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Johns JD, Olszewski R, Strepay D, Lopez IA, Ishiyama A, Hoa M. Emerging Mechanisms in the Pathogenesis of Menière's Disease: Evidence for the Involvement of Ion Homeostatic or Blood-Labyrinthine Barrier Dysfunction in Human Temporal Bones. Otol Neurotol 2023; 44:1057-1065. [PMID: 37733989 PMCID: PMC10840868 DOI: 10.1097/mao.0000000000004016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
HYPOTHESIS Analysis of human temporal bone specimens of patients with Menière's disease (MD) may demonstrate altered expression of gene products related to barrier formation and ionic homeostasis within cochlear structures compared with control specimens. BACKGROUND MD represents a challenging otologic disorder for investigation. Despite attempts to define the pathogenesis of MD, there remain many gaps in our understanding, including differences in protein expression within the inner ear. Understanding these changes may facilitate the identification of more targeted therapies for MD. METHODS Human temporal bones from patients with MD (n = 8) and age-matched control patients (n = 8) were processed with immunohistochemistry stains to detect known protein expression related to ionic homeostasis and barrier function in the cochlea, including CLDN11, CLU, KCNJ10, and SLC12A2. Immunofluorescence intensity analysis was performed to quantify protein expression in the stria vascularis, organ of Corti, and spiral ganglion neuron (SGN). RESULTS Expression of KCNJ10 was significantly reduced in all cochlear regions, including the stria vascularis (9.23 vs 17.52, p = 0.011), OC (14.93 vs 29.16, p = 0.014), and SGN (7.69 vs 18.85, p = 0.0048) in human temporal bone specimens from patients with MD compared with control, respectively. CLDN11 (7.40 vs 10.88, p = 0.049) and CLU (7.80 vs 17.51, p = 0.0051) expression was significantly reduced in the SGN. CONCLUSION The results of this study support that there may be differences in the expression of proteins related to ionic homeostasis and barrier function within the cochlea, potentially supporting the role of targeted therapies to treat MD.
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Affiliation(s)
- J. Dixon Johns
- Auditory Development and Restoration Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
- Department of Otolaryngology, Georgetown University School of Medicine, Washington DC, USA
| | - Rafal Olszewski
- Auditory Development and Restoration Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Dillon Strepay
- Auditory Development and Restoration Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Ivan A. Lopez
- Department of Head & Neck Surgery, University of California School of Medicine, Los Angeles, CA, USA
| | - Akira Ishiyama
- Department of Head & Neck Surgery, University of California School of Medicine, Los Angeles, CA, USA
| | - Michael Hoa
- Auditory Development and Restoration Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
- Department of Otolaryngology, Georgetown University School of Medicine, Washington DC, USA
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Sagi V, Kosaraju N, Moore LS, Mulders JY, Solyali M, Ma X, Regula DP, Hooper JE, Stankovic KM. Mortui vivos docent: a modern revival of temporal bone plug harvests. Front Neurosci 2023; 17:1242831. [PMID: 37886674 PMCID: PMC10598599 DOI: 10.3389/fnins.2023.1242831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/04/2023] [Indexed: 10/28/2023] Open
Abstract
Human temporal bones (HTBs) are invaluable resources for the study of otologic disorders and for evaluating novel treatment approaches. Given the high costs and technical expertise required to collect and process HTBs, there has been a decline in the number of otopathology laboratories. Our objective is to encourage ongoing study of HTBs by outlining the necessary steps to establish a pipeline for collection and processing of HTBs. In this methods manuscript, we: (1) provide the design of a temporal bone plug sawblade that can be used to collect specimens from autopsy donors; (2) establish that decalcification time can be dramatically reduced from 9 to 3 months if ethylenediaminetetraacetic acid is combined with microwave tissue processing and periodic bone trimming; (3) show that serial sections of relatively-rapidly decalcified HTBs can be successfully immunostained for key inner ear proteins; (4) demonstrate how to drill down a HTB to the otic capsule within a few hours so that subsequent decalcification time can be further reduced to only weeks. We include photographs and videos to facilitate rapid dissemination of the developed methods. Collected HTBs can be used for many purposes, including, but not limited to device testing, imaging studies, education, histopathology, and molecular studies. As new technology develops, it is imperative to continue studying HTBs to further our understanding of the cellular and molecular underpinnings of otologic disorders.
