Ototoxicity of Povidone-Iodine applied to the middle ear cavity of guinea pigs

OBJECTIVE

Povidone-Iodine preparation is used as a disinfectant in otological surgeries. The ototoxicity of Povidone-Iodine preparation was evaluated using infant, young and adult guinea pigs. The effects of different concentrations and of different exposure durations on compound action potentials were also studied.

MATERIALS & METHODS

Povidone-Iodine was used to fill one middle ear cavity of the guinea pig, and the compound action potential (CAP) was measured from the round window membrane at 24h, 7 days, and 28 days. The contralateral side was filled with saline as control. Test sounds used were clicks and tone bursts of 2, 4, and 8 kHz.

RESULTS

At 24h, Povidone-Iodine solution showed a significant toxic effect in the infant group. In the young animal group, no toxic effect was seen. In the adult group, a mild degree of deafness for 2 kHz was found. At 7 days, the young group showed significant hearing loss for all frequencies, but the adult group did not show any hearing loss. With a half strength solution, both young and adult group did not show hearing loss. At 28 days, with a full strength solution, hearing loss became prominent for all sound stimulation. With 1/8th dilution, the young group showed a moderate hearing loss, but the adult group did not.

CONCLUSION

The thicker round window membrane in human is expected to provide more protection to the human cochlea than in the guinea pig model that we have studied. Mild hearing loss at 24h and 7 days using 10% solution, but no hearing loss with 5% solution at 7 days may indicate that rinsing of the middle ear cavity with saline during surgery should minimize the ototoxic effect of this product. The age of the animals does influence the outcome of the ototoxicity experiment. From this experiment, Povidone-Iodine preparations in the infant should be used with caution. Povidone scrub should not be used for otologic surgery.

Production of a human antibody fragment against the insulin-like growth factor І receptor as a fusion protein

The aim of this study was to isolate single-chain variable fragments (scFvs) against human insulin-like growth factor I receptor (IGFIR) from a phage library displaying human scFvs. Isolated scFvs-displaying phages showed affinity for IGF-IR in comparison to the control. Expression of scFv proteins in Escherichia coli for further characterization, however, proved extremely difficult. Alternatively, the scFv protein was expressed as a fusion protein with a maltose-binding protein (MBP) that is a highly soluble E. coli protein. The MBPscFv fusion protein expressed in a soluble form in E. coli was purified to homogeneity by two-step affinity chromatography. The resulting MBP-scFv exhibited affinity for IGF-IR and structurally-related insulin receptor (IR). These results suggest both that MBPscFv fusion proteins are practical alternatives to isolating scFv proteins for further characterization and that successful isolation of human scFvs against a specific protein of interest requires vigorous screening in the early stages. Such screening is accomplished by using two independent screening methods such as measuring binding to IGF-IR but not to IR by ELISA or measuring competitive binding by IGF-I in addition to binding to IGF-IR alone.

Safety of ofloxacin (OFLX) and fosfomycin sodium (FOM) ear drops

OBJECTIVE

The objective of this study is to evaluate the safety of two ear drops, Ofloxacin (OFLX: Taribid Otic Solution, Daiichi Seiyaku) and Fosfomycin sodium (FOM: Fosmicin S, Meiji Seiyaku).

METHODS

Albino guinea pigs were used as experimental animals, and the ototoxicity was evaluated by means of threshold changes in the compound action potentials (CAP), when topically applied to the middle ear cavity of the guinea pig. The sound stimuli applied were; click sound, with tone bursts of 8 kHz, 4 kHz, and 2 kHz. In one group of animals, after one application of the ear drops in the right middle ear cavity, the change in CAP was compared with a contralateral saline control at 24h, one week, and four weeks. In other group of animals, the ear drops were applied into the middle ear cavity for seven consecutive days and the CAP was measured at 24h.

RESULTS

At 24h the CAP threshold for click, 8 and 4 kHz elevated significantly for both the saline and ear drop treatment, but the threshold returned to normal when measured at 7 days and 28 days. Seven consecutive days of ear drops administration resulted in no reduction in the CAP for either ear drops.

CONCLUSIONS

Based on the lack of changes in the CAP, these two ear drops studied did not show any significant ototoxicities.

Role of dorsal neck proprioceptive inputs to vestibular compensation in humans

To investigate the role of cervical proprioceptive inputs in the process of vestibular compensation, we performed static posturography in patients with acute and compensated unilateral vestibular dysfunction, by applying vibratory stimulation to the dorsal neck muscles. Neck vibration induced disequilibrium in both groups of patients, but was more pronounced in the compensated patients. These results indicate that manipulation of the neck afferents causes discompensation in subjects whose vestibular dysfunction has already been compensated by multisensory inputs including neck afferents.

