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Fibrinogen is not a prognostic factor for response to HELP-apheresis in sudden sensorineural hearing loss (SSHL). Eur Arch Otorhinolaryngol 2014; 272:3693-703. [DOI: 10.1007/s00405-014-3449-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 12/12/2014] [Indexed: 10/24/2022]
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Abstract
OBJECTIVE The effect of cochlear blood flow (CBF) on speech perception ability in cochlear implant (CI) users has not been reported. We investigated various factors influencing speech perception including CBF in CI users. PATIENTS Eighty-two patients who received CI surgery at an academic hospital. METHODS CBF was measured during CI surgery using laser Doppler flowmetry. The speech perception level was measured after a sufficient interval after CI surgery. Multivariate analysis was used to evaluate the influences of age, duration of deafness, sex, cause of deafness, and CBF on the speech perception level. RESULTS CBF decreased significantly with age but was not related to the speech perception level. In patients with congenital hearing loss, the speech perception level was significantly worse in children who received a CI at 3 years of age than in those who received a CI at 2 years of age or younger. Duration of deafness before CI surgery had deteriorative effects on the speech perception level. CONCLUSION CBF may be associated with progression of hearing loss. However, measuring CBF during CI surgery is not useful for predicting postoperative speech perception.
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Kitanishi, Mikio Suzuki, Hiroya Kit T. Immunohistochemical Detection of Vasoactive Intestinal Polypeptide (VIP) and the VIP Receptor in the Rat Inner Ear. Acta Otolaryngol 2009. [DOI: 10.1080/00016489850182369-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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4
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Ayari Okamoto Ugnell, Makoto Hasega. Effect of Carbon Dioxide on Cochlear Blood Flow in Guinea Pigs. Acta Otolaryngol 2009. [DOI: 10.1080/000164800453810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Abstract
BACKGROUND Recurrent parotitis (RP) of childhood is a rare condition of unknown aetiology, probably immunologically mediated. OBJECTIVE To review the clinical presentation, diagnosis and management of RP of childhood. METHODS Retrospective study from 1983 to 2004 of children diagnosed with RP of childhood at a tertiary children's hospital. RESULTS We identified 53 children, 37 (70%) male and 16 (30%) female. The age of onset was biphasic, with peaks at 2-5 years of age and at 10 years. The commonest symptoms were swelling (100%), pain (92.5%) and fever (41.5%). Symptoms usually lasted 2-7 days with a median of 3 days. The mean frequency was 8 episodes per year. The diagnosis was often delayed, >1 year in 70% of patients, maximum 8 years. The most common diagnoses, before the definitive diagnosis of RP, were mumps (21%), 'infection' (15%) and stones (11%). Sialogram (57%) and/or ultrasound (41%) showed sialectasis in 81% of patients. Over half the patients (54%) were given antibiotics at least once to treat the parotitis. Two children had hypogammablobulinaemia, one child had human immunodeficiency virus infection, and one child had Sjogren's syndrome. Two children had high titre antinuclear antibodies. CONCLUSIONS Recurrent parotitis had a biphasic age distribution. The major clinical features that distinguish it from other causes of parotid swelling are the lack of pus and recurrent episodes. A clinical diagnosis can often be confirmed by ultrasound. Antibiotics do not have a role in treatment. Affected children should be screened for Sjogren's syndrome and immune deficiency.
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Affiliation(s)
- C M Leerdam
- Department of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Westmead, New South Wales, Australia.
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Nakashima T, Hattori T, Sone M, Sato E, Tominaga M. Blood flow measurements in the ears of patients receiving cochlear implants. Ann Otol Rhinol Laryngol 2002; 111:998-1001. [PMID: 12450173 DOI: 10.1177/000348940211101108] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We measured cochlear blood flow in 12 patients who received cochlear implants, using a laser-Doppler probe with an outer diameter of 0.8 mm. The subjects had congenital deafness, idiopathic progressive sensorineural hearing loss, Waardenburg's syndrome, narrow internal auditory canal, or sudden deafness. Putting the probe tip to the site of drilling for cochlear implantation, we measured blood flow before, during, and after the cochlear bony wall was opened. The laser-Doppler output was confirmed even after the tip of the probe was inserted into the perilymphatic space in all cases. Our results revealed that blood flow was maintained in all cochleas, although there was a probability of reduction in blood flow volume. We conclude that laser-Doppler flowmetry is both relatively safe and useful for measuring blood flow in the ears during cochlear implantation procedures.
