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Biomedical subjects

I Sando

Publications and source records attributed to I Sando.

At least 55 records · Page 3Linked to original sources
PubMed1993

Mucosal folds in human eustachian tube: a hypothesis regarding functional localization in the tube.

Differences in the extent of mucosal folding in the superior versus the inferior half of the human eustachian tube (ET) lumen were studied by measuring, as it appeared in histologic cross section, the length of the mucosal margin in the pharyngeal portion, the midcartilaginous portion, the isthmus portion, and the osseous portion of each half of the ET in 16 normal ET temporal bone specimens from 16 individuals 12 to 70 years of age. The mucosal margin of the ET was significantly longer in the inferior half than in the superior half in all four portions (paired t test: pharyngeal portion t[15] = 3.59, p < .01; midcartilaginous portion t[15] = 3.52, p < .01; isthmus portion t[15] = 4.15, p < .01; osseous portion t[15] = 2.24, p < .05). These results indicate that the inferior half of the ET mucosa has more folds than the superior half, and that the surface area of the inferior half of the ET is larger than that of the superior half. This, together with the finding previously reported that secretory components of the ET such as glands and goblet cells are more richly distributed in the inferior (floor) portion than in the superior (roof) portion of the ET, may be related to the fact that the floor of the ET has an active role in clearance function. A hypothesis regarding localization of the ventilatory and clearance functions within the ET is proposed.

Adolescent↗
PubMed1993

Bony dehiscence between singular canal and round window niche.

The incidence of bony dehiscence of the human singular canal was studied by examining 409 human temporal bones obtained from 300 individuals. Such a dehiscence was noted in three (0.7%) of the bones from three (1%) of the individuals, all male, aged 2, 6, and 76 years. All of these bony dehiscences were located between the round window niche and the cribrose area of the singular canal. The finding of a microfissure in the vicinity of the bony dehiscence in two of the three cases indicates that such dehiscences occur independently of microfissures. Although the incidence of bony dehiscences of the singular canal is small, these dehiscences appear to have considerable clinical significance in that they form a communication between the middle and inner ears or possibly between the middle ear and the cerebrospinal fluid space.

Adolescent↗
PubMed1993

Facial nerve near the external auditory meatus in man: computer reconstruction study--preliminary report.

The anatomy of the facial nerve relative to its intratemporal and extratemporal courses varies over time with developmental changes. Otologic and parotid surgery in infants and children demands detailed knowledge of the precise anatomy of the facial nerve with respect to the tympanic ring and external auditory canal. The authors analyzed this area using our three-dimensional (3-D) computer-aided reconstruction and measurement method studying the spatial relations of the facial nerve to the tympanic ring and stylomastoid foramen. Temporal bones from five normal individuals aged 36 gestational weeks, 3 months, 8 months, 4 years, and 17 years were retrieved from the temporal bone collection stored at the Elizabeth McCullough Knowles Otopathology Laboratory in Pittsburgh. Three-dimensional reconstruction of the facial nerve comparing the developmental anatomy across the various age groups provides the surgeon with the technical information necessary to address problems in this area.

Adolescent↗
PubMed1993

Computer-aided 3-D reconstruction and measurement of the facial canal and facial nerve. I. Cross-sectional area and diameter: preliminary report.

Using a computer-aided three-dimensional (3-D) reconstruction method, measurements were made at eight representative sites of diameters and the cross-sectional area of the facial canal, facial nerve, and the space between the canal and nerve. Materials used were serial histology sections of seven normal human temporal bones obtained from individuals of different ages. Two areas of decreased cross-sectional area of the facial canal were found: the proximal part of the labyrinthine portion and the middle part of the tympanic portion. These narrowings in the canal appeared to be correlated with decreased superior-inferior diameter of the facial canal in those portions, especially in adult temporal bones, and also with decreased cross-sectional area, both of the nerve and of the space between the canal and the nerve, in these portions. The developmental etiology of these narrowings is speculated on, and their possible relationship to Bell's palsy is discussed.

Adolescent↗
PubMed1993

3-D anatomy of Scarpa's ganglion and surrounding structures.