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Affiliation(s)
- Varun Sagi
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Nikitha Kosaraju
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, United States
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Lindsay S. Moore
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Jip Y. Mulders
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Mehmet Solyali
- Department of Physics, Stanford University School of Humanities and Sciences, Stanford, CA, United States
| | - Xiaojie Ma
- Department of Otolaryngology – Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA, United States
| | - Donald P. Regula
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Jody E. Hooper
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Konstantina M. Stankovic
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, United States
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, United States
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Rönnblom A, Niklasson A, Werner M, Stål P, Tano K. Forces Required for Isolated Malleus Shaft Fractures. Otol Neurotol 2021; 42:1515-1520. [PMID: 34353981 PMCID: PMC8584207 DOI: 10.1097/mao.0000000000003306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND HYPOTHESIS Isolated malleus shaft fractures are rare cases. A commonly reported cause is a finger pulled out from a wet outer ear canal after a shower or bath. The objective was to investigate experimentally the mechanism and forces needed to establish an isolated malleus shaft fracture. METHODS Ten fresh-frozen human temporal bones were adapted to allow visual inspection of the structures involved while negative pressure trauma was applied. Thirty malleus bones were broken and the required forces were measured. Measurements from 60 adult test subjects were used to create mathematical and physical models to calculate and measure the forces necessary for generating trauma. To calculate the maximum muscle force developed by the tensor tympani muscle, the muscle area and fiber type composition were determined. RESULTS The temporal bone experiments showed that applied negative pressure in a wet ear canal could not fracture the malleus shaft with only passive counterforce from supporting structures, although the forces exceeded what was required for a malleus shaft fracture. When adding calculated counteracting forces from the tensor tympani muscles, which consisted of 87% type II fibers, we estimate that a sufficient force is generated to cause a malleus fracture. CONCLUSION The combination of a negative pressure created by a finger pulling outward in a wet ear canal and a simultaneous counteracting reflexive force by the tensor tympani muscle were found to be sufficient to cause an isolated malleus fracture with an intact tympanic membrane.
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Affiliation(s)
- Anton Rönnblom
- Department of Clinical Science, Otorhinolaryngology/Sunderby Research Unit
| | - Anders Niklasson
- Department of Clinical Science, Otorhinolaryngology/Sunderby Research Unit
| | - Mimmi Werner
- Department of Clinical Science, Otorhinolaryngology
| | - Per Stål
- Department of Integrative Medical Biology, Laboratory of Muscle Biology, Umeå University, Umeå, Sweden
| | - Krister Tano
- Department of Clinical Science, Otorhinolaryngology/Sunderby Research Unit
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Wu PZ, O'Malley JT, de Gruttola V, Liberman MC. Primary Neural Degeneration in Noise-Exposed Human Cochleas: Correlations with Outer Hair Cell Loss and Word-Discrimination Scores. J Neurosci 2021; 41:4439-47. [PMID: 33883202 DOI: 10.1523/JNEUROSCI.3238-20.2021] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/23/2021] [Accepted: 03/27/2021] [Indexed: 11/21/2022] Open
Abstract
