than for ossiculoplasty (55%). When success was defined as a postoperative air-bone gap within 20 dB, the success rate was 97% in myringoplasties and 85% in ossiculoplasties. There was no significant deterioration over time of the mean postoperative air-bone gap for any frequency.

CONCLUSION

Cumulative data from several authors show that -50% of patients undergoing partial ossiculoplasty have a postoperative air-bone gap of 0 to 10 dB, and 80% have a postoperative air-bone gap of 0 to 20 dB. Equally good results may be achieved with autograft (no difference was found between interposition of the incus or the head of the malleus), homograft, or alloplastic partial prostheses. With alloplastic total prostheses, 36% of patients have a postoperative air-bone gap of 0 to 10 dB, and 74% have a postoperative air-bone gap of 0 to 20 dB.

In vitro model for frontal sinus obliteration with bioactive glass S53P4

An in vitro model was used to investigate the behavior of a massive frontal sinus obliteration with bioactive glass S53P4 (BG) for clinical purposes. Two sizes of granules (0.63-0.8 mm or 0.8-1.0 mm) in 16 separate BG amounts, weight 25 g, were tested both in simulated body fluid (SBF) and a buffer containing trishydroxymethyl aminomethane citric acid (TRIS-c.a) in standard conditions. The dissolution of silicon (Si) and phosphate (P) was detected with direct current plasma atom emission spectroscopy (DCP-AES) monthly up to 6 months. The BG masses were scanned by computer tomography (CT) and the scans analyzed by Region of Interest (ROI) technique. Calcium phosphate (CaP)- and silica (Si)-gel-layers were studied by scanning electron microscopy (SEM) at 1, 3, and 6 months. Cumulative loss of Si and P was stronger in TRIS -c.a than in SBF (p < 0.0001), and it was higher with smaller than with larger granules in both solutions (p < 0.0001). This was shown correspondingly by the decrease in Hounsfield units (HU) by ROI analysis (p < 0.0001). In SBF-soaked BG masses, the CaP-layer occurred on the uppermost granules, and in TRIS-c.a at 3-6 months, on the granules in the center and lower parts. The decrease of HU seems to reveal indirectly the resorption of BG.

Adhesion of new bioactive glass coating

A valuable alternative to the existing biomedical implant coatings is a bioactive glass (BAG) coating that is produced by reactive plasma spraying. A mechanical performance requirement that is of the utmost importance is the adhesion strength of the coating. Considering the application as dental implant, a new adhesion test (shear test), which was close to the service conditions, was designed. A Ti6Al4V rod (3 mm) with a sprayed BAG coating of 50 microm was glued with an epoxy glue to a hollow cylindrical counterpart and was used as such in the tensile machine. This test was evaluated by finite element analysis (FEA). Preliminary experiments showed that a conversion from shear to tensile adhesion strength is possible by using the Von Mises criterion (sigma = 3(1/2)tau), indicating that thin coatings of brittle materials can behave as a ductile material. The new coating technique was proved to produce a high quality coating with an adhesion strength of 40.1 +/- 4.8 MPa in shear and 69.4 +/- 8.4 MPa in tension. The FEA revealed that no one homogeneously distributed shear stress is present but several nonhomogeneously distributed stress components (shear and tensile) are present in the coating. This analysis indicated that real service conditions are much more complicated than standard adhesion tests.