A 'neural' response with 3-ms latency evoked by loud sound in profoundly deaf patients

A large negative deflection with a latency of 3 ms was observed in the auditory brainstem response (ABR) waveforms of some patients with peripheral profound deafness. This deflection was termed the N3 potential. In this paper, we review patients with the N3 potential and discuss the characteristics of abnormal ABR waveforms. The origin of the N3 potential was also discussed, especially with respect to vestibular evoked potentials. In most of the patients, audiograms showed no response to the maximum output of an audiometer in the high-frequency range and a residual response in the low-frequency range. The N3 potentials were noted at intensities of 80 dB nHL or greater. As the stimulus intensity increased, the amplitude of the potential increased and the latency decreased. A high repetition rate (83.3/s) of the click stimulus influenced the latency and amplitude of the N3 potential. The potential was replicated on retest within less than a month, and had a consistent latency and amplitude over the scalp. The results indicate that the N3 potential is not an electrical artifact but a physiological neural response evoked by a loud sound. The N3 potential is most likely not an auditory evoked response from cochlear or a response from a semicircular canal, because it has a 3-ms latency, a sharp waveform, and is unassociated with vertigo. The results suggest that the N3 potential may be a saccular acoustic response.

Developmental anatomy of the supratubal recess in temporal bones from fetuses and children

The supratubal recess (STR), located superior to the bony eustachian tube and anterior to the attic and often the site of disease, is clearly separated from the attic by the presence of a bony partition. Its anatomic development in childhood, however, remains nuclear. We reviewed serial horizontal sections of fetal and children's temporal bones from the collection of the Otopathology Laboratory, University of Minnesota. Apparently, upward expansion of the bony eustachian tube begins at a late fetal stage and continues throughout childhood, thus forming the STR. Our finding that the STR had already developed in temporal bones without pneumatization of petrous bone suggests that its formation is independent of the air-cell system. Absorption of mesenchymal tissue in the STR tends to be slower than elsewhere in the temporal bone. Surrounded solely by petrous bone, the STR seems, both developmentally and anatomically, a distinctive compartment of the middle ear.

Three-component analysis of benign paroxysmal positional nystagmus

Three-component analysis of Benign Paroxysmal Positional Nystagmus (BPPN), focusing on the horizontal, vertical, and torsional, using a computerized eye movement analysis system, was carried out in 10 patients. Using a pendular rotation stimulus, we also measured three components of eye movement elicited from the vertical semicircular canals in normal subjects. We compared two components (vertical and torsional) of BPPN with that of eye movements elicited from the vertical semicircular canals. In BPPN, the torsional component of eye movements was larger than that of the vertical component. Conversely, the vertical component from the vertical semicircular canals was larger than that of the torsional component. From these results, by analysing the vestibulo-ocular reflex of the vertical semicircular canals, it is difficult to support the idea that the pathology of the BPPV is localized in the posterior semi-circular canal alone.

Low-frequency biasing of round window responses in guinea pigs and chinchillas

The acoustic biasing technique using low-frequency sound is of increasing interest to investigators, not only as a means of studying cochlear transduction but also as a promising tool for assessing cochlear pathology such as endolymphatic hydrops. We compared normal modulation patterns of round window responses in guinea pigs and chinchillas, whose low-frequency auditory characteristics are known to be different. A 50-Hz sine wave (90 dB SPL for guinea pigs and 80 dB SPL for chinchillas), which evoked an equivalent magnitude of cochlear microphonics (CM) in both species, was used to modulate the compound action potential (CAP) and the summating potential (SP) elicited by 8-kHz tone bursts. Overall patterns of CAP and SP modulation were almost identical between the two species except for a difference in the phase of 50 Hz CM. The phase of maximum SP enlargement was in accord with that of maximum CAP suppression, which led to inferred basilar membrane (BM) position at maximum scala tympani displacement by between 45 and 90 degrees. More complex or hysteresis effects seemed to be involved in the modulation of CAP and SP magnitude, in addition to the biasing effect owing solely to BM displacement.

A device for controlling odorant stimulation and olfactory evoked responses in humans

We developed a device for odorous stimuli control to record olfactory evoked responses from the human scalp. The characteristics of the apparatus are as follows. Translating the subject's respiration into electric signals with a sensor attached to the nose. The period and timing of odorous stimuli could be adjusted, so that stimuli could be synchronous with respiration. The interstimulus interval could be arbitrarily selected once every 1 to 9 respiration(s) so that adaptation could be prevented. We obtained evoked responses to odorous stimuli using this apparatus from the human scalp, whose positive peak latencies were approximately 350 and 700 msec. Such responses were not recorded if oxygen stimuli were used instead of odorous stimuli or with click sounds produced by the switching electromagnetic valve. Three types of odorant evoked scalp potentials were obtained in normal human subjects. The first type consisted mainly of two positive peaks with a peak latency of about 350 msec (P350) and about 700 msec (P700). The second type and the third type consisted of only one positive peak with a peak latency of about 350 msec and 700 msec, respectively. Such a P350 or P700 peak as that observed in the normal subjects was not detected in anosmic patients.

Topography of binaural interaction in the auditory brainstem response

The scalp topography of binaural interaction (BI) in the auditory brainstem response (ABR) was studied in fourteen normal individuals. BI was observed from all recording sites of the scalp, and the peak amplitude was noted mostly in the bilateral parietal and occipital regions. There was a significant difference in amplitude shown by significance probability mapping (SPM) when the waveform obtained by binaural stimulation was compared with the sum of the waves obtained by monaural stimulation. The topography of BI was different from that of the wave III and the wave IV/V complex. In contrast to previous reports by other workers, we found that BI mainly corresponded to the first half of the wave IV/V complex.