Animal studies suggest that cochlear nerve degeneration precedes sensory cell degeneration in both noise-induced hearing loss (NIHL) and age-related hearing loss (ARHL), producing a hearing impairment that is not reflected in audiometric thresholds. Here, we investigated the histopathology of human ARHL and NIHL by comparing loss of auditory nerve fibers (ANFs), cochlear hair cells and the stria vascularis in a group of 52 cases with noise-exposure history against an age-matched control group. Although strial atrophy increased with age, there was no effect of noise history. Outer hair cell (OHC) loss also increased with age throughout the cochlea but was unaffected by noise history in the low-frequency region (<2 kHz), while greatly exacerbated at high frequencies (≥2 kHz). Inner hair cell (IHC) loss was primarily seen at high frequencies but was unaffected by noise at either low or high frequencies. ANF loss was substantial at all cochlear frequencies and was exacerbated by noise throughout. According to a multivariable regression model, this loss of neural channels contributes to poor word discrimination among those with similar audiometric threshold losses. The histopathological patterns observed also suggest that, whereas the low-frequency OHC loss may be an unavoidable consequence of aging, the high-frequency loss, which produces the classic down-sloping audiogram of ARHL, may be partially because of avoidable ear abuse, even among those without a documented history of acoustic overexposure.SIGNIFICANCE STATEMENT As regenerative therapeutics in sensorineural hearing loss enter clinical trials, it becomes critical to infer which cochlear pathologies are present in addition to hair cell loss. Here, by analyzing human autopsy material, we show that acoustic injury accelerates age-related primary neural degeneration, but not strial degeneration, neither of which can be inferred from audiometric thresholds. It exacerbates outer hair cell (OHC) loss only in the high-frequency half of the cochlea, suggesting that the apical loss is age-related, whereas the basal loss is partially noise induced, and therefore avoidable. Statistical analysis suggests that neural loss helps explain differences in word-recognition ability among individuals with similar audiometric thresholds. The surprising correlation between neural loss and OHC loss in the cochlea's speech region also implicates neural loss in the well-known decline in word scores as thresholds deteriorate with age.
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Tona R, Lopez IA, Fenollar-Ferrer C, Faridi R, Anselmi C, Khan AA, Shahzad M, Morell RJ, Gu S, Hoa M, Dong L, Ishiyama A, Belyantseva IA, Riazuddin S, Friedman TB. Mouse Models of Human Pathogenic Variants of TBC1D24 Associated with Non-Syndromic Deafness DFNB86 and DFNA65 and Syndromes Involving Deafness. Genes (Basel) 2020; 11:E1122. [PMID: 32987832 DOI: 10.3390/genes11101122] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 01/08/2023] Open
Abstract
Human pathogenic variants of TBC1D24 are associated with clinically heterogeneous phenotypes, including recessive nonsyndromic deafness DFNB86, dominant nonsyndromic deafness DFNA65, seizure accompanied by deafness, a variety of isolated seizure phenotypes and DOORS syndrome, characterized by deafness, onychodystrophy, osteodystrophy, intellectual disability and seizures. Thirty-five pathogenic variants of human TBC1D24 associated with deafness have been reported. However, functions of TBC1D24 in the inner ear and the pathophysiology of TBC1D24-related deafness are unknown. In this study, a novel splice-site variant of TBC1D24 c.965 + 1G > A in compound heterozygosity with c.641G > A p.(Arg214His) was found to be segregating in a Pakistani family. Affected individuals exhibited, either a deafness-seizure syndrome or nonsyndromic deafness. In human temporal bones, TBC1D24 immunolocalized in hair cells and spiral ganglion neurons, whereas in mouse cochlea, Tbc1d24 expression was detected only in spiral ganglion neurons. We engineered mouse models of DFNB86 p.(Asp70Tyr) and DFNA65 p.(Ser178Leu) nonsyndromic deafness and syndromic forms of deafness p.(His336Glnfs*12) that have the same pathogenic variants that were reported for human TBC1D24. Unexpectedly, no auditory dysfunction was detected in Tbc1d24 mutant mice, although homozygosity for some of the variants caused seizures or lethality. We provide some insightful supporting data to explain the phenotypic differences resulting from equivalent pathogenic variants of mouse Tbc1d24 and human TBC1D24.