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Affiliation(s)
- Tsutomu Nakashima
- Department of Otorhinolaryngology, Nagoya University School of Medicine, Nagoya, Japan
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7
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Lamm K, Arnold W. The effect of blood flow promoting drugs on cochlear blood flow, perilymphatic pO(2) and auditory function in the normal and noise-damaged hypoxic and ischemic guinea pig inner ear. Hear Res 2000; 141:199-219. [PMID: 10713508 DOI: 10.1016/s0378-5955(00)00005-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The effect of blood flow promoting drugs, such as hydroxyethyl starch (HES) either of low or high molecular weight (HES 70, HES 200), pentoxifylline, ginkgo biloba, naftidrofuryl and betahistine, and various combinations of the drugs was studied in unexposed and noise-exposed (broad-band noise, bandwidth 1-12 kHz, 106 dB SPL, 30 min) guinea pigs. The results were compared without therapy and placebo (isotonic saline, NaCl). The cochlear blood flow (CoBF) and the partial pressure of oxygen in the perilymph (PL-pO(2)) were continuously and simultaneously recorded over a period of 210 min. In addition, cochlear microphonics (CMs), compound action potentials of the auditory nerve (CAPs) and auditory brain stem responses (ABRs) were registered. Noise-induced hearing loss (NIHL) paralleled a decrease of PL-pO(2). Both were found to occur before evidence of reduced CoBF. PL-pO(2) and CoBF declined progressively post-exposure, while CMs, CAPs and ABRs showed no further deterioration or signs of recovery up to 180 min after cessation of noise. Treatment started 60 min post-exposure, respectively after 90 min, without manipulation in unexposed animals, and was then studied for a further 120 min. In unexposed animals, CoBF increased significantly during infusion of HES 70, HES 200, pentoxifylline and betahistine. NaCl, ginkgo biloba and naftidrofuryl did not alter CoBF. PL-pO(2) decreased significantly during infusion of all administered drugs and combinations, except for NaCl. CMs, CAPs and ABRs remained constant, with the exception of increased ABRs after infusion of HES 70 and HES 200. In noise-exposed animals, a sustained therapeutic effect on cochlear ischemia was achieved only by HES 200 and pentoxifylline. HES 70, betahistine and ginkgo biloba compensated cochlear ischemia only during infusion; however, 30-60 min after termination of therapy, no significant difference of values for CoBF was observed compared to the untreated noise-exposed groups. NaCl and naftidrofuryl showed no effect on CoBF. None of the applied drugs had a sustained compensatory effect on cochlear hypoxia. CMs, CAPs and ABRs improved significantly after HES 70, HES 200 and betahistine, resulting in partial recovery of CMs, and partial (betahistine) or even full (HES 70 and HES 200) recovery of CAPs and ABRs. In contrast, NaCl, pentoxifylline, ginkgo biloba and naftidrofuryl had no therapeutic effect on NIHL.
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Affiliation(s)
- K Lamm
- Department of Otolaryngology, Head and Neck Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, D-81675, Munich, Germany.
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Zenk J, Scheffler D, Scheffler P, Delb W, Iro H. The influence of noise on blood flow in the basilar artery (BA) - measurements with transcranial color-coded duplex sonography (TCCD). Hear Res 2000; 140:157-64. [PMID: 10675643 DOI: 10.1016/s0378-5955(99)00195-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Acoustic stimuli are being reported as a cause of changes in resistance in the basilar artery (BA). It was the aim of this study to investigate this effect under standardized conditions dependent upon the intensity of the evoking stimulus. Twenty healthy subjects with normal hearing (male/female 14/6; mean age 26.4 years) were exposed to 'pink noise' for periods of 2 min at 75, 85 and 95 dB(A). Parallel to this, the Doppler spectrum of the BA and both the Pourcelot resistance index and the Gosling pulsatility index were measured by means of transcranial color-coded Doppler sonography. In comparison with the base value (at rest) a significant increase in resistance was noted during noise exposure. The noise-induced resistance changes could be interpreted as a consequence of changes in activity of the various centers of the auditory pathway and cerebral function. Further animal experiments may prove the connection between BA blood flow and resistance and their changes depending on different acoustic stimuli or different hearing pathophysiology.