We reconstructed in three dimensions, and measured by a computer-aided method developed by us, Scarpa's ganglion and surrounding important anatomical structures in 7 normal human temporal bones obtained from 7 individuals aged 7 days to 72 years. We found that this ganglion is shaped like an hourglass and lies with its superior part directed anterosuperolaterally, and its inferior part posteroinferomedially; these two parts are connected by the isthmus ganglionaris. Although the dimensions of the parts of the ganglion varied, such a structure was distinguishable in all the specimens we studied. The volume of the ganglion was found to be relatively consistent in these postnatal specimens; although the width and height of the ganglion varied, they were inversely correlated with each other (linear regression analysis, p < 0.05). We did note, however, some postnatal increase in the distance from the ganglion to its neighboring structures. We also identified a significant correlation between the width of the ganglion and the length of the internal auditory canal and the distance from the ganglion to the vestibular endorgans in any given specimen (linear regression analysis, p < 0.05). These results suggest that although the volume of Scarpa's ganglion does not change after birth, its shape does change with the growth of the individual temporal bone.

Adolescent↗
PubMed1993

Torsion of the human semicircular canals and its influence on their angular relationships.

We used a computer-aided three-dimensional reconstruction and measurement method to measure torsion of the the semicircular canals (SCCs) in 10 normal human temporal bones from 10 individuals (3 months to 76 years old). Torsion of each SCC was measured as the angle between the "standard line" (the line connecting the ampullated and nonampullated ends of the SCC) and the plane of greatest SCC torsion. Torsion was greatest for the anterior SCC (16.4 +/- 3.6 degrees), followed by the lateral SCC (9.5 +/- 6.7 degrees) and the posterior SCC (8.5 +/- 4.2 degrees). The angles between the overall plane described by each SCC and the other SCCs between the anterior and lateral, the anterior and posterior, and the posterior and lateral SCCs were also measured and were found to be 78.7 +/- 10.0, 107.9 +/- 5.5, and 87.3 +/- 6.9 degrees, respectively. Finally the angles between the torsion plane of each SCC and the others were measured and found to be 92.6 +/- 15.4, 95.8 +/- 11.2, and 90.9 +/- 8.3 degrees, respectively. These results indicate that on average torsion in the SCCs tend to bring the angle between pairs of SCCs close to a right angle. This tendency to have a right angle between SCCs is thought to promote optimal vestibular function. Speculation is offered regarding the etiology of the greater torsion of the anterior SCC.

Adolescent↗
PubMed1993

Computer-aided three-dimensional reconstruction and measurement of facial canal dehiscence.

Location, shape and dimensions of the dehiscence in the facial canal to the middle ear space were studied in 20 temporal bones obtained from 19 individuals aged 1 day to 72 years at death by using our computer reconstruction and measurement method. The most frequent site of dehiscence was the oval window area (70%), particularly in its posterior half and on the inferior to inferomedial aspect of the canal. The shape of the dehiscence tended to be oval in the oval window area, but rather irregular in the other areas. The dehiscence ranged from 0.4 to 2.64 mm in length, from 0.12 to 1.59 mm in width, and from 0.03 to 1.87 mm2 in surface area. Proximity of these dehiscences to the field of otological surgery is stressed.

Computer Graphics↗
PubMed1992

Branchio-oto-renal syndrome: further delineation of an underdiagnosed syndrome.

We report on a woman who was diagnosed with branchio-oto-renal (BOR) syndrome after 2 pregnancies complicated by oligohydramnios due to renal hypoplasia and agenesis. Both babies died neonatally of pulmonary hypoplasia. Histopathology of the temporal bones of the second child showed marked immaturity of the middle ear cleft, ossicles, facial nerve and canal, and cochlear nerve. Maternal renal ultrasound study was normal although intravenous pyelography indicated renal hypoplasia. The frequency of BOR syndrome among cases of recurrent fetal renal hypoplasia/dysplasia or agenesis is unknown, and parental renal ultrasonography may not identify a heritable renal defect. Investigations should include a family history, and examination of relatives to look for preauricular pits, lacrimal duct stenosis, and branchial fistulae and/or cysts. Hearing studies and IVP may be indicated.

Abnormalities, Multiple↗
PubMed1992

Three-dimensional computer-aided reconstruction and measurement of the temporal bone for singular neurectomy.

A computer reconstruction method was used to study five normal temporal bones for the three-dimensional anatomy necessary for singular neurectomy. The length of the singular canal was 4.9 +/- 0.6 mm. The distal portion of the singular canal courses at a sharp angle (48.2 degrees) to the direction of the transmeatal surgical approach for this operation. The reconstructions indicated that the singular canal can be exposed by introducing a drill through the external auditory meatus at a point 0.71 mm posteroinferior to the posteromedial margin of the round window on the saucerized medial wall of the round window niche. The distance from this site to the distal end-portion of the singular canal averaged 1.47 mm. The point on the drilling course (from the drilling site to the singular canal) closest to the vestibular end of the hook portion of the cochlea was 0.48-1.00 mm from the drilling site. The reconstructions also indicated that the dissection should proceed superomedially, if necessary, after a 1-mm-deep straight dissection along the transmeatal approach. The ampulla of the posterior semicircular canal, cochlear aqueduct and inferior cochlear vein were all found to lie within 2 mm of the drilling point.