Analysis of auditory brainstem response waveforms derived ipsilaterally and contralaterally to monaural stimulation

The auditory brainstem responses (ABRs) obtained from 28 normal healthy adults were studied using the ipsilateral and contralateral recordings from the positions of vertex and each mastoid to monaural stimulation. Each wave of ABRs recorded by ipsilateral and contralateral derivations to stimulation site showed slightly significantly differences. Comparing the ipsilateral and contralateral data, the latencies of waves II and V showed a slightly small reduction in the ipsilateral recording, while these of waves III and IV showed a small increase. Next, the distributions of potentials and latencies of waves II to V were investigated from ABRs situating different electrodes in mid-coronal array of the scalp and non-cephalic reference electrode on the seventh cervical vertebra (CVII). The results of latencies showed the reverse relation to the data obtained from the ipsilateral and contralateral recordings using the reference electrodes on each mastoid. These facts suggest that the comparable differences of latencies in the bilaterally recorded ABRs are explained by the pseudo-phenomena of differential recordings, which the phase delayed or advanced potential propagated to each mastoid being reference electrode position.

The temporal bone in multiple myeloma

Multiple myeloma is a malignant disease of the skeleton. Anatomically, any bone may ultimately come to be involved in a given case. In a literature review, no published series of temporal bone findings have been reported. In this study, oto-histopathologic changes associated with multiple myeloma are analyzed and reported in 15 temporal bones from 8 patients. The bone marrow of 13 temporal bones was involved by the tumor. Osteolysis was evident in 11 temporal bones. Serous otitis media (SOM) or purulent otitis media (POM) was seen in 13 ears with 12 showing mastoid effusions. Eight ears exhibited pathological changes in inner ears, including degeneration of the organ of Corti, atrophy of stria vascularis, decreased ganglion cells, and labyrinthine hydrops. The inner ear changes were most severe in 2 patients who had otologic symptoms. Infiltration of myeloma cells was not apparent in the middle ear mucosa or the inner ears.

Pathogenesis of tympanosclerosis

In spite of the wealth of information on the clinical, histologic, and pathologic aspects of tympanosclerosis, the pathogenesis of tympanosclerosis is still unclear. In an attempt to understand the pathogenesis, 319 human temporal bones from 196 individuals with otitis media were studied. The extent and nature of tympanosclerosis and the characteristics of the otitis media associated with it were studied. Forty-five temporal bones from 35 individuals with otitis media were found to have tympanosclerosis, giving an incidence of 14.1%. It was seen most commonly in individuals over 40 years of age (86.7%). The male-to-female ratio was 1.6:1. The most common site of occurrence was the tympanic membrane (88.9%). Tympanosclerosis was seen more often in the anterior and posterior inferior quadrants of the tympanic membrane and that, too, in a central position. Tympanosclerosis was seen more commonly in temporal bones with irreversible inflammatory changes, and in this group, late plaques were more commonly seen than early or intermediate plaques. Audiometric charts failed to show any direct relationship between extent of tympanosclerosis and the severity of hearing loss. The only audiometric finding of any consequence was a mixed hearing loss in the presence of middle ear tympanosclerosis.

Potter's syndrome: a temporal bone histopathological study

Histopathological findings in seven temporal bones from four infants diagnosed as Potter's syndrome are described. The infants were labelled as Potter's syndrome after autopsy confirmed bilateral renal agenesis. Extrarenal manifestations included pulmonary hypoplasia and facial anomalies. The middle ear volume in infants with Potter's syndrome remained unchanged with age resulting in a significantly higher percentage of residual middle ear mesenchyme in these infants as compared to normal infants. Dehiscence of the facial nerve was seen in all the temporal bones studied. One ear showed the presence of eosinophilic effusion in the endolymphatic sac, an underdeveloped malleus and a wide facial nerve canal. The inner ear structures showed no significant anomalies except for the absence of the organ of Corti in the basal turn of the cochlea in one of the ears.

Three-component analysis of caloric nystagmus in humans

Three-component analysis of caloric nystagmus, focusing on the horizontal, vertical, and torsional, using a computerized eye movement analysis system, was carried out in 10 normal human subjects. The caloric response was induced by cold stimulation to the right ear of the subjects in the supine and prone positions. In the supine position, the three components of nystagmus were toward the left (10 subjects), upward (eight subjects) or downward (two subjects), and clockwise (10 subjects). In the prone position, on the other hand, the three components were directed toward the right (10 subjects), downward (five subjects), upward (three subjects), and counterclockwise (10 subjects); there was no vertical direction in two subjects. These findings indicate that caloric stimulation activates the three semicircular canals simultaneously. Also the changes in the nystagmus direction in the supine and prone positions could be explained, at least partially, by the nonconvective component of caloric stimulation.