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Affiliation(s)
- J Zenk
- Department of Otorhinolaryngology - Head and Neck Surgery, Saarland University, D-66424, Homburg, Germany
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9
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Yazawa Y, Suzuki M, Kitano H, Kitajima K. Differences between cochlear blood flow and endolymphatic sac blood flow in guinea-pigs. Acta Otolaryngol 1998; 118:80-5. [PMID: 9504168 DOI: 10.1080/00016489850155170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cochlear blood flow (CoBF) and endolymphatic sac (ES) blood flow (ESBF) were measured in different groups of guinea-pigs by laser-Doppler flowmetry after the intravenous administration of various drugs through the jugular vein for 60 sec. These drugs included 50% glycerol, 70% isosorbide, 20% mannitol, 7% sodium bicarbonate and 1% diphenidol. For CoBF measurements, a probe was positioned on the basal turn of the right cochlea via a ventral approach. For ESBF measurements, it was placed on the right ES through the posterior cranial fossa via a dorsal approach. The average initial measured value of ESBF (8.31 +/- 2.97 ml/min/100 g) was significantly greater (p < 0.0001) than that of CoBF (4.33 +/- 1.15 ml/min/100 g). Following administration of most drugs except for diphenidol, both CoBF and ESBF increased immediately after administration; however, following diphenidol administration both CoBF and ESBF decreased. The magnitude of the CoBF response tended to be greater than that of the ESBF response (p = 0.006-0.112). It seems likely that this reflects anatomical differences in the vascular supplies, i.e. CoBF from the vertebrobasilar artery and ESBF from the external carotid artery. In addition, the presence of micropores or fenestrations in the ES vasculature may contribute to the differences between CoBF and ESBF.
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Affiliation(s)
- Y Yazawa
- Department of Otolaryngology, Shiga University of Medical Science, Otsu City, Japan
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Jung TT, Hwang AL, Miller SK, Rhee CK, Park YS. Effect of leukotriene inhibitor on cochlear blood flow in salicylate ototoxicity. Acta Otolaryngol 1995; 115:251-4. [PMID: 7610815 DOI: 10.3109/00016489509139302] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Our previous studies showed that salicylate ototoxicity is associated with decreased levels of vasodilating prostaglandins (PGs) and increased vasoconstricting leukotrienes (LTs) in the perilymph and reduced cochlear blood flow (CoBF). The purpose of this study was to test the hypothesis that leukotriene inhibitor prevents salicylate ototoxicity by preventing abnormal elevation of LT levels in the inner ear, thus averting a decrease in CoBF resulting from abnormal levels of arachidonic acid metabolites in the inner ear. Ototoxicity was induced in chinchillas by either local round window membrane (RWM) application or systemic treatment with salicylate both with and without pretreatment with leukotriene inhibitor (Sch 37224). A moderate reduction in CoBF was documented with both local RWM and systemic treatment with salicylate. Salicylate induced hearing loss and reduction in CoBF were prevented by pretreatment with a leukotriene inhibitor. This study suggests that leukotriene inhibitor prevents salicylate ototoxicity by averting a decrease in CoBF mediated by abnormal levels of arachidonic acid metabolites in the inner ear.
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Affiliation(s)
- T T Jung
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Loma Linda University School of Medicine, CA, USA
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11
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Tyagi I, Nakashima T, Ito A, Yanagita N. Effect of hemorrhagic hypotension on blood flow to the basal and upper turns of the cochlea. Auris Nasus Larynx 1995; 22:93-5. [PMID: 7487679 DOI: 10.1016/s0385-8146(12)80106-4] [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: 01/25/2023]
Abstract
The effect of hemorrhagic hypotension on blood flow in the cochlea was studied in guinea pigs. Using two laser Doppler probes, simultaneous measurements were made from the basal and upper turns of the cochlea. Hypotension induced by removal of blood resulted in reduction of cochlear blood flow. Cochlear blood flow, however, did not reduce the same extent as the extent of hypotension and the reduction of blood flow was observed to be more remarkable in the upper turns than in the basal turn.
