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Biomedical subjects

I Sando

Publications and source records attributed to I Sando.

At least 19 recordsLinked to original sources
PubMed2002

The potential risk of carotid injury in cochlear implant surgery.

BACKGROUND: The advent of cochlear implantation has revolutionized the options afforded to the deaf population. With the increase in the prevalence of this procedure have come larger experiences in the associated technical challenges and complications. RESULTS: We present the evaluation and management of a patient with an unusual complication of improper placement of the implant electrode into the carotid canal and its management. We discuss the anatomy of the carotid artery and its proximity to the cochlea to emphasize the potential risk to this large vessel. CONCLUSIONS: Damage to the carotid canal and the carotid artery is a potential risk of cochlear implant surgery. When available, we recommend intraoperative electrical testing of the cochlear implant be performed. If there is doubt as to the placement of the electrode, a radiograph should be obtained before the patient is taken out of the operating room to avoid this complication.

Audiometry↗
PubMed2001

Temporal bone histopathological study of Noonan syndrome.

Four temporal bone specimens, obtained from three individuals 1--6 years of age with Noonan syndrome (NS), were studied histopathologically. All four specimens were accompanied by similar inner ear abnormalities including the reduced number of spiral ganglion cells, enlarged lateral semicircular canal, and dislocated endolymphatic sac and vestibular aqueduct. The mean population of spiral ganglion cells (15,699 cells) was approximately half of those (32,978 cells) in four age-matched control cases. In addition, they had several middle ear abnormalities including the remaining mesenchyme and dehiscence of the facial canal. To our knowledge, this is the first report to describe the histopathological temporal bone findings in patients with NS. We discuss the implications of the observed abnormalities with regard to clinical issues.

Child↗
PubMed2001

Vestibular abnormalities in congenital disorders.

This paper reviews the histopathologic features of vestibular abnormalities in congenital disorders affecting the inner ear, based upon a comprehensive literature survey and a review of cases in our temporal bone collection. The review proceeds in three systematic steps. First, we surveyed associated diseases with the major phenotypic features of congenital abnormalities of the inner ear (including the internal auditory canal and otic capsule). Second, the vestibular anomalies are examined specifically. Finally, the anomalies are discussed from a developmental perspective. Among vestibular anomalies, a hypoplastic endolymphatic duct and sac are observed most frequently. Anomalies of the semicircular canals are also often observed. From embryological and clinical viewpoints, many of these resemble the structural features from fetal stages and appear to be associated with vestibular dysfunction. It is expected that progress in genetic analysis and accumulation of temporal bone specimens with vestibular abnormalities in congenital diseases will provide crucial information not only for pathology of those diseases, but also for genetic factors that are responsible for the specific vestibular abnormalities.

Animals↗
PubMed2001

Mucosa-associated lymphoid tissue in middle ear and eustachian tube.

The presence of mucosa-associated lymphoid tissue (MALT) was investigated histopathologically in every 20th section from 99 vertically cut, celloidin-embedded temporal bone-eustachian tube (ET) specimens. Among specimens from infants and children between 1 month and 7 years of age, MALT was found in 22 of 44 (50%). However, in 26 adults over 18 years of age, MALT was found in only 2 specimens (7.7%), a significantly lower incidence than that in infants and children. Moreover, MALT did not appear in any of the 21 neonates under the age of 1 month. All 99 specimens were classified into 2 groups: 41 specimens with otitis media (OM) and 58 specimens without OM. The presence of MALT was significantly higher in specimens with OM (43.9%) than in specimens without OM (13.8%). Mucosa-associated lymphoid tissue was found in the ET, middle ear, and mastoid process in 18 specimens (43.9%). 5 specimens (12.2%), and 1 specimen (2.4%) with OM, respectively, and in 8 (13.8%), 0, and 0 specimens without OM. In regard to the distribution of MALT, it occurred more frequently in the pharyngeal half of the cartilaginous portion of the ET than in the rest of the ET, middle ear, and mastoid; the presence was significantly greater in the inferior half of the cartilaginous portion of the ET than in the superior half. Inflammatory cell infiltration in the cartilaginous and bony portions of the ET was significantly greater in specimens with OM than in specimens without OM with no MALT. However, even in some specimens without OM, inflammatory cells were found in the ET, particularly in the pharyngeal half of the cartilaginous portion of the ET. These findings suggest that MALT has a close relationship to OM and that it may be a local response to repeated infection.