Low-frequency modulation of compound action potential in experimental perilymphatic fistula and endolymphatic hydrops

We have tested the hypothesis that the cause of cochlear dysfunction associated with perilymphatic fistula (PLF) is closely related to endolymphatic hydrops (ELH). Using guinea pigs, we studied the tone-burst elicited compound action potential (CAP) and its modulation as caused by a 50 Hz biasing tone in experimental PLF. We compared these results with those of experimental ELH. Following perilymph aspiration through the perforated round window membrane, mild but significant elevations of CAP thresholds at tested frequencies were found. A reduction in the amplitude of cochlear microphonics (CM) for a 50 Hz sine wave appeared to correlate with these CAP threshold changes. However, there were no significant changes in the modulation effect of the 50 Hz biasing tone on the CAP elicited by an 8 kHz tone burst. This finding differed from that in ears with experimental ELH, in which significant reductions of both 50 Hz CM and the degree of CAP modulation were consistently observed. We concluded that it is unlikely that the underlying mechanisms of a modification to the low frequency response of the base of the cochlea following perilymph aspiration is linked to that of experimental ELH.

Inner ear damage and passage through the round window membrane of Pseudomonas aeruginosa exotoxin A in a chinchilla model

By the use of computer-assisted morphometric analysis of the organ of Corti and/or measurements of action potential threshold changes, inner ear changes in chinchillas were evaluated 4 weeks after application on the round window membrane of a Pseudomonas aeruginosa exotoxin A solution. Severe inner ear damage was detected after application of 50 ng (5 microL at a concentration of 10 micrograms/mL) exotoxin A, whereas application of 5 ng exotoxin did not cause measurable inner ear damage. Perilymph concentrations of exotoxin A were measured with an enzyme-linked immunosorbent assay 1.5 to 19 hours after 50 ng, 0.5 micrograms, or 5 micrograms of exotoxin A was applied on the round window membrane. Only the highest concentration produced measurable levels of exotoxin in the inner ear fluids. It is concluded that exotoxin A present on the round window membrane of the chinchilla has the ability to penetrate into the inner ear and cause irreversible inner ear changes.

Cochleotoxicity of otic drops in the chinchilla: comparative study of Bestron and Cortisporin

Bestron, a new otic preparation containing cefmenoxime, was applied to the round window membrane of the chinchilla and the long-term cochleotoxicity was evaluated by means of electrocochleography. The thresholds of the compound action potential (CAP) in all frequency areas tested ranged within normal values. The input-output and -latency relationships of the CAP resulted in no significant deterioration of hearing. However, identical treatment with Cortisporin resulted in elevated CAP threshold in the high frequency area and deterioration of the input-output and -latency of the CAP. These findings indicate that Bestron is noncochleotoxic as compared with Cortisporin and therefore may be used safely in the treatment of infected ears.

Middle ear inflammatory mediators and cochlear function

Sensorineural hearing loss (SNHL) has been documented in patients with otitis media. Despite a number of clinical and pathologic works dealing with this common problem, animal studies searching for possible relationships between the middle ear inflammation and cochlear function remain insufficient. Bacterial inoculation and ototoxins and inflammatory products in the middle ear cavity cause SNHL in rodents. Human serum albumin placed in the middle ear cavity in chinchillas also produces SNHL, owing to the effects of nonspecific inflammation in the middle ear cavity. Most of the middle ear inflammatory mediators enter the inner ear through the round window route, and alteration of the permeability of the round window membrane plays an important role in causing cochlear dysfunction. Although an immunologic response in the middle ear plays an important role in otitis media, the immunologic response in the inner ear as it relates to middle ear inflammatory mediators requires further study.

[Influence of neck vibration on body sway]

To investigate the influence of the cervical input to the equilibrium, the effect of neck vibratory stimulation on body sway was analyzed in 49 normal human subjects. Body perturbations during standing posture were recorded by a force platform with or without vibratory stimulus on the upper cervical region, and analyzed by computer. During the neck vibratory stimulation, the center of gravity was shifted to the forward, and the amplitude of the body sway was increased especially along the front-rear axis. These results indicate that the proprioceptive inputs from the cervical receptors largely modifies the body equilibrium in normal subjects.

The ionic and electric environment in the endolymphatic sac of the chinchilla: relevance to the longitudinal flow

The ionic composition of the endolymph in the endolymphatic sac (ES) of the chinchilla was measured using double-barreled ion-selective micro-electrodes. The DC potential of the ES was 9.3 +/- 1.8 mV (N = 18). The K+, Na+, and Cl- concentrations of the ES were 13.3 +/- 4.7 mM (N = 6), 129.0 +/- 8.8 mM (N = 6), and 124.3 +/- 16.6 mM (N = 6), respectively. In light of the chemical potentials of the cochlear endolymph previously reported [Ikeda and Morizono (1989), Hear. Res., 39, 279-286] the pressure gradient of the endolymph between the cochlea and ES was calculated to be 71.5 mmHg at 38 degrees C. The contribution of the osmotic and hydrostatic pressure gradients of the endolymph to the longitudinal flow is discussed.