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Affiliation(s)
- I Tyagi
- Department of Otorhinolaryngology, Nagoya University School of Medicine, Japan
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12
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Degoute CS, Dubreuil C, Ray MJ, Guitton J, Manchon M, Banssillon V, Saumet JL. Effects of posture, hypotension and locally applied vasoconstriction on the middle ear microcirculation in anaesthetized humans. EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY AND OCCUPATIONAL PHYSIOLOGY 1994; 69:414-20. [PMID: 7875138 DOI: 10.1007/bf00865405] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Studies by laser-Doppler flowmetry of middle ear microcirculation changes induced by physical and chemical stimuli in the animal have only recently been made. This prospective study, performed in humans, was designed to compare the effects of a postural manoeuvre (headup tilt 30 degrees), hypotension and locally applied vasoconstriction on middle ear blood flow during anaesthesia. Circulatory changes provoked by a headup tilt of 30 degrees, and successive intravenous boluses of potent vasodilators, were compared with circulatory changes provoked by locally applied adrenaline, in ten healthy patients in good physical states undergoing middle ear surgical repair. Heart rate and direct arterial pressure were continuously recorded via a radial artery cannula. Middle ear blood flow was continuously recorded via a laser-Doppler probe placed on the promontorium cavi tympani. Metabolic parameters (partial pressure of O2 and CO2 in arterial blood, pH, arterial lactate concentrations) and arterial concentrations of propofol were measured just before and just after the experiment. Headup tilt did not modify heart rate, mean arterial pressure or middle ear blood flow. Vasodilators (nicardipine, nitroprusside, nitroglycerin) provoked a fall in arterial pressure (P < 0.0001, P < 0.0001, P < 0.019, respectively), but did not induce any significant variations in heart rate; variations occurred in middle ear blood flow (P > 0.05, not significant) which were different according to patients and agents. Locally applied adrenaline provoked a fall in the middle ear blood flow (P < 0.0012), with no effect on heart rate and arterial pressure. There were no significant changes in metabolic values, or propofol serum concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C S Degoute
- Service d'Anesthesie-Réanimation, Centre Hospitalo-Universitaire Lyon-Sud, Pierre-Bénite, France
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13
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Yazawa Y, Kitahara M. Endolymphatic sac blood flow versus cochlear blood flow following intravenous administration of isosorbide in guinea pigs. ACTA OTO-LARYNGOLOGICA. SUPPLEMENTUM 1994; 510:29-32. [PMID: 8128869 DOI: 10.3109/00016489409127298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Endolymphatic sac (ES) blood flow (ESBF) and cochlear blood flow (CBF) were measured in different groups of guinea pigs by laser-Doppler flowmetry (Advance Laser Flowmeter, Model ALF 2100) after the intravenous administration of 70% isosorbide (1.6 ml/kg). The measurements were made under general anesthesia with intraperitoneal pentobarbital sodium. Respiration was controlled by a respirator after tracheotomy, and blood pressure was monitored through the femoral artery (Gould Statham P23 ID Pressure Transducer). For ESBF measurements, a probe was placed on the right ES after entering the posterior cranial fossa via the dorsal approach. For CBF measurements, a probe was placed on the basal turn of the right cochlea via the ventral approach. Isosorbide was administered intravenously through the jugular vein for 60 s. Both ESBF and CBF increased immediately after administration, reached a peak within 3-6 min and decreased gradually to their initial baseline levels in 11-15 min. Both blood flow changes almost always corresponded to systemic blood pressure changes, although a slight delay was observed in blood pressure compared to the blood flow. The magnitude of the CBF response tended to be greater than that of the ESBF response (p < 0.1). This may result from the anatomical differences in the two blood supplies, i.e., from the vertebral artery (CBF) and the external carotid artery (ESBF).