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Nogaki T, Nomura Y, Shimatani Y, Kobayashi H. Temperature Measurements of the Semicircular Canal During Green Laser Irradiation of the Canal: A Preliminary Study. Ear Nose Throat J 2020; 100:63S-67S. [PMID: 32551961 DOI: 10.1177/0145561320932794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Laser irradiation of the semicircular canal (SCC) is a good treatment for intractable benign paroxysmal positional vertigo. However, there were few reports on the temperature changes during laser irradiation. OBJECTIVE To measure the internal temperature of the SCC and vestibule during green laser irradiation of the SCC and investigate morphologic changes using human temporal bones. METHODS After the lateral SCC was blue-lined, a thermocouple was inserted into the SCC through a hole made in the canal wall. Another thermocouple was inserted into the vestibule through the oval window. Green laser was irradiated to the lateral canal wall. After the irradiation, the tissues were inspected as paraffin using HE staining. RESULT The internal temperature of the SCC rose from 33 ° to 52 °C by a single laser irradiation of 1.5 W × 2 seconds and 82 °C by a single laser irradiation of 1.7 W × 3 seconds to the canal wall with a black spot. Continuous laser irradiation of 1.5 W × 3 seconds, 10 times resulted in a temperature rise of 92 °C from 33 °C. Throughout the whole experiments, temperatures within the vestibule were unchanged. Histopathology showed that the irradiated areas of the lateral canal wall were partially deficient with or without carbonization after single irradiation. By continuous laser irradiations, the SCC bony wall showed a peroration of 40 µm in diameter with carbonized edges. CONCLUSIONS Green laser irradiation of the SCC produced char formation with perforation in the canal wall. High temperatures within the SCC were recorded for a short period of less than 30 seconds. However, the vestibule didn't show temperature changes.
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Affiliation(s)
- Taketoshi Nogaki
- Department of Otorhinolaryngology, Showa University School of Medicine, Tokyo, Japan
| | - Yasuya Nomura
- Department of Otorhinolaryngology, Showa University School of Medicine, Tokyo, Japan
| | - Yuichi Shimatani
- Department of Medical Engineering, Faculty of Engineering, 119825Tokyo City University, Tokyo, Japan
| | - Hitome Kobayashi
- Department of Otorhinolaryngology, Showa University School of Medicine, Tokyo, Japan
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Abstract
Age-related hearing loss is a chronic degenerative disorder affecting one in two individuals above the age of 75. Current population projections predict a steady climb in the number of older individuals making the search for interventions to prevent or reverse this disorder even more critical. There is growing acceptance that aberrant activity of resident or infiltrating immune cells, such as macrophages, is a major factor contributing to the onset and progression of age-related degenerative diseases. However, how macrophage populations and their functionally-driven morphological characteristics change with age in the human cochlea remains largely unknown. In this study, we employed immunohistochemical approaches along with confocal and super-resolution imaging, three-dimensional reconstructions, and quantitative analysis to determine age-related changes in macrophage numbers and morphology as well as interactions with other cell-types and structures of the auditory nerve and lateral wall in the human cochlea. In the cochlea of human ears from young and middle aged adults those macrophages in the auditory nerve assumed a worm-like structure in contrast to those in the spiral ligament or associated with the dense microvascular network in the stria vascularis which exhibited a highly ramified morphology. Macrophages in both the auditory nerve and cochlear lateral wall showed morphological alterations with age. The population of activated macrophages in the auditory nerve increased in cochleas obtained from older donors. Dual-immunohistochemical staining with macrophage, myelin, and neuronal markers revealed increased interactions of macrophages with the glial and neuronal components of the aged auditory nerve. These findings implicate the involvement of abnormal macrophage-glia interactions in age-related physiological and pathological alterations in the human cochlea. There is clearly a need to further investigate the contribution of macrophage-associated inflammatory dysregulation in human presbyacusis.