Adolescent↗
PubMed1992

Stria vascularis in Ménière's disease: a quantitative histopathological study.

To investigate the role of pathology of the stria vascularis in Ménière's disease, the vascularity and the cross-sectional area of the stria vascularis in a midmodiolar section of the cochlea were examined by histological observation and a computer-aided planimetric, respectively, in eight temporal bones from individuals with Ménière's disease and eight age-matched normal temporal bones. The number of vessels in the stria vascularis was significantly smaller in most of the cochlear turns in ears with Ménière's disease than in control ears, and the cross-sectional area of the stria vascularis in the same sections was significantly smaller in all the cochlear turns in ears with Ménière's disease than in controls. Furthermore, vascularity correlated significantly with the cross-sectional area of the stria vascularis in all the temporal bones examined. From these results it appears that poor vascularity of the stria vascularis is closely related to strial atrophy, and that these pathological findings might be important factors in the pathophysiology of Ménière's disease.

Adult↗
PubMed1992

Temporal bone histopathological findings in campomelic dysplasia.

Both temporal bones of a newborn (35 gestational weeks old) with campomelic syndrome were studied histopathologically. This is to our knowledge the second temporal bone report (third case) of this syndrome. The findings included: abnormal cartilagenous and osseous tissues and abnormality in the globuli interossei in the otic capsule; deformities of the vestibule and semicircular canals, probably due to compression by the abnormal cartilaginous tissue; hypoplastic cochlea and semicircular canals; aberrant course of the facial nerve; wide dehiscence of the facial canal in the tympanic portion; slight hypoplasia of the malleus and anomalies in the incus and stapes; and large epitympanic space. These findings closely resembled those of the first report, and suggest that: 1) campomelic dysplasia is a definite disease entity with consistent pathogenesis, and 2) similar otologic manifestations may be expected in the majority of patients with this syndrome.

Abnormalities, Multiple↗
PubMed1992

Elastin at the hinge portion of the eustachian tube cartilage in specimens from normal subjects and those with cleft palate.

The density of elastin in the intermediate portion between the lateral lamina and the medial lamina of human eustachian tube (ET) cartilage was examined in six normal adults, seven normal children, and six children with cleft palate (CP) in order to obtain information about how the physical properties of the ET cartilage differ as a function of age and presence of CP. Cross sections of the midcartilaginous portions of the ETs that had been stained with Weigert's elastin stain were photographed at uniform magnification, the area for study was projected, and the meshlike are of the ET cartilage that stained elastin-positive was represented on paper by lines. A digitizer was used to measure the total length of all the lines representing elastin in each photomicrograph, and the mean was determined for each of the three groups. The mean density of elastin was significantly greater in normal adults than in normal children (Student's t test, t = 2.781; p less than .02). It was also significantly greater in normal children than in CP children (Wilcoxon t = 24.0; p less than .05). These results appear to indicate that CP children have poorer elasticity in this area of the ET cartilage, which might cause functional obstruction (floppiness) of the ET in those children.

Adult↗
PubMed1992

Distributions of eustachian tube goblet cells and glands in children with and without otitis media.

The distributions of the goblet cells and submucosal glands in eustachian tubes (ETs) from children with or without otitis media (OM) were studied. From 12 temporal bone-ET specimens obtained from children 1 to 7 years old at death, representative vertically cut histology sections were selected, stained with periodic acid-Schiff-Alcian blue and hematoxylin, and studied by light microscopy. In children without OM, the density of the goblet cells was significantly lower in the roof than in the floor of the ET and was highest in the midcartilaginous portion; glands were most richly distributed near the pharyngeal orifice, and became less densely distributed toward the tympanic portion. In children with OM, the density of the goblet cells was significantly higher both in the roof and floor portions, and the glands were more richly distributed than in the ETs of children without OM. The possibility that the observed increase in ET secretory components in children with OM impairs the passage of air through these tubes is discussed.

Acute Disease↗
PubMed1992

Histopathology of tubotympanum of children with otitis media treated with ventilation tubes.