Effect of ototopic application of a corticosteroid preparation on cochlear function

The ototoxicity of the corticosteroid triamcinolone diacetate was investigated using the compound action potential (CAP) of the auditory nerve as a parameter when the drug was applied to the middle ear cavity of the chinchilla. Comparison with the contralateral ear, instilled with Ringer's solution, demonstrated no significant difference in the threshold, amplitude, and latency of the CAP responses at the overall frequencies tested. In addition, the side difference of the CAP threshold in individual animals showed that this corticosteroid did not induce cochlear dysfunction in any case.

Ionic activities of the inner ear fluid and ionic permeabilities of the cochlear duct in endolymphatic hydrops of the guinea pig

Ionic activities (K+, Na+, and Cl-) of the perilymph and endolymph of the basal turn were measured using ion-selective microelectrodes in experimentally induced endolymphatic hydrops of the guinea pig. Three months following the obstruction of the endolymphatic duct and sac, the endocochlear potential (EP) of hydroptic ears was measured at 59.7 +/- 9.6 mV (N = 12) which was significantly lower than the EP of the contralateral control ears (84.4 +/- 2.8 mV, N = 12). A paired t-test (P greater than 0.05) showed no significant differences of ion concentrations of the inner ear fluid between the hydroptic and contralateral ears. Ion permeabilities of the cochlear duct following anoxia were calculated according to the Nernst-Planck equation. Comparing hydroptic and normal ears following anoxia, a statistically significant decrease was observed in the permeability coefficients for K+. Similarly, K+ conductance was significantly lower in the hydroptic ears than in the normal ears. Total conductance of the cochlear duct, defined as the sum of each ion conductance, was 0.560 siemens in the normal ears and 0.217 siemens in the hydroptic ears. On the basis of the Goldman-Hodgkin-Katz equation, preexisting negative EP in the normal state was calculated to be -24.5 mV in normal ears and -21.4 mV in hydroptic ears. Therefore, the positive component of the EP was 108.9 mV in normal ears and 81.1 mV in hydroptic ears. These findings suggest that the pathophysiology of hydrops involves changes in K+ permeability and the inhibition of the electrogenic transport processes.

Pathophysiology of inner ear fluid imbalance

Maintenance of homeostasis of inner ear fluids and biochemical integrity of inner ear tissue are essential for proper functioning of the auditory and vestibular end organs. Although various regulatory mechanisms exist in a different portion of the labyrinth, the inner ear is known to respond to systemic challenges. The association of Meniere's syndrome with an imbalance of inner ear fluid homeostasis has been hypothesized for the past century. Among many factors, the effects of hormonal imbalance on inner ear fluid composition and inner ear function have however scarcely been studied. The purpose of this study was to explore the relationship between the autonomic nervous system and inner ear function and possible mechanisms of functional disturbances in an experimental condition. An infusion of supraphysiologic amounts of epinephrine, a stress related hormone, resulted in an elevation of osmolality in serum and perilymph. Furthermore, the infusion of epinephrine resulted in elevation of threshold, prolongation of latency, and depression of amplitude in the compound action potential of the auditory nerve. These findings were most marked at high frequencies. We hypothesized that the epinephrine-induced hearing loss was brought about by an increase in perilymphatic osmolality, as well as by the ionic imbalance caused by the osmotic gradient. Since emotional stress has been implicated as a mechanism of inducing a Meniere's attack, evaluation of the relationship between the autonomic system and cochlear function may contribute to the understanding of possible mechanisms of inner ear dysfunction caused by hormonal imbalances.

Otic preparations altered permeability and thickness of the round window membrane of the chinchilla

The effects of topical otic preparations (Cortisporin, Coly-Mycin, Aristocort, and Bestron) upon the permeability of the round window membrane (RWM) in chinchillas were investigated. Using K(+)-selective microelectrodes, the concentration of tetraethylammonium (TEA) ions was measured. Changes in the thickness of the RWM were measured using light microscopy. The RWM permeability was reduced significantly in Cortisporin- and Coly-Mycin-treated ears. Moreover, these two drugs resulted in a marked thickening of the RWM. In contrast, Aristocort or Bestron resulted in no alteration of the RWM permeability.

Toxicity of ototopical drugs: animal modeling

It is important to be aware of the potential ototoxicity of any drug, vehicle, or antiseptic that is used in the middle ear. Frequently used ear drops (Cortisporin otic suspension, Coly-Mycin S Otic, and VoSoL otic solution) were studied for their ototoxicity. Compound action potentials were measured before and at 1, 2, and 24 hours following drug application on the round window membranes of chinchillas. Each drug was applied for 10 minutes and then was removed by rinsing. The sound pressure in decibels sound pressure level that produced a compound action potential amplitude of 10 microV was defined as the threshold. The change in threshold was interpreted as hearing loss. On the basis of the short-term results at 24 hours following drug application, the ototoxicity of Coly-Mycin was calculated to be twice that of Cortisporin, and the ototoxicity of VoSoL four times that of Cortisporin.