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Affiliation(s)
- Y Yazawa
- Department of Otolaryngology, Shiga University of Medical Science, Otsu, Japan
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Hua HB, Chang JS, Rui G. Effects of carbogen on decreases in endocochlear potential and cochlear microcirculation induced by ischemia of the cochlea. Acta Otolaryngol 1993; 113:720-4. [PMID: 8291429 DOI: 10.3109/00016489309135891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Preventive effects of carbogen on decreases in endocochlear potential (EP) and cochlear microcirculation induced by ischemia of the cochlea were examined in guinea pigs with intravital microscopy. The experimental model giving a severe decline in cochlear blood flow (CBF) was established by occlusion of both common carotid arteries and one of the vertebral arteries and i.v. infusion of adenosine triphosphate (ATP). The results showed no significant difference in the magnitude and pattern of the decrease in the cochlear microcirculation induced by ATP infusion and arterial occlusion before and after carbogen inhalation. However, even with a dramatic decrease in CBF, carbogen could reduce the decline in EP. The results clearly indicate that although carbogen fails to ameliorate cochlear ischemia in the face of a large impairment of the blood supply caused by a drop of blood pressure and cardiac output, it does in fact enhance the oxygen delivery to the cochlea and thus provide a therapeutic means of treating certain inner ear diseases caused by insufficient blood supply to the cochlea.
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Affiliation(s)
- H B Hua
- Institute of Otorhinolaryngology, Chinese Great Wall Hospital, Beijing
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15
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Abstract
Reduced cochlear blood flow (CBF) has been implicated in various pathologies of the inner ear, including sudden deafness, noise-induced hearing loss and Meniere's disease. Thus the aim of some current therapeutic regimens to treat these conditions is to increase CBF and thereby improve oxygenation of the inner ear tissues. Most of the vasodilating agents in clinical use, however, do not have specific experimental evidence to support their effects on CBF. The hypotension which can follow systemic administration may limit their local effectiveness and general utility, just as it complicates the interpretation of the data in animal experiments. In the current study we investigated the effect of six agents, known for their systemic cardiovascular actions, on CBF: hydralazine, sodium nitroprusside, papaverine, nicotinic acid, verapamil and histamine. The effect of these drugs was studied after topical applications on the round window membrane (RWM) and systemic intravenous administrations. CBF was monitored with a laser Doppler flowmeter (LDF). Topical administration of sodium nitroprusside was the most effective in increasing CBF, followed, in order, by hydralazine and histamine. No change in CBF was observed for papaverine, verapamil or nicotinic acid. Systemic administrations of all the agents caused a marked decrease in blood pressure and variable effects on CBF. We discuss the CBF changes in relation to the different pharmacological mechanisms of action of each drug. The study demonstrates the effectiveness of topical application of vasodilating agents in increasing CBF.
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Affiliation(s)
- K A Ohlsén
- Kresge Hearing Research Institute, University of Michigan, Ann Arbor 48109-0506
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16
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Baldwin DL, Ohlsén KA, Miller JM, Nuttall AL. Cochlear blood flow and microvascular resistance changes in response to hypertonic glycerol, urea, and mannitol infusions. Ann Otol Rhinol Laryngol 1992; 101:168-75. [PMID: 1739264 DOI: 10.1177/000348949210100212] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The effect of hyperosmotic agents on cochlear blood flow (CBF) was tested in normal guinea pigs and in guinea pigs having prior unilateral operations to ablate the endolymphatic duct. Laser-Doppler-measured CBF was normalized to remove apparent changes related directly to systemic blood pressure. Hyperosmotic fluids were given via venous infusion: glycerol (20% and 40% solutions), urea (10%, 30%, and 40% solutions), and mannitol (40% solution). All agents were dissolved in 0.9% saline and the mixtures were given at a rate of 0.3 to 0.6 mL/min for 5 minutes. Control infusions were of 0.9% saline and isotonic dextran 70 (Pharmacia). All hyperosmotic infusions resulted in similar increases in normalized cochlear blood flow (nCBF) that extended to a maximum of 300% of the baseline value in a dose-dependent way during the infusion time period. Within approximately 30 minutes following infusions, nCBF had returned to baseline levels. Saline infusion alone had little effect on nCBF, but isotonic dextran 70 gave a sustained increase to 122% of the baseline levels. There was no difference between the responses of nCBF in hydropic and normal cochleas for either control or hyperosmotic solutions. Measurements of systemic hematocrit at time intervals during and following the infusions showed that transient reductions of up to approximately 8% (for the maximum osmotic challenge) occurred during the infusion. It is concluded that the hyperosmotic treatments tested here are equally effective for short-term enhancements of nCBF in both normal and hydropic cochleas. The basis of the flow increase is partially rheologic and partially due to a local vasodilation.
