Contribution to morphological knowledge of the development of the human incudo-mallear joint

Conductive Hearing Loss with Age-A Histologic and Audiometric Evaluation

A retrospective analysis to quantify age-related changes of the incudo-malleolar joint (IMJ) and incudo-stapedial joint (ISJ), and to analyse changes in the air-bone gap (ABG) with age, was performed. Defined histologic parameters of 153 IMJ and 106 ISJ from subjects aged from birth to 70 years were correlated to age. Additionally, audiograms of 1760 ears of 974 other subjects aged 20 to 80 years were retrospectively analysed and the ABG was correlated to age. The joint space (age group from 0 to 10 compared to 61 to 70 years) became significantly wider with age (IMJ: from a mean of 44 µm to 100 µm, p < 0.001; ISJ: from a mean of 28 µm to 69 µm, p < 0.009. The thickness of cartilage of the incus decreased in the first 20 years of life (IMJ, from a mean of 88 µm to 65 µm, p < 0.01; ISJ: from a mean of 44 µm to 35 µm, p < 0.01). The ABGs of younger ears (20–40 years) was significantly larger at 500 Hz compared to older ears (60–80 years) by 2–4 dB, while it was significantly smaller by 3–5 dB at 4000 Hz (p < 0.0017). Interindividual variations in all age groups were large for both analyses. The increased joint spaces could potentially reduce the stiffness in the joints and explain the increase in ABG at 4000 Hz and the drop at 500 Hz. While the average change is small and of minimal clinical relevance, a larger increase of ABG with age is seen in some subjects.

Ciliated cell observation by SEM on the surface of human incudo-malleolar-joint articular cartilage: are they a new chondrocyte phenotype?

BACKGROUND

Scanning electron microscopy (SEM) study of the human incus bone is scanty whilst, to our knowledge, no information regarding human incudo-malleolar joint articular-cartilage morphology has previously been provided.

AIMS/OBJECTIVES

Our aim was to shed some light on this morphological issue and to propose some theoretical perspectives on its functional role.

MATERIAL AND METHODS

The human incudo-malleolar joint was documented with field emission SEM on samples recovered during ear surgery procedures after patients' informed consent.

RESULTS

Normal articular cartilage chondrocytes, flattened cells with prominent nucleus and short microvilli were observed. Interestingly, cells provided with long cilia were identified. Type A cilia are arranged in a pyramidal formation with extra-long cilia stemming from the cluster, projecting upwards in an antenna-like formation ending with a dilated structure that as a whole, resembles the stereocilia with kinocilium. Types B, C and D cilia resemble those of the genital and respiratory tracts.

CONCLUSIONS AND SIGNIFICANCE

It is therefore possible to hypothesize that the observed ciliated cells may be a new chondrocyte phenotype with sensory function. Motile cilia confer the ability to distinguish variations in synovial fluid chemical composition and, in addition, they perhaps may also play some role in the mechanism of sound transmission.