Round window membrane permeability during experimental purulent otitis media: altered Cortisporin ototoxicity

Round window membrane (RWM) permeability is the most critical factor influencing cochlear function following otitis media. Because otic drops are frequently used during purulent otitis media (POM), we investigated RWM permeability and ototoxicity of Cortisporin otic suspension after inducing experimental POM. Unilateral POM was induced in eight chinchillas by inoculating type 7F Streptococcus pneumoniae into the right ears. Left ears were inoculated with phosphate-buffered saline (control). When POM resolved, the animals were divided into two groups. The round window niches of group 1 were covered with Cortisporin otic suspension. Compound action potentials were measured before and after drug application. The RWM permeability was measured in group 2 by use of tetraethylammonium (TEA) ions as tracers, and the arrival time of TEA and the slope of the potassium-selective microelectrode response were measured. Animals with otitis media exhibited less susceptibility to ototoxicity of Cortisporin otic suspension and reduced RWM permeability to the medium-sized molecule TEA.

Eye movement analysis system using computerized image recognition

A new technique for an eye movement analysis system utilizing infrared video recording and a computerized image recognition method is presented. The system consists of an infrared lighting apparatus, a very small infrared video charge-coupled device camera, a video tape recorder, an analogue-digital converter, and microcomputers. This system makes it possible to simultaneously analyze the slow-phase velocity quantitatively not only of the horizontal and vertical but also of the rotatory components of the energy-induced nystagmus. The maximum slow-phase velocity of the rotatory component of energy-induced nystagmus was found to be 4.1 degrees per second on an average in this study.

Effect of Escherichia coli endotoxin on cochlear potentials following its application to the chinchilla middle ear

The compound action potential (CAP) of the eighth nerve and the endocochlear potential (EP) were examined in the chinchilla as an animal model when Escherichia coli endotoxin (100 micrograms) was applied to the middle ear cavity. A significant elevation of the CAP threshold at 2, 3, and 4 kHz was observed 48 h after the instillation of endotoxin, but this hearing loss was thought to be caused by a conductive component. No significant change in the CAP threshold was recognized 30 days after instillation. The EP in either period showed no significant difference. These findings indicate that the application of endotoxin at the concentration used in the present study does not cause a cochlear disturbance.

Permeability of the round window membrane to middle-sized molecules in purulent otitis media

The effect of pneumococcal otitis media on the permeability of the round window membrane was evaluated using tetraethylammonium ions as a tracer. Round window membrane permeability is reduced significantly at resolved stages of purulent otitis media. In contrast, measurements of round window membrane permeability indicate that acute purulent otitis media has a tendency to facilitate such permeability. Moreover, histologic observations of the round window membrane following bacterial inoculation further support the evidence of functional changes in round window membrane permeability. These findings indicate that the round window membrane in resolved stages of purulent otitis media plays a protective role in preventing the penetration of harmful substances into the inner ear.

Electrochemical aspects of cations in the cochlear hair cell of the chinchilla: a cellular model of the ion movement

The dc potential and ion composition (K+, Na+, and Ca++) in the hair cells of the cochlea were examined using ion-selective microelectrodes. The K+, Na+, and Ca++ concentrations were 124.0 +/- 29.8 mM, 6.9 +/- 4.1 mM, and 1.7 +/- 1.4 microM in the hair cells, respectively. The electrochemical potential gradients for K+, Na+, and Ca++ across the apical membranes of the hair cells were calculated to be 160.0 +/- 29.8 mV, 87.6 +/- 27.0 mV, and 194.4 +/- 35.2 mV, respectively. Those for K+, Na+, and Ca++ across the basolateral membranes of the hair cells were -12.6 +/- 33.3 mV, 126.8 +/- 28.3 mV, and 170.8 +/- 30.1 mV, respectively. These findings were discussed in light of the transport mechanism necessary to maintain the ionic composition of hair cells.

The preparation of acetic acid for use in otic drops and its effect on endocochlear potential and pH in inner ear fluid

The ototoxicity of an otic drop preparation containing 2% acetic acid and 3% propylene glycol (VoSol, Denver Chemical Co., Humacao, PR) was investigated according to measurements of endocochlear potential (EP) and inner ear fluid pH. The application of this preparation to the round window membrane for 30 minutes caused a depression in EP from 80.5 +/- 2.5 mV (mean +/- SD; n = 6) to 11.7 +/- 7.7 mV, and lowered inner ear fluid pH from 7.55 +/- 0.09 to 5.06 +/- 0.19 (n = 6) in perilymph and from 7.52 +/- 0.07 to 5.88 +/- 0.63 (n = 6) in endolymph. Two percent acetic acid produced similar changes after 30 minutes: EP was reduced from 83.0 +/- 2.2 mV to 34.0 +/- 2.9 mV and endolymphatic pH from 7.49 +/- 0.04 to 6.83 +/- 0.21 (n = 4). However, the application of artificial perilymph of pH 4 titrated with HCl induced no significant changes in either EP or endolymphatic pH. We suggest that the mechanisms of ototoxicity in the otic drop preparation are Na+ and K+-ATPase inhibition, and that such inhibition is due to the intracellular acidification of strial cells resulting from the penetration of acetic acid across the cell membrane, and to the direct and synergistic actions of propylene glycol.