Effects of quinine on the excitability and voltage-dependent currents of isolated spiral ganglion neurons in culture

This work examined how quinine, a drug that induces both hearing loss and tinnitus, interfered with the excitability of spiral ganglion (SG) neurons in cultures. The membrane potential changes and the modification of the action-potential waveform induced by quinine were studied in SG neurons under current clamp. The effects of the drug on voltage-dependent currents in SG neurons were also investigated by the voltage-clamp method. Quinine did not appreciably affect either resting membrane potentials or input resistance at rest. However, action potentials fired by SG neurons were significantly broadened by the presence of quinine. With higher concentrations of quinine (>20 microM), the amplitude of action potentials was also reduced. Voltage-clamp results demonstrated that quinine primarily blocked the whole cell potassium currents (IK) in a voltage-dependent manner. Up to 100 microM of quinine did not appreciably block IK evoked by a test pulse to -35 mV. In contrast, IK was significantly reduced with more positive test pulses, e.g., the concentration needed to obtain 50% inhibition (IC50) was 8 microM for a test pulse to 65 mV. At higher concentrations (>20 microM), quinine also reduced the size of sodium currents (INa) in a use-dependent manner, while leaving calcium currents (ICa) relatively unaffected. Compared with the potency of quinine's effects on other targets in the inner ear, the relatively low IC50 and the voltage-dependent nature of quinine inhibition on IK suggested that its modulation of the waveform and threshold of action potentials of SG neurons probably was primarily responsible for its ototoxic effects. From the point of view of how neural signaling process is affected by the drug, quinine-induced tinnitus may be explained by its broadening of action potentials while the drug's inhibition on INa may result in hearing loss by making the conversion from excitatory postsynaptic potentials to the generation of action potentials more difficult.

Effects of quinine on neural activity in cat primary auditory cortex

The effect of systemically applied quinine on single-unit firing activity in primary auditory cortex was investigated in seven cats. A dose of 100 or 200 mg/kg of quinine hydrochloride was administered intramuscularly and recordings from the same units were performed prior to application and continuously up to on average 5.5 h after administration. All animals showed 10-40 dB of threshold shift about 30 min after administration and some animals showed recovery during the course of the investigation. Significant increases were found in spontaneous firing rates for low-firing-rate units (initial firing rate < 1 spike/s). For high-firing-rate units (initial firing rate > 1 spike/s) no significant changes were observed. There were no significant changes in modal and mean interspike interval. The time-to-rebound peak in the autocorrelation function for spontaneous firings was not altered significantly. The rate of burst occurrence showed no significant change. The best modulation frequency in response to stimulation with periodic click trains decreased after administration, but the limiting rate did not change. Peak cross-correlation coefficients for the spontaneous firings of simultaneously recorded cells showed a significant increase and the correlogram's central peak was significantly narrower after quinine application. Dose effects were only present for cross-correlation results and temporal modulation transfer functions. The results for both spontaneous firing rate, peak width in the cross-correlogram and click stimulation were similar to those observed in salicylate-treated cats (Ochi and Eggermont, 1996). The other findings were different from those observed after salicylate. It is obvious that the effects of quinine on the auditory system are not the same as those of salicylate. The increased synchronization of the spontaneous firings across different neurons observed after application of both drugs may be related to tinnitus.

Intensity-related changes in cochlear blood flow in the guinea pig during and following acoustic exposure

This study examined the effects of acoustic exposure at different intensities on cochlear blood flow (CBF) using laser Doppler flowmetry. CBF was measured in anesthetized guinea pigs exposed to either a 10 kHz pure tone at 125, 105, or 90 dB SPL, or wide-band noise at 85 dB SPL for 1 h. Mean arterial blood pressure and heart rate were recorded continuously. Arterial acid-base status, cochlear temperature, cochlear microphonics (CM), and compound action potentials (CAP) were measured before and after exposure. There was a small, but significant, steady decline in basal CBF after 40 min loud sound exposure (125 dB SPL), but no change in basal CBF occurred with the lower intensities (85-105 dB SPL). In contrast, there was a significant increase in apical CBF after 1 h exposure to either moderate wideband noise (85 dB SPL) or a 10 kHz tone at 105 dB SPL. These changes persisted during a 20-min post-exposure period. In most cases, the cochlear temperature and cardiorespiratory variables monitored remained unchanged during and after the exposures as compared to the controls. CM and CAP amplitudes showed extensive losses after acoustic overstimulation (125 dB SPL), but no permanent changes were found at the lower intensities used. The present findings confirm the occurrence of intensity-related effects of acoustic exposure on the cochlear microcirculation.