We studied histopathologically the middle ear (ME) and eustachian tube (ET) in 12 temporal bones from eight children who had had otitis media with effusion that had been treated with ventilation tubes (VTs) for 3 weeks to 11 months. In the ME, 1) only a minimal amount of effusion was seen in most of the ears treated for 3 months or longer, 2) the severity of submucosal inflammation almost paralleled the amount of effusion, 3) the amount of granulation tissue on the tympanic membrane at the site of VT insertion also seemed to parallel the degree of ME inflammation, and 4) epidermal ingrowth was seen in both of the two ears treated with VTs for 10 and 11 months. Pathologic findings in the ET were generally more severe than those in the ME, but tended to decrease with longer VT therapy. In two ears with VTs obstructed by inflammatory granulomatous tissue, the entire ME cavity was filled with effusion, and dense effusion plugged the bony portion of the ET. The results of this study indicate that 3 to 11 months of treatment with a VT is effective for reversing the ME effusion and for reducing inflammation in the ME. Some inflammation may be left in the ET, however, even with 11 months of VT therapy, and epithelial ingrowth should be watched for when VT therapy lasts 10 months or longer. Despite the fact that most of our temporal bones were from infants and children who had a variety of systemic diseases or disorders and in whom their terminal event might have contributed to our findings, we consider these temporal bones to be informative.

Child↗
PubMed1992

Facial canal dehiscence: histologic study and computer reconstruction.

The incidence, location, shape, and dimensions of dehiscences in the facial canal to the middle ear space were studied in 160 temporal bones obtained from 129 individuals 24 gestational weeks to 109 years of age at death by means of light microscopy and our computer reconstruction and measurement method. Dehiscences were observed in 95 of the 129 individuals (74%) and in 119 of the 160 bones (74%). The incidence was found to be quite high among fetuses and newborns, lowest in individuals in their twenties and then again quite high in the geriatric population (chi 2 test, chi 2 = 5.45 and 4.41, p < .05). The most frequent site of dehiscence was the oval window area, particularly in its posterior half (57% of all ears) on the inferior to inferomedial aspects of the canal; these dehiscences were clearly demonstrated in reconstructed images. The incidence of dehiscence in the area of the cochleariform process was 16%, and all these dehiscences were on the lateral to superolateral aspect of the canal. The second genu area and the mastoid portion were sites of dehiscence in 21% and 18%, respectively, of specimens; more than half of the dehiscences in the second genu area and mastoid portion were on the lateral to anterolateral and posterior aspects of the facial canal, respectively. The shape of the dehiscence tended to be oval in the oval window area, but rather irregular in the other areas. The dehiscences ranged from 0.4 to 2.64 mm in length, from 0.12 to 1.59 mm in width, and from 0.03 to 1.87 mm2 in surface area. The proximity of these dehiscences to the field of otologic surgery is stressed.

Adolescent↗
PubMed1992

Computer-aided three-dimensional measurement of the human vestibular apparatus.

Using a computer-aided three-dimensional reconstruction and measurement method, 12 measurements were made to determine the dimensions of the maculae, cristae ampullares, and semicircular canals in 18 temporal bones from nine pairs of age-matched male and female individuals (1 day to 76 years old). The surface areas of the utricular and saccular maculae were significantly larger in male than in female specimens (two-way analysis of variance, F = 9.00, df = 1, p less than 0.01; F = 4.57, df = 1, p less than 0.05, respectively). The width of the utricular macula and the length of the saccular macula were also significantly greater in male than in female specimens (two-way analysis of variance, F = 5.17, df = 1, p less than 0.05; F = 4.33, df = 1, p less than 0.05, respectively). Finally, the three semicircular canals were larger in diameter in male vs. female specimens; this difference was statistically significant for the superior semicircular canal (two-way analysis of variance, F = 10.74, df = 1, p less than 0.01). By contrast, none of these dimensions of those vestibular structures showed any significant change in size with advancing postnatal age. We propose from these findings that there appears to be sexual dimorphism in the vestibular apparatus.

Adolescent↗
PubMed1992

Temporal bone histopathologic findings of Waardenburg's syndrome: a case report.

A histopathological study of the temporal bones of a 3-year-old black girl who had bilateral deafness associated with Waardenburg's syndrome type II showed a similar pattern of pathology in both ears. The most striking findings were an absence of pigmentation in the inner ear and cochleosaccular abnormality. This is, to our knowledge, only the third report on human temporal bone histopathology in Waardenburg's syndrome and the first report of such a case with absence of pigment (melanin) in the inner ear. A possible association of hearing loss with absence of inner ear pigment in this case is discussed.

Child, Preschool↗