Proteases and protease inhibitors in immune complex otitis media in chinchillas

Using an immune complex-induced (IC) otitis media model in chinchillas sensitized with human serum albumin (HSA), we measured the levels of protease activity, protease inhibitors, and HSA in the middle ear fluid (MEF). The effect of a corticosteroid agent (triamcinolone) on the degree of IC otitis media also was studied. The levels of protease inhibitors alpha 1-antitrypsin and alpha 2-macroglobulin in the MEF were significantly higher than in nonsensitized animals. Fibrinolytic (plasminogen activator [PA]) activity was detected in the MEF; however, only a small level of activity of nonspecific proteases was detected because of the significant level of antitryptic activity in the MEF. The levels of protease inhibitors and PA activity were significantly reduced by the steroid treatment. It is concluded that protease inhibitors play an important role in the protection of the middle ear mucosa and that corticosteroid treatment can reduce the severity of IC otitis media.

Effects of carbon dioxide in the middle ear cavity upon the cochlear potentials and cochlear pH

To elucidate the effects of CO2 in the middle ear upon the cochlea, measurements were made of the cochlear potentials (compound action potential and endocochlear potential) and of the pH of the inner ear fluids and the organ of Corti. Gas containing CO2 did not affect the AP threshold, except for a slight decrease in AP threshold elicited by an 8 kHz tone burst with 10% CO2 flow. The EP did not vary with CO2 gas. The CO2 gas mixture reduced the pH in perilymph significantly, by 0.11 +/- 0.05 with 5% CO2 and by 0.17 +/- 0.04 with 10% CO2, in comparison with 100% N2. The CO2 gas slightly but significantly decreased the endolymph pH, by 0.05 +/- 0.04 with 5% CO2 and by 0.09 +/- 0.06 with 10% CO2. The removal of perilymph led to a greater acidification of endolymph with CO2 gas. Acidification of the organ of Corti was also noted with the CO2 gas flush. These findings indicate that CO2 in the middle ear influences the acid-base regulation of inner ear fluids and the cochlear function.

Electrochemical profile for calcium ions in the stria vascularis: cellular model of calcium transport mechanism

The d.c. potential and the Ca2+ concentration in the stria vascularis of the chincilla were measured using double-barreled Ca2+-selective microelectrodes with fine tips. The impalement of the microelectrode through the stria vascularis indicated two or three regions showing low Ca2+ concentrations. The first region with a low Ca2+ concentration, presumably corresponding to the basal cell, showed a Ca2+ concentration of 2.5 +/- 1.9 microM. The low Ca2+ region, adjacent to the endolymph, showed 0.31 +/- 0.15 microM and presumably corresponds to the marginal cell. In contrast, the Ca2+ concentrations in the spiral ligament, intrastrial space and endolymph were 1.6 +/- 0.2 mM, 0.75 +/- 0.12 mM, and 17 +/- 7 microM, respectively. Based upon the electrochemical profile for Ca2+ ions, we hypothesize mechanisms of cellular Ca2+ transport where Ca2+ ions from perilymph are accumulated into endolymph via the action of Ca2+-ATPase located in apical membranes of both the basal and marginal cells.

Electrochemical profiles for monovalent ions in the stria vascularis: cellular model of ion transport mechanisms

The electrochemical profiles for K+, Na+, and Cl- ions in tissues of the lateral wall of the cochlea in the chinchilla were measured using an ion-selective microelectrode. Based upon the changes of the d.c. resting potential and ion composition, five distinct compartments were identified in the lateral wall. The first compartment, corresponding to the spiral ligament, showed an ionic composition similar to perilymph. The second, corresponding to the basal cell layer of the stria vascularis, showed a characteristic recording of the ion-sensitive barrel: a spike-like change of the ion concentration (K+: 100.1 +/- 16.8 mM, Na+: 33.9 +/- 20.2 mM, Cl-: 70.2 +/- 9.4 mM). The third compartment, corresponding to the extracellular space of the stria vascularis, showed a higher d.c. potential (60.4 +/- 9.5 mV) than that of the second region, with a low K+ concentration (22.1 +/- 14.9 mM) and a high Na+ (78.3 +/- 5.7 mV) than the fifth compartment, corresponding to the scala media (78.1 +/- 4.1 mV), and K+ and Na+ concentrations similar to those of endolymph, while the Cl- concentration in the fourth compartment (117.6 +/- 21.5 mM) was lower than that of endolymph (143.3 +/- 13.9 mM). A thermodynamic study of electrochemical potential gradients suggests the possibility that the Na-K pump and Na-K-2Cl cotransport exist at the basolateral membrane of the marginal cells.

Effect of albumin-bound furosemide on the endocochlear potential of the chinchilla. Alleviation of furosemide-induced ototoxicity

The effects of albumin-unbound furosemide and albumin-bound furosemide on the cochlear function were compared by the continuous observation of the endocochlear potential (EP) in the chinchilla using the microelectrode method. The EP depression following the intravenous injection of 50 mg/kg of furosemide was 108.5 +/- 2.7 mV, while the addition of 1.0 and 1.3 g/kg of albumin induced the EP depression to be 35.0 +/- 4.8 and 8.1 +/- 1.9 mV, respectively, and both prolonged the time to attain the minimum EP. However, there was no difference in the recovery time of the EP between the two groups. The results indicate that access to the site of furosemide action in the cochlea is dependent on the unbound fraction of furosemide and that the albumin-bound furosemide alleviates the EP depression induced by furosemide alone with the augmentation of diuresis.