A universal ossicular replacement prosthesis: clinical trials of 152 cases

An ossicular replacement prosthesis is described that advances implant design in several respects. The head is a flattened egg shape, which eliminates pressure points against the pars tensa and provided balance on the stapes. Dense hydroxylapatite ceramic provides maximal biocompatibility. The shaft, of either Teflon or Plastipore, is easily cut to size and is replaceable to minimize wastage. Interchangeable partial or total shaft variants are provided. Trials in more than 200 patients have produced optimal results. Among 152 mature patients in 85% of the good-risk cases, the air-bone gap closed to within 20 dB and in 65% to within 10 dB; in 69% of all cases the gap closed to within 20 dB. Extrusion rates were 5% in good-risk cases and 7% overall. Long-term extrusions have not occurred. Inasmuch as cartilage interpositioning is unnecessary, the prosthesis is rapidly prepared and implanted by an easily mastered technique.

Strial circulation impairment due to acoustic trauma

Blood circulation in the cochlear lateral wall after exposure to a non-physiological level of sound (120-125 dB SPL, 3 h) was investigated immunohistologically. Kanamycin (KM), which was expected to function as a tracer of blood flow, was administered to guinea pigs 5 min to 21 h after sound termination. At 5-30 min, KM was scarce in the capillaries of the stria vascularis (CSVs), whereas abundant KM was present in the spiral ligament vessels. These findings differed markedly from those in non-sound-exposed animals. After the initial period, KM gradually did enter into the CSVs, but its pattern of existence there differed from the normal pattern. These observations suggest that acoustic trauma causes blood stagnation in the strial capillaries, leading to strial dysfunction.

Phantom auditory perception (tinnitus): mechanisms of generation and perception

Phantom auditory perception--tinnitus--is a symptom of many pathologies. Although there are a number of theories postulating certain mechanisms of its generation, none have been proven yet. This paper analyses the phenomenon of tinnitus from the point of view of general neurophysiology. Existing theories and their extrapolation are presented, together with some new potential mechanisms of tinnitus generation, encompassing the involvement of calcium and calcium channels in cochlear function, with implications for malfunction and aging of the auditory and vestibular systems. It is hypothesized that most tinnitus results from the perception of abnormal activity, defined as activity which cannot be induced by any combination of external sounds. Moreover, it is hypothesized that signal recognition and classification circuits, working on holographic or neuronal network-like representation, are involved in the perception of tinnitus and are subject to plastic modification. Furthermore, it is proposed that all levels of the nervous system, to varying degrees, are involved in tinnitus manifestation. These concepts are used to unravel the inexplicable, unique features of tinnitus and its masking. Some clinical implications of these theories are suggested.

The vessels of the stria vascularis: quantitative comparison of three rodent species

The stria vascularis (SV) was quantitatively compared in three species commonly used in auditory research: guinea pig, mouse and gerbil. Measurements were obtained for surface area, cross-sectional area, length, width and thickness of SV. Surface area and length were proportional to the overall size of the cochlea in each species, but there was no significant difference between species in mean cross-sectional area. In guinea pig and mouse, there was no significant difference in thickness (endolymphatic surface to spiral ligament) and a similar pattern was observed for width (Reissner's membrane to spiral prominence): the width of SV increased from the apical end to a point 80% of the distance from the apex, then decreased to the basal end of SV. The thickness of gerbil SV was significantly less (P less than 0.001) and there was less of a gradient in width as compared to guinea pig and mouse. The vessels of SV were compared in terms of vascular density (vessels per unit area), rbc density (red blood cells per unit area), R/V (rbc density/vascular density), inter-vessel spacing and vessel diameter. Highly significant (P less than 0.001) differences between species were found in vascular density, RBC density and vessel diameter, but there were no differences between species for R/V or inter-vessel spacing. The results of this study may reflect differences in the metabolic requirements of SV among different species.