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Affiliation(s)
- D L Baldwin
- Department of Otolaryngology, Kresge Hearing Research Institute, University of Michigan, Ann Arbor
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Kallinen J, Didier A, Miller JM, Nuttall A, Grénman R. The effect of CO2- and O2-gas mixtures on laser Doppler measured cochlear and skin blood flow in guinea pigs. Hear Res 1991; 55:255-62. [PMID: 1757293 DOI: 10.1016/0378-5955(91)90110-u] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The effects of carbogen (5% CO2: 95% O2) 10% CO2-in-air and 100% O2 on cochlear blood flow (CBF), skin blood flow (SBP), blood pressure (BP) and arterial blood gases were investigated in the anesthetized, respired or self-respiring guinea pig. In respired animals, CBF and SBF were increased with carbogen and 10% CO2-in-air and decreased with O2. BP was elevated with each gas. In freely breathing animals, only 10% CO2-in-air caused a small increase in CBF; both carbogen and O2 caused CBF to decrease. SPF changes were similar in form, but larger than those seen in respirated subjects. No consistent change in BP was seen during breathing of these mixtures. Arterial PO2 was increased by carbogen and 10% CO2-in-air for both groups. PCO2 increased for both CO2 gas mixtures during forced respiration; but in free-breathing animals PCO2 only increased for 10% CO2-in-air (normal PCO2 values were maintained with carbogen thorough increased breathing rate). The observed changes in CBF were consistent with a balance between a combined vasoconstrictive effect of PO2 and vasodilation effect of PCO2 on cochlear vessels. Analysis of cochlear vascular conductivity (CBF/BP) indicated that vasodilation was significant only with 10% CO2-in-air in respirated animals. In all other conditions the increased CBF apparently reflects the increase profusion pressure associated with respiration of each gas. For clinical purposes, while carbogen does not appear to directly cause vasodilation of cochlear vessels it does lead to an increased oxygenation of the cochlea blood and would appear to avoid the cochlear vasoconstriction caused by 100% O2.
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Affiliation(s)
- J Kallinen
- University Central Hospital Department of Otolaryngology, Turku, Finland
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Abstract
Antroscopy has an established role in the diagnosis of maxillary sinus disease; however, its role in overall patient management requires clarification if it is to be widely adopted as an outpatient procedure. This study examined 100 consecutive attenders to an antroscopy clinic and monitored their diagnosis and management plan both before and after antroscopy. Diagnosis was altered or added to in 79% of cases and management in 73% of cases. The trend after knowledge of antroscopic findings was towards more medical treatment and less surgical intervention. Such a change would clearly have significant resource implications. While computed tomographic scanning time is limited, outpatient sinus endoscopy can be used as an intermediate investigation, with only selected patients going forward to be more comprehensively investigated.
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Affiliation(s)
- E W Fisher
- Royal National Throat, Nose and Ear Hospital, London, UK
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19
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Bernard PA, Bourret CS, Stenstrom R. Hearing fluctuation during migraine attacks. Activity of propranolol-HCl in rats. Acta Otolaryngol 1991; 111:249-55. [PMID: 2068910 DOI: 10.3109/00016489109137383] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Transitory hearing impairment has been well documented in humans during basilar migraine attacks. Ischemia induced by activation of central nervous system adrenoreceptors by cAMP is one of the mechanisms that has been implicated, as well as calcium metabolism alterations. Propranolol-HCl has proven to be an effective treatment. Massive local adrenaline release is regarded as the primum movens mechanism triggering the liberation of other beta-receptor activators resulting in sterile edema and exudate. This exudate can be visualized (via ophthalmoscope) and is viewed as pathognomonic of a migraine attack. We investigated both the action of adrenaline and Propranolol-HCl on brainstem auditory potentials in 3 groups of young rats. The first group was perfused intra-arterially with adrenaline. The second group received the same treatment plus a prophylactic daily dose of Propranolol-HCl. The third group served as the control and received Propranolol-HCl, but was perfused with a Ringer solution. Alterations in blood flow and hearing sensitivity (BERA) following perfusion occurred in the first group only. Propranolol seems to exhibit a protective action during experimental attempts to induce migraine-like attacks in rats.