Changes of the permeability of round window membrane in otitis media

The effects of endotoxin, exotoxin, and otitis media on the permeability of the round window membrane (RWM) in chinchillas was investigated by detecting tetraethylammonium chloride, applied to the RWM, using a potassium-selective microelectrode in the scala tympani. The RWM, 48 hours following the application of endotoxin or exotoxin, became significantly more permeable to tetraethylammonium chloride than the normal RWM. Two weeks after the obstruction of the eustachian tube, the permeability of the RWM was decreased. These results suggest that bacterial toxins and the consequential migration of chemical inflammatory mediators act as promotive factors of RWM permeability, and that a pathologic thickness of the RWM and the presence of effusion induced by the obstruction of the eustachian tube acts as an inhibitory factor. In the clinical role of RWM permeability in human otitis media, these two factors must be taken into consideration.

Calcium transport mechanism in the endolymph of the chinchilla

The Ca2+ transport mechanism between endolymph and perilymph was evaluated by the effects of vanadate and amiloride on the endocochlear potential (EP) and the Ca2+ concentration in endolymph using Ca2+-selective microelectrodes. Under normal conditions, the EP was 81.8 +/- 0.9 mV, and the Ca2+ concentrations in endolymph and perilymph were 16.6 +/- 1.3 microM and 1.85 +/- 0.11 mM (N = 12), respectively. Therefore, the uphill electrochemical potential gradient for Ca2+ from perilymph to endolymph, 20.2 +/- 2.0 mV, indicates the existence of an active uptake of Ca2+ into endolymph. Vanadate, the inhibitor of Ca2+-ATPase, topically applied to the round window membrane caused biphasic changes of the EP and the endolymph Ca2+ concentration; the former in a transient increase followed by a consistent decrease and the latter in a slow decrease followed by a slow increase. Amiloride induced a slight EP depression and a concomitantly slight elevation of the Ca2+ concentration in endolymph. The electrochemical potential gradient for Ca2+ between endolymph and perilymph vanished with the use of vanadate but was not affected by amiloride. These results suggest that Ca2+-ATPase, sensitive to vanadate, maintained the bulk of active Ca2+ transport in the cochlea and that the participation of Na+-Ca2+ exchange is negligible.

Potassium ion conductance of the cochlear partition: differences between the chinchilla and guinea pig

The time courses of the endocochlear potential (EP) and the K+ concentrations in the inner ear fluid under permanent anoxia were observed in the chinchilla and guinea pig using K+-selective microelectrodes. The EP following 30 min of anoxia in the chinchilla (-10.9 +/- 2.2 mV) showed a significantly less negative value than that of the guinea pig (-25.7 +/- 2.6 mV). The K+ concentration in endolymph induced by anoxia decreased less in the chinchilla than in the guinea pig. The average K+ conductance of the cochlear partition 10-30 min after anoxia in the guinea pig (0.1703 +/- 0.0792 S) was approximately 7.9 times that of the chinchilla (0.0216 +/- 0.0042 S), which is thought to be responsible for the difference of the anoxic EP between the two species.

Magnesium ion activity in the mammalian endolymph measured with ion-selective microelectrodes

The free Mg++ concentration in endolymph was measured with Mg++-selective microelectrodes based on the neutral ligand ETH 1117. The property of Mg++ microelectrodes was obtained from calibration solutions, containing various Mg++ concentrations with the background electrolytes resembling endolymph. The range between 10 and 0.1 mM Mg++ concentrations changed the potentials of Mg++ microelectrodes by 14.4 +/- 3.0 mV. The endocochlear potential and the Mg++ concentration in the endolymph were 82.0 +/- 5.0 mV and 0.77 +/- 0.29 mM in the guinea pig, and 84.4 +/- 4.9 mV and 1.12 +/- 0.24 mM in the chinchilla, respectively. These results are discussed in the light of the dependence of Na+, K+-ATPase and its interaction with Ca++.

Relationship between antigen levels in middle ear and antigen passage through round window membrane in antigen-induced otitis media

By using an antigen-induced (Arthus) otitis media (OM) model in chinchillas sensitized with human serum albumin (HSA), we investigated the passage of HSA through the round window membrane (RWM) by measuring HSA levels in both the middle ear fluid (MEF) and the perilymph (PL). The effect of corticosteroid treatment on HSA passage was also studied. Mean HSA levels in both the MEF and the PL were proportional to the HSA dose administered (0.5, 5, 50 mg/ml). The proportion of HSA-positive PL samples was significantly lower in the sensitized group than that of the control (p less than 0.01). HSA levels in the PL appear to depend on HSA levels in the MEF, which were significantly depressed in the sensitized animals. These results suggest that an immunological reaction may be involved in the reduction of antigen (HSA) passage through the RWM by reducing antigen concentrations in the MEF. Corticosteroid treatment reduces the passage of HSA into the PL in non-sensitized animals.