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Affiliation(s)
- Kenyaria V. Noble
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Ting Liu
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Lois J. Matthews
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - Bradley A. Schulte
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - Hainan Lang
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States
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Stieger C, Guan X, Farahmand RB, Page BF, Merchant JP, Abur D, Nakajima HH. Intracochlear Sound Pressure Measurements in Normal Human Temporal Bones During Bone Conduction Stimulation. J Assoc Res Otolaryngol 2018; 19:523-539. [PMID: 30171386 DOI: 10.1007/s10162-018-00684-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 06/12/2018] [Indexed: 01/18/2023] Open
Abstract
Bone conduction (BC) is heavily relied upon in the diagnosis and treatment of hearing loss, but is poorly understood. For example, the relative importance and frequency dependence of various identified BC sound transmission mechanisms that contribute to activate the cochlear partition remain unknown. Recently, we have developed techniques in fresh human cadaveric specimens to directly measure scalae pressures with micro-fiberoptic sensors, enabling us to monitor the input pressure drive across the cochlear partition that triggers the cochlear traveling wave during air conduction (AC) and round-window stimulation. However, BC stimulation poses challenges that can result in inaccurate intracochlear pressure measurements. Therefore, we have developed a new technique described here that allows for precise measurements during BC. Using this new technique, we found that BC stimulation resulted in pressure in scala vestibuli that was significantly higher in magnitude than in scala tympani for most frequencies, such that the differential pressure across the partition-the input pressure drive-was similar to scala vestibuli pressure. BC (stimulated by a Bone Anchored Hearing Aid [Baha]) showed that the mechanisms of sound transmission in BC differ from AC, and also showed the limitations of the Baha bandwidth. Certain kinematic measurements were generally proportional to the cochlear pressure input drive: for AC, velocity of the stapes, and for BC, low-frequency acceleration and high-frequency velocity of the cochlear promontory. Therefore, our data show that to estimate cochlear input drive in normal ears during AC, stapes velocity is a good measure. During BC, cochlear input drive can be estimated for low frequencies by promontory acceleration (though variable across ears), and for high frequencies by promontory velocity.
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Affiliation(s)
- Christof Stieger
- Department of Otolaryngology, Harvard Medical School, Boston, MA, USA. .,Eaton-Peabody Laboratories, Massachusetts Eye & Ear, Boston, MA, USA. .,University Bern, Bern, Switzerland. .,Department of ENT, University of Basel Hospital, Hebelstr. 10, 4031, Basel, Switzerland.
| | - Xiying Guan
- Eaton-Peabody Laboratories, Massachusetts Eye & Ear, Boston, MA, USA
| | | | - Brent F Page
- Eaton-Peabody Laboratories, Massachusetts Eye & Ear, Boston, MA, USA
| | - Julie P Merchant
- Eaton-Peabody Laboratories, Massachusetts Eye & Ear, Boston, MA, USA
| | - Defne Abur
- Eaton-Peabody Laboratories, Massachusetts Eye & Ear, Boston, MA, USA.,Smith College, Northampton, MA, USA
| | - Hideko Heidi Nakajima
- Department of Otolaryngology, Harvard Medical School, Boston, MA, USA.,Eaton-Peabody Laboratories, Massachusetts Eye & Ear, Boston, MA, USA
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Wu PZ, Liberman LD, Bennett K, de Gruttola V, O'Malley JT, Liberman MC. Primary Neural Degeneration in the Human Cochlea: Evidence for Hidden Hearing Loss in the Aging Ear. Neuroscience 2018; 407:8-20. [PMID: 30099118 DOI: 10.1016/j.neuroscience.2018.07.053] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/25/2018] [Accepted: 07/30/2018] [Indexed: 01/18/2023]
Abstract
The noise-induced and age-related loss of synaptic connections between auditory-nerve fibers and cochlear hair cells is well-established from histopathology in several mammalian species; however, its prevalence in humans, as inferred from electrophysiological measures, remains controversial. Here we look for cochlear neuropathy in a temporal-bone study of "normal-aging" humans, using autopsy material from 20 subjects aged 0-89 yrs, with no history of otologic disease. Cochleas were immunostained to allow accurate quantification of surviving hair cells in the organ Corti and peripheral axons of auditory-nerve fibers. Mean loss of outer hair cells was 30-40% throughout the audiometric frequency range (0.25-8.0 kHz) in subjects over 60 yrs, with even greater losses at both apical (low-frequency) and basal (high-frequency) ends. In contrast, mean inner hair cell loss across audiometric frequencies was rarely >15%, at any age. Neural loss greatly exceeded inner hair cell loss, with 7/11 subjects over 60 yrs showing >60% loss of peripheral axons re the youngest subjects, and with the age-related slope of axonal loss outstripping the age-related loss of inner hair cells by almost 3:1. The results suggest that a large number of auditory neurons in the aging ear are disconnected from their hair cell targets. This primary neural degeneration would not affect the audiogram, but likely contributes to age-related hearing impairment, especially in noisy environments. Thus, therapies designed to regrow peripheral axons could provide clinically meaningful improvement in the aged ear.