Adolescent↗
PubMed2001

Histopathologic study of temporal bone and eustachian tube in oculoauriculovertebral spectrum.

Bilateral temporal bone specimens from a 21-month-old girl and a left temporal bone-eustachian tube (ET) specimen from a full-term female newborn, both with oculoauriculovertebral spectrum, were studied histopathologically. The external and middle ears demonstrated severe anomalies, similar to those of previous reports describing the histopathologic findings of this syndrome. In addition, despite having a normal auricle, the 21-month-old child had bilateral hypoplastic cochleas as seen in Mondini dysplasia. The newborn had several anomalies of the ET, including a widely opened cartilaginous portion of the ET lumen and absence of the lateral lamina of the ET cartilage. We discuss the implications of the observed anomalies with regard to developmental and clinical issues.

Eustachian Tube↗
PubMed2000

Histopathological study on temporal bone and eustachian tube in trisomy 22.

Two temporal bone-eustachian tube (ET) specimens, one from a 34-gestational week-old male newborn and the other from a 3-month-old female infant, both with trisomy 22, were studied histopathologically. Both cases demonstrated severe inner-ear anomalies including hypoplastic cochlea, atrophy of the saccular macula, and dislocated endolymphatic sac and vestibular aqueduct. In addition, they had several anomalies in the ET including widely developed medial lamina of the ET cartilage, undeveloped lateral lamina of the ET cartilage, and absence of attachment of the tensor veli palatini muscle to the ET cartilage. We discuss the implications of the observed anomalies with regard to developmental and clinical issues.

Abnormalities, Multiple↗
PubMed2000

Postnatal development of eustachian tube cartilage. A study of normal and cleft palate cases.

Infants with cleft palate (CP) display eustachian tube (ET) dysfunction. This study compared the postnatal development of the volume of ET cartilage in 34 normal cases and 10 CP cases using a personal computer. In cases with age under 1 month old, the total volume of ET cartilage was 61.94+/-20.89 mm(3) (mean+/-S.D.) in 16 normal control cases and 50.07+/-24.69 mm(3) in nine CP cases (t-test, not significantly different from normal). The ratio of lateral lamina (LL) to medial lamina (ML) volume (LL/ML) was reduced significantly (t-test, P<0.001) from 0.23+/-0.07 in 16 normal control cases to 0.09+/-0.05 in nine CP cases under 1 month old. In 34 normal ET cases whose ages were under 20 years, statistically significant positive correlations were found between the total volume of ET cartilage (y1) and age (x), volume of LL (y2) and age, and volume of ML (y3) and age (P<0.01, r=0.731, 0.614, 0.719). The regression lines were y1=20.37x+95.57, y2=2.02x+15.60, and y3=18. 35x+79.97. With the result obtained from this study, it is assumed that immaturity of the ET cartilage in infants, especially that of LL of the ET cartilage in CP infants, may be a significant risk factor for developing otitis media with effusion.

Adolescent↗
PubMed2000

Histopathologic study of the human eustachian tube and its surrounding structures following irradiation for carcinoma of the oropharynx.

OBJECTIVE: To describe a histopathologic analysis of a human temporal bone demonstrating patulous changes of the eustachian tube (ET) and its surrounding structures following radiation therapy. DESIGN: Retrospective histopathologic case review and comparison with an age-matched control. SETTING: Elizabeth McCullough Knowles Otopathology Laboratory, University of Pittsburgh School of Medicine, Pittsburgh, Pa. RESULTS: A widened patulous ET was verified by demonstrating fibrous tissue replacement of the surrounding supporting structures related to the ET. The ET lumen was patulous and wider than the control case. Ostmann fatty tissue, the levator veli palatini muscle, and submucosal glands around the ET cartilage were replaced by dense connective tissue. CONCLUSION: This is the first histopathologic report, to our knowledge, demonstrating the effects on the ET lumen and supporting structures following acute weight loss, possible tumor infiltration, and radiation changes for carcinoma of the oropharynx.