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Affiliation(s)
- P A Bernard
- Inner Ear Biology Laboratory, Faculty of Medicine, University of Ottawa, Ontario, Canada
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Miller JM, Bredberg G, Grenman R, Suonpää J, Lindström B, Didier A. Measurement of human cochlear blood flow. Ann Otol Rhinol Laryngol 1991; 100:44-53. [PMID: 1824672 DOI: 10.1177/000348949110000108] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cochlear blood flow (CBF) was measured with a laser-Doppler (L-D) flowmeter (Periflux PR2-B) in four unanesthetized human subjects with chronic tympanic membrane perforations and nine anesthetized human subjects undergoing middle ear operations. The L-D recordings were made over the promontory and/or the round window membrane during carbogen breathing and direct electrical stimulation of the cochlea in both groups and with warm water irrigation of the external ear canal in the anesthetized subjects. Carbogen led to little or no change in CBF as monitored with either measurement approach in either subject group. Electrical stimulation yielded an increase (15% to 25%) in CBF as recorded from the promontory in seven of the nine subjects tested. Warm (44 degrees C to 49 degrees C) water irrigation produced changes of 20% to 60% in CBF that were partially recoverable in the 10 minutes available for study. This study demonstrated the feasibility of direct CBF measurement in humans with the L-D method. Moreover, the data indicate that carbogen has little influence on CBF and that electrical stimulation at relatively safe levels and warm water irrigation of the ear canal produce increases in human CBF.
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Affiliation(s)
- J M Miller
- Kresge Hearing Research Institute, University of Michigan, Ann Arbor 48109-0506
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Umemura K, Takiguchi Y, Nakashima M, Nozue M. Effect of arachidonic acid on the inner ear blood flow measured with a laser Doppler flowmeter. Ann Otol Rhinol Laryngol 1990; 99:491-5. [PMID: 2112355 DOI: 10.1177/000348949009900615] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The present study was undertaken to clarify the effect of arachidonic acid (AA) on the inner ear blood flow of rats as measured with a laser Doppler flowmeter. With the rats under anesthesia with sodium pentobarbital, the middle ear was approached ventrally and a laser Doppler probe was positioned over the lateral wall of the cochlea. Drugs were administered via the subclavicular artery. The dose range of each drug was determined so as not to affect the systemic blood pressure. The AA (20 to 70 micrograms) increased the inner ear blood flow dose-dependently; this effect was abolished by indomethacin (5 mg orally). Both prostaglandin E2 (PGE2; 1 to 50 ng) and CS-570, a PGI2 analogue (12.8 to 25.6 ng) caused a dose-dependent increase in the inner ear blood flow. The response of PGI2 was shorter than that of PGE2. On the other hand, a stable thromboxane A2 (STA2; 30 to 80 ng) decreased the inner ear blood flow dose-dependently. Administration of PGF2 alpha (0.2 to 3 micrograms) showed no effect on the inner ear blood flow. These results indicated that the effect of AA was mediated mainly via PGI2 and PGE2.
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Affiliation(s)
- K Umemura
- Department of Pharmacology, Hamamatsu University School of Medicine, Japan
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Axelsson A, Nuttall AL, Miller JM. Observations of cochlear microcirculation using intravital microscopy. Acta Otolaryngol 1990; 109:263-70. [PMID: 2316348 DOI: 10.3109/00016489009107442] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The guinea pig cochlea was prepared for visual observation of blood vessels using fluorescence intravital microscopic techniques. Measurements were made of the lateral wall vessels in the third cochlear turn and of the basilar membrane and lateral wall vessels in the first turn. A stable and consistent pattern of flow was observed under a variety of manipulations, including blood pressures of less than 20 mmHg. The rationale for the choice of observation areas in the cochlea and the specific vessel types studied at these locations are discussed. The change in blood velocity in cochlear blood vessels during pentoxifylline perfusion and during exsanguination are described.