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Affiliation(s)
- P Z Wu
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA 02115, USA; Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - L D Liberman
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA
| | - K Bennett
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - V de Gruttola
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - J T O'Malley
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA
| | - M C Liberman
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA 02114, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA 02115, USA.
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Abstract
OBJECTIVE To quantitatively assess the effect of serous labyrinthitis, suppurative labyrinthitis, and labyrinthitis ossificans on vestibular hair cells, dark cells, and transitional cells. METHODS We examined human temporal bone specimens with serous labyrinthitis, suppurative labyrinthitis, and labyrinthitis ossificans, then compared them with age-matched control groups without labyrinthitis. We evaluated the density of type I and II vestibular hair cells, dark cells, and transitional cells in the peripheral sensorial organs. RESULTS The mean density of type I vestibular hair cells in the maculae of the saccule significantly differed between the serous labyrinthitis group and its control group. The loss of type I and II vestibular hair cells in all of the peripheral sensorial organs was significantly higher in the suppurative labyrinthitis group than in its control group. The mean density of dark cells in the lateral and posterior semicircular canals was significantly lower in the suppurative labyrinthitis group than in its control group. The mean density of type I and II vestibular hair cells, dark cells, and transitional cells was significantly lower in the labyrinthitis ossificans group than in its control group. CONCLUSION The loss of vestibular hair cells and degenerative changes in dark cells and transitional cells could affect vestibular function in patients with labyrinthitis.
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Affiliation(s)
- Serdar Kaya
- 1 Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA.,2 Department of Otolaryngology-Head and Neck Surgery, Gebze Fatih State Hospital, Gebze, Kocaeli, Turkey
| | - Patricia A Schachern
- 1 Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Vladimir Tsuprun
- 1 Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Sebahattin Cureoglu
- 1 Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
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Monsanto RDC, Pauna HF, Kwon G, Schachern PA, Tsuprun V, Paparella MM, Cureoglu S. A three-dimensional analysis of the endolymph drainage system in Ménière disease. Laryngoscope 2016; 127:E170-E175. [PMID: 27440440 DOI: 10.1002/lary.26155] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 05/23/2016] [Accepted: 05/31/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To measure the volume of the endolymph drainage system in temporal bone specimens with Ménière disease, as compared with specimens with endolymphatic hydrops without vestibular symptoms and with nondiseased specimens STUDY DESIGN: Comparative human temporal bone analysis. METHODS We generated three-dimensional models of the vestibular aqueduct, endolymphatic sinus and duct, and intratemporal portion of the endolymphatic sac and calculated the volume of those structures. We also measured the internal and external aperture of the vestibular aqueduct, as well as the opening (if present) of the utriculoendolymphatic (Bast's) valve and compared the measurements in our three study groups. RESULTS The volume of the vestibular aqueduct and of the endolymphatic sinus, duct, and intratemporal endolymphatic sac was significantly lower in the Ménière disease group than in the endolymphatic hydrops group (P <.05). The external aperture of the vestibular aqueduct was also smaller in the Ménière disease group. Bast's valve was open only in some specimens in the Ménière disease group. CONCLUSIONS In temporal bones with Ménière disease, the volume of the vestibular aqueduct, endolymphatic duct, and intratemporal endolymphatic sac was lower, and the external aperture of the vestibular aqueduct was smaller as compared with bones from donors who had endolymphatic hydrops without vestibular symptoms and with nondiseased bones. The open status of the Bast's valve in the Ménière disease group could be secondary to higher retrograde endolymph pressures caused by smaller drainage systems. These anatomic findings could correlate with the reason that some patients with hydrops develop clinical symptoms, whereas others do not. LEVEL OF EVIDENCE N/A Laryngoscope, 127:E170-E175, 2017.