Carcinoma, Squamous Cell↗
PubMed2000

Ossification of eustachian tube cartilage and Ostmann's fatty tissue in chronic renal failure.

Ossification of the eustachian tube (ET) cartilage in 2 cases of chronic renal failure is reported for the first time. In both cases, the ossification was observed in the medial lamina of the ET cartilage. In addition, ossification of Ostmann's fatty tissue was observed in case 1, and ossification of the lateral lamina of the ET cartilage was seen in case 2. Correlation between ossification in chronic renal failure and dysfunction of the ET caused by ossified ET cartilage and Ostmann's fatty tissue is discussed.

Adipose Tissue↗
PubMed2000

Postnatal development of the tympanic cavity: a computer-aided reconstruction and measurement study.

A computer-aided 3-D reconstruction and measurement method was used to assess postnatal volume and height changes in the tympanic cavity. Materials used were 14 normal human temporal bones obtained from 6 infants (under 1 year of age) and 8 adults (over 18 years of age). After defining the boundaries of the tympanic cavity, its total volume and height and the volume and height of the epitympanum, mesotympanum and hypotympanum were measured. The relationship between the volume of the tympanic cavity and age, and the correlation between the volume of the tympanic cavity and the grade of pneumatization of the air cells were also studied. The average volume of the tympanic cavity in adults (640.1+/-69.1 mm3, n = 8) was about 1.5 times larger than the volume of the infant cavity (451.7+/-68.2 mm3, n = 6). The hypotympanum increased most postnatally and the mesotympanum least. The volume of the tympanic cavity increased in proportion to increasing pneumatization in bone surrounding the cavity. The postnatal increase in the height of the tympanic cavity appears to be the major contributor to the increase in volume of the cavity. Postnatal changes in the tympanic cavity have clinical implications.

Adolescent↗
PubMed2000

Cellular distribution of mucosa-associated lymphoid tissue with otitis media in children.

This study examined mucosa-associated lymphoid tissue (MALT) in the eustachian tube (ET), middle ear (ME), and mastoid antrum (MA) in 163 celloidin-embedded temporal bones from children with or without otitis media. Otitis media was defined by the presence of histopathologically identified inflammatory cell infiltration in the mucosa or cavity of the ME. We found MALT in the ET in 30 cases (46.2%), in the ME in 19 cases (29.2%), and in the MA in 4 cases (6.2%) out of 65 cases of otitis media, and in the ET in 7 (7.1%), in the ME in 0, and in the MA in 0 out of 98 specimens without otitis media. No MALT appeared in any children under the age of 1 month. Immunohistochemical methods were used to investigate MALT in 12 horizontally cut temporal bones with OM. The follicular area contained OPD4-positive (helper-inducer T) cells and a few CD8-positive (cytotoxic and suppressor T) cells, whereas the parafollicular area contained OPD4-positive and CD8-positive T cells. CD57-positive (natural killer) cells were confined to the germinal center. CD30-positive (activated T and B) cells were observed throughout the follicles. A few CD15-positive (granulocyte, monocyte) cells were found in the follicles. Histopathologic and immunohistochemical findings were indistinguishable for MALT in the ET, ME, and MA. Our results suggest that MALT may be a mechanism for producing a rapid and massive local immune reaction to repeated bacterial infections via the ET.

Antigens, CD↗
PubMed2000

Length of the eustachian tube and its postnatal development: computer-aided three-dimensional reconstruction and measurement study.