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Affiliation(s)
- A Axelsson
- Department of Audiology, Sahlgren's Hospital, Göteborg, Sweden
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Carlisle L, Aberdeen J, Forge A, Burnstock G. Neural basis for regulation of cochlear blood flow: peptidergic and adrenergic innervation of the spiral modiolar artery of the guinea pig. Hear Res 1990; 43:107-13. [PMID: 1690196 DOI: 10.1016/0378-5955(90)90219-f] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The spiral modiolar artery is the terminal artery in the cochlea, and as such is expected to play a major role in the control of cochlear blood flow. In this study, we examined the distribution of adrenergic and peptidergic nerve fibres on the spiral modiolar artery of the guinea pig using histofluorescence and immunofluorescence techniques. The spiral modiolar artery was dissected from the modiolus so that the entire length of the vessel and its branches, could be observed. Noradrenaline was identified using the glyoxylic acid histofluorescence technique. The presence of the vasoactive peptides substance P, calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY) and vasoactive intestinal polypeptide (VIP), was investigated using antibodies against these peptides. Each putative transmitter tested yielded labelled nerve fibres throughout the length of the spiral modiolar artery and its branches. Double-labelling experiments confirmed that CGRP and substance P are contained in the same fibres but that VIP and substance P appear to be contained in different populations of fibres. These results establish that nerve fibres containing vasoactive peptides and noradrenaline supply the spiral modiolar artery and suggest that they are involved in the regulation of cochlear blood flow.
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Affiliation(s)
- L Carlisle
- Electron Microscopy Unit, Institute of Laryngology and Otology, London, U.K
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Scheibe F, Haupt H, Berndt H, Magnus S, Weymar P. Laser light transmission and laser Doppler blood flow measurements on the human, rat and guinea pig cochlea. Eur Arch Otorhinolaryngol 1990; 247:20-3. [PMID: 2310544 DOI: 10.1007/bf00240943] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In order to test the applicability of laser-Doppler flowmetry in monitoring cochlear blood flow clinically, the thickness and the helium-neon laser light transmission of specimens of human, rat and guinea pig promontory bone and human skin were determined. Furthermore, comparative laser-Doppler measurements were taken from the promontory in patients, rats and guinea pigs. Due to the different thicknesses of the promontory bone in different species, the light transmission was found to be considerably higher for the animal cochlea (rat, 15%; guinea pig, 6.6%) than the human cochlea (1.7%). However, a clearly higher laser-Doppler signal was recorded from both the human and the rat cochleas as compared with the guinea pig. The relative laser light attenuation by the human skin specimens corresponded to that of the human promontory bone. The findings are discussed with regard to the suitability of the laser-Doppler method for blood flow measurements in the human cochlea.
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Affiliation(s)
- F Scheibe
- ENT Clinic, Humboldt University, Berlin, German Democratic Republic
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Abstract
Wistar-Kyoto rats (WKY) were intra-arterially infused with angiotensin II (AII) or phenylephrine for 10 min. Both vasoactive compounds produced an initial increase in cochlear blood flow (CoBF) as measured by laser Doppler flowmetry, followed by a slow steady return to baseline, despite sustained elevations in systemic blood pressure. These results suggest autoregulation of CoBF in the WKY rat. In a second experiment. All was infused directly into the anterior inferior cerebellar artery (AICA) which feeds the cochlear artery. Significant reductions in CoBF were noted without changes in systemic blood pressure. Pretreatment with the specific angiotensin-receptor antagonist, sarthran (Sar1, Thr8-AII), diminished subsequent AII-induced reductions in CoBF. These results indicate that AII binding to vascular receptors may induce vasoconstriction in the supplying vessels of the cochlea, and thus, the interaction of blood-borne AII and vascular angiotensin receptors may participate in the autoregulation of CoBF.
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Affiliation(s)
- W S Quirk
- Kresge Hearing Research Institute, University of Michigan, Ann Arbor 48109-0506
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Tausch-Treml R, Scherer H, Gewiese B, Ziessow D. [Effect of static magnetic fields on the acoustic action potential of the cochlea in guinea pigs]. THE SCIENCE OF NATURE - NATURWISSENSCHAFTEN 1989; 76:114-7. [PMID: 2725688 DOI: 10.1007/bf00366601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Several experiments carried out during the past years indicate that strong magnetic fields induce disturbed blood circulation in capillaries and arterioles. When exposed to a magnetic field, disturbed blood circulation was found in the capillaries in frog webs as well as changes in skin temperature in several kinds of species. In our experiments we assessed the influence of a 8.5 T static magnetic field on the function of the inner ear of guinea pigs by monitoring the cochlea action potential. When blood circulation is disturbed in this organ it shows a rapid decline in function. Even when exposed to the magnetic field for 3 h, we could find no change in the function of the inner ear of the guinea pigs.
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Affiliation(s)
- J M Miller
- University of Michigan, Kresge Hearing Research Institute, Ann Arbor 48109-0506
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