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Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
- Department of Otolaryngology and Head and Neck Surgery, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
| | - Henrique F Pauna
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
- Department of Otolaryngology and Head and Neck Surgery, Campinas State University, Campinas, São Paulo, Brazil
| | - Geeyoun Kwon
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Patricia A Schachern
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Vladimir Tsuprun
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Michael M Paparella
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
- Paparella Ear, Head, & Neck Institute, Minneapolis, Minnesota, U.S.A
| | - Sebahattin Cureoglu
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
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Kaya S, Paparella MM, Cureoglu S. Pathologic Findings of the Cochlea in Labyrinthitis Ossificans Associated with the Round Window Membrane. Otolaryngol Head Neck Surg 2016; 155:635-40. [PMID: 27221575 DOI: 10.1177/0194599816651245] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/03/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To quantitatively demonstrate and classify the histopathologic changes in the cochlea of the human temporal bones with labyrinthitis ossificans (LO). STUDY DESIGN Comparative human temporal bone study. SETTING Tertiary academic medical center. SUBJECTS AND METHODS We compared 23 temporal bone specimens from 19 deceased donors with LO associated with the round window membrane (RWM) and 27 age-matched specimens from 20 deceased donors without any otologic diseases. We focused on the location of LO in the inner ear, the intensity of endolymphatic hydrops, the number of spiral ganglion cells and cochlear hair cells, and the areas of the stria vascularis and spiral ligament. In addition, we created a new pathologic grading system for temporal bone specimens from deceased donors with LO associated with the RWM. RESULTS We most often observed LO in the scala tympani of the basal cochlear turn. In the LO group (as compared with the control group), the intensity of endolymphatic hydrops was significantly increased; the number of spiral ganglion cells was significantly decreased in all segments; the loss of outer and inner hair cells was significantly increased in all turns of the cochlea; the atrophy of the stria vascularis was significantly greater in all turns of the cochlea; and atrophy of the spiral ligament was significantly greater in the basal and middle cochlear turn. CONCLUSION LO was associated with significant cochlear damage (to the spiral ganglion cells, cochlear hair cells, stria vascularis, and spiral ligament) and with increased intensity of endolymphatic hydrops.
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Affiliation(s)
- Serdar Kaya
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology-Head and Neck Surgery, Gebze Fatih State Hospital, Gebze, Turkey
| | | | - Sebahattin Cureoglu
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
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Monsanto RDC, Pauna HF, Kaya S, Hızlı Ö, Kwon G, Paparella MM, Cureoglu S. Epitympanum volume and tympanic isthmus area in temporal bones with retraction pockets. Laryngoscope 2016; 126:E369-E374. [PMID: 27107158 PMCID: PMC10132351 DOI: 10.1002/lary.25937] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/22/2016] [Accepted: 01/29/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To compare the volume of the epitympanic space, as well as the area of the tympanic isthmus, in human temporal bones with retraction pockets to those with chronic otitis media without retraction pockets and to those with neither condition. STUDY DESIGN Comparative human temporal bone study. METHODS We generated a three-dimensional model of the bony epitympanum and measured the epitympanic space. We also compared the area of the tympanic isthmus. RESULTS The mean total volume of the epitympanum was 40.55 ± 7.14 mm3 in the retraction pocket group, 50.03 ± 8.49 mm3 in the chronic otitis media group, and 48.03 ± 9.16 mm3 in the neither condition group. The mean volume of the anterior, lateral, and medial compartments in temporal bones in the retraction pocket group was significantly smaller than in the two control groups (P < 0.05). Total epitympanic volume was also significantly smaller in the retraction pocket group than in both control groups (P < 0.05). The mean area of the tympanic isthmus was significantly smaller in the retraction pocket group (8.11 ± 2.44 mm2 ) than in the chronic otitis media group (9.82 ± 2.06 mm2 ) or the neither condition group (10.66 ± 1.78 mm2 ) (P < 0.05). CONCLUSION Our data indicate that temporal bones with retraction pockets have a smaller volume bony epitympanum and a smaller tympanic isthmus area as compared with temporal bones from both control groups. The smaller volume tympanic isthmus in the retraction pocket group may suggest that a blockage in the aeration pathways to the epitympanum could create dysventilation, resulting in negative pressure and ultimately in retraction pockets and cholesteatomas. LEVEL OF EVIDENCE NA Laryngoscope, 126:E369-E374, 2016.