Cochlear blood flow: measurement techniques

The measurement of inner ear blood flow and other microvascular variables is subject to unique technical problems which are compounded by methodological limitations. As a result, the interpretation of experimental results is often difficult. This report discusses the most important methods currently available for cochlear blood circulation measurements and the technical problems associated with their use. The use of a combination of measurements to resolve problems of interpretation is stressed. An extensive review of the pertinent literature is provided in relation to each method.

Acute effects of noradrenalin related vasoactive agents on the ototoxicity of aspirin: an experimental study in the guinea pig

Aspirin is known to be ototoxic when administered at high doses. Its mode of action is unknown but an alteration of the vascular function has been suspected. To further document this hypothesis, acute effects of some vasoactive agents on the ototoxicity of aspirin were tested in experiments on the guinea pig using sensori-neural electrophysiological responses and morphometry of the vessels of the stria and the spiral lamina. Electrophysiological measures showed no modification of sensory responses but neural responses revealed clear changes after administration of noradrenalin related agents, limited modifications after a drug acting partly as a serotonin antagonist, and no change after a dopaminergic agent. Morphometric studies showed no modification of the strial but some effect on the spiral vessels. The results are compatible with the hypothesis of a vascular involvement in the ototoxicity of aspirin and they point toward an interaction with the noradrenergic sympathetic cochlear system in the spiral lamina.

Quinine reduces noxious cochlear effects of furosemide and ethacrynic acid

Endocochlear potential (EP) and eighth nerve action potential (AP) were measured in chinchillas. We investigated the interaction of quinine with the loop diuretics furosemide and ethacrynic acid to determine whether the cochlear effects of these agents are attenuated by pretreatment with quinine. Animals were injected with either furosemide, 25 mg/kg intravenously (IV), or ethacrynic acid, 15 mg/kg IV. Control animals injected without pretreatment were found to have a large decrease in EP, with a decrease of compound action potentials (CAP) amplitude and an elevation of CAP threshold. Animals pretreated with quinine, 25 mg/kg, were found to have a significantly smaller reduction of EP and CAP amplitude following injection of either diuretic. No significant differences in urine volumes were noted between experimental and control groups. Quinine is known to cause nonspecific changes in the membranes of epithelial cells, which may cause alterations of the transport of organic anions by such tissues. Such an effect on epithelial cells in the cochlea may cause reduced uptake of loop diuretics in this organ, resulting in reduced toxicity.

Effects of carbon monoxide on cochlear electrophysiology and blood flow

The belief that the cochlea is particularly vulnerable to a reduction in oxygen availability comes predominantly from studies reporting the disruption of electrophysiological measures, such as the compound action potential, endocochlear potential, inner hair cell intracellular potentials or afferent nerve fiber responses by asphyxiation. Because hypoxia has frequently been suggested as an underlying mechanism by which many ototoxic agents produce injury, and because such agents are not likely to completely disrupt oxygen delivery, we investigated the effects of graded hypoxia (using doses of carbon monoxide) on cochlear blood flow, the compound action potential (CAP) and the cochlear microphonic (CM). High doses of carbon monoxide injected intra-peritoneally yielded reversible loss of the CAP sensitivity for high frequency tone bursts, the extent of which was dose dependent. The loss was observed first at the highest frequency tested (50 kHz) and as carboxyhemoglobin levels increased, contiguous lower frequencies were influenced. Recovery progressed from low to high frequencies as carboxyhemoglobin levels declined. Carbon monoxide administration also produced a dose dependent elevation in the cochlear blood flow measured by a laser Doppler flow monitor. The data suggest that carbon monoxide administration disrupts cochlear function only under extremely severe exposure conditions. An elevation in cochlear blood flow may well serve as a protective mechanism which maintains cochlear function in the face of declining blood oxygen carrying capacity and delivery. While the site of action of carbon monoxide in the cochlea is uncertain, the data clearly indicate that elements involved in the generation of the CAP for high frequency tones are particularly vulnerable.(ABSTRACT TRUNCATED AT 250 WORDS)