Eleven normal human temporal bone-eustachian tube (ET) specimens obtained from 11 individuals whose ages were 3 months to 88 years were studied to investigate the path length along the ET lumen and its postnatal development by means of a computer-aided 3-dimensional reconstruction and measurement method. The path length of the ET lumen of the 3-month-old infant was 21.2 mm, and its growth was in correlation with age to attain its adult length (average, 37.00 +/- 4.16 mm). The ratio of the length of the cartilaginous portion together with the junctional portion to the length of the bony portion was 8:1 in an infant at the age of 3 months and 4:1 in adults. That the bony portion of the ET develops relatively more than the cartilaginous and junctional portions may cause this finding. In addition, there is a developmental shift in the orientation of the cartilaginous portion with respect to the bony portion of the ET. In children, the cartilaginous and bony portions are both aligned with the line that connects the pharyngeal orifice and the tympanic orifice. In adults, however, the cartilaginous portion is angled inferiorly and laterally from the bony portion. This change may reflect the relative growth of the face.

Adolescent↗
PubMed1999

Multiple temporal bone anomalies in isotretinoin syndrome: a temporal bone histopathologic case report.

Vitamin A and its derivatives are known teratogens. To our knowledge, this is the second temporal bone histopathologic report on anomalies related to these substances. A white boy (aged 4 years 5 months at death) was born with a complex central nervous system dysgenesis related to his mother's use of isotretinoin (Accutane) early in pregnancy. Histopathologic examination revealed multiple anomalies in the temporal bones: a narrow external auditory canal, protrusion of bone marrow into the middle ear cavity, anomalies of the ossicles, hypoplasia of the facial nerve, absence of the chorda tympani nerve and the stapedius muscle, anomalies of the membranous labyrinth in the vestibule, a hypoplastic lateral semicircular canal, and a large vestibular aqueduct and endolymphatic sac.

Abnormalities, Drug-Induced↗
PubMed1999

Histopathological changes of the eustachian tube cartilage and the tensor veli palatini muscle with aging.

OBJECTIVES: The eustachian tube (ET) and the tensor veli palatini muscle (TVPM) are thought to play an important role in ventilatory function. Calcification of the ET cartilage and the replacement of TVPM by fat tissue are often observed histologically in elderly patients. To our knowledge, however, there are no quantitative studies of these pathological findings in relation to age. STUDY DESIGN: The calcification of the ET cartilage and the atrophy of the TVPM in 36 normal human temporal bones obtained from 36 individuals with ages ranging from 2 days to 88 years were investigated. METHODS: The number of calcified chondrocytes in the midportion of the ET cartilage was quantified as the average number of cells per square millimeter. Atrophy of the TVPM was evaluated at the midportion of the site where the TVPM is attached to the tip of lateral lamina of ET cartilage. A grade of 0, 1, 2, 3, or 4 was assessed for each section, which indicated approximately 0% to 5%, 5% to 30%, 30% to 70%, 70% to 95%, or 95% to 100% of the TVPM replacement by fat tissue, respectively. RESULTS: A statistically significant correlation was found between the number of the calcified cells and aging (P < .001). A statistically significant correlation was also found between the degree of the atrophy of TVPM and aging (P < .001). CONCLUSIONS: The calcification of the ET cartilage and the atrophy of the TVPM are closely associated with aging. Therefore, it is suggested that these two findings may be a predisposing factor for ET dysfunction in elderly adults.

Adolescent↗
PubMed1999

Inflammatory response to chronic otitis media in DiGeorge syndrome: a case study using immunohistochemistry on archival temporal bone sections.

Immunohistochemical analyses were conducted on archival celloidin-embedded human temporal bone sections from an 8-month-old boy with chronic otitis media and DiGeorge syndrome. We employed antigen retrieval methods with saturated sodium hydroxide-methanol solution, microwave incubation, and proteolytic treatment to demonstrate the distribution of T-lymphocytes, B-lymphocytes, macrophages, and intercellular adhesion molecule 1 (ICAM-1) expression in the middle ear. B-lymphocytes and macrophages were observed predominantly within the middle ear mucosa. T-lymphocytes were rare. Further, ICAM-1 was expressed in the vascular endothelium of the lamina propria, as well as infiltrating mononuclear cells. This suggests that the expression of ICAM-1 can be induced in the middle ear with otitis media, even if T-lymphocytes are depressed in a cell-mediated immunodeficiency disorder such as DiGeorge syndrome.

Antibodies, Monoclonal↗