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Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Banco de Olhos de Sorocaba Hospital, Sorocaba, Brazil
| | - Henrique Furlan Pauna
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, University of Campinas, Campinas, São Paulo, Brazil
| | - Serdar Kaya
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Gebze Fatih State Hospital, Gebze, Kocaeli, Turkey
| | - Ömer Hızlı
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.,Giresun A. Ilhan Ozdemir State Hospital, Giresun, Turkey
| | - Geeyoun Kwon
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | | | - Sebahattin Cureoglu
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A..
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Kaya S, Hızlı Ö, Kaya FK, Monsanto RD, Paparella MM, Cureoglu S. Peripheral vestibular pathology in Mondini dysplasia. Laryngoscope 2016; 127:206-209. [PMID: 27075694 DOI: 10.1002/lary.25995] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/09/2016] [Accepted: 03/01/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS In this study, our objective was to histopathologically analyze the peripheral vestibular system in patients with Mondini dysplasia. STUDY DESIGN Comparative human temporal bone study. METHODS We assessed the sensory epithelium of the human vestibular system with a focus on the number of type I and type II hair cells, as well as the total number of hair cells. We compared those numbers in our Mondini dysplasia group versus our control group. RESULTS The loss of type I and type II hair cells in the cristae of the superior, lateral, and posterior semicircular canals, as well as in the saccular and utricular macula, was significantly higher in our Mondini dysplasia group than in our control group. The total number of hair cells significantly decreased in the cristae of the superior, lateral, and posterior semicircular canals, as well as in the saccular and utricular macula, in our Mondini dysplasia group. CONCLUSION Loss of vestibular hair cells can lead to vestibular dysfunction in patients with Mondini dysplasia. LEVEL OF EVIDENCE NA Laryngoscope, 127:206-209, 2017.
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Affiliation(s)
- Serdar Kaya
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Gebze Fatih State Hospital, Gebze, Kocaeli, Turkey
| | - Ömer Hızlı
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Giresun A. Ilhan Ozdemir State Hospital, Giresun, Turkey
| | - Fatıma Kübra Kaya
- Stem Cell Institute, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Rafael DaCosta Monsanto
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil
| | | | - Sebahattin Cureoglu
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, U.S.A
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Abstract
BACKGROUND Pena-Shokeir syndrome type I is a rare genetic disorder that includes multiple congenital facial and joint anomalies as well as pulmonary hypoplasia. Affected infants are usually premature, and 30% of them are stillborn. So far, studies have reported low-set ears in such infants, with no middle or inner ear findings. METHOD Histopathological study of human temporal bones with Pena-Shokeir syndrome type I. RESULTS Our case report describes an infant with severely decreased number of spiral ganglion cells and number of outer and inner hair cells of the cochlea, mild loss of vestibular hair cells, hypoplasia in the facial nerves, and ischemic degeneration of Schwann cells in the modiolus. CONCLUSION Pena-Shokeir syndrome type I is associated with a degenerative process in the labyrinth.
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Affiliation(s)
- Serdar Kaya
- Department of Otolaryngology, University of Minnesota, Minneapolis, MN, USA Department of Otolaryngology-Head and Neck Surgery, Gebze Fatih State Hospital, Gebze, Kocaeli, Turkey
| | | | - Ömer Hızlı
- Department of Otolaryngology, University of Minnesota, Minneapolis, MN, USA Department of Otolaryngology-Head and Neck Surgery, Giresun A. Ilhan Ozdemir State Hospital, Giresun, Turkey
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