Laser Doppler measurements of cochlear blood flow during loud sound exposure in the guinea pig

This investigation examined the effects of loud sound of different frequencies and intensities on cochlear blood flow as measured by the laser Doppler flowmeter. Cochlear blood flow was measured in anesthetized guinea pigs during a 1 h exposure to either a 2, 4, or 12 kHz pure tone or high-pass noise (10-40 kHz) at 90, 103, or 110 dB SPL. Cochlear function was assessed using the compound action potential audiogram before and after exposure. There was no change in blood flow in the second turn with a 2, 4, or 12 kHz tone but there was a significant (P less than 0.05) decline in flow in the first cochlear turn at the end of either the 12 kHz tone or high-pass noise exposure at 103 and 110 dB SPL. There were elevations in the thresholds of the cochlear compound action potential after all but the 90 dB exposures to 12 kHz or high-pass noise. No such changes were observed in blood flow or electrophysiology in control animals. These findings demonstrate that there is a small but significant decline in cochlear blood flow with high intensity sound exposure. However, the relationship between this change in blood flow and the development of cochlear damage is unclear.

Animal models of inner ear vascular disturbances

Animal models of vascular disorders are identified or developed for the evaluation of functional deficits and morphologic alterations. This information will serve a useful purpose for a better understanding of sudden deafness, Meniere's disease, and presbycusis. The study of microcirculation of the inner ear vessels reveals that their responses to various stimuli, such as anoxia, sympathetic nerve stimulation, hypothermia, and drugs, are different from those of the middle ear vessels. In sudden occlusion of the major vascular supply to the inner ear, the cochlea is found to be more vulnerable than the vestibular labyrinth; outer and inner hair cells and stria vascularis are most often affected. Animal models for Meniere's disease are also described, and the importance of vascularity at the endolymphatic duct and sac is discussed from an etiologic viewpoint. In presbycusis, animal models show sensory cell and spiral ganglion cell atrophies in different locations than in human cochleas, and the relationship between these atrophies and vascular impairments is not clear at the present time.

Overview of mechanical damage to the inner ear: noise as a tool to probe cochlear function

The majority of experiments causing mechanical damage to the cochlea involve the use of sound pressure waves to cause overstimulation. This presentation is an overview of the research during the past years on the structural damage produced by noise. The effect of noise on the cochlea depends on the type of noise exposure-impulse or continuous. Experiments have been conducted to determine the effect of increasing intensity, the effect of increasing duration, and the effect of equal energy presented over varying periods of time. The initial mechanism of damage, the progression of damage over time, and the ability of hair cells to recover are discussed. Noise has been used as a tool to probe cochlear function by selectively damaging regions along the length of the sensory epithelium and by selectively damaging one of the two types of hair cells. Results obtained from these types of experiments have given us information on cochlear mechanics, as well as of stereocilia micromechanics and transduction. Information on susceptibility of hair cells to noise confirms previous results, suggesting the presence of structural and metabolic gradients both longitudinally and radially within the sensory epithelium. Moreover, noise lesions have been used to map the afferent innervation pattern to the cochlear nucleus, and noise studies show correlation of hair cell damage with efferent innervation pattern.

A morphometric technique for analysis of cochlear vessels

A computer based system was developed for morphometric analysis of the cochlear lateral wall vasculature. Variables measured were vascular density, RBC density, vessel width, aggregation density, lumen compression count, WBC count and pigment density. Vessels were divided into three systems based on the lateral wall structures that they supplied. The results indicated that these three vessel systems were morphologically distinct in terms of their vascular density, RBC density, and vessel width. How these differences relate to functional needs of the lateral wall is discussed.