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Localization of endotoxin in the inner ear following inoculation into the middle ear.

Sensorineural hearing loss is known to be a significant sequela of otitis media (OM). The pathophysiology of such hearing loss in OM is thought to be due to transmission of toxins and other bacterial products through the round window membrane, damaging the hair cells of the basal turn of the cochlea. Other routes, such as those involving the oval window, blood vessels and lymphatics, may also be involved. The purpose of this study was to elucidate the routes from the middle ear cavity to the inner ear and also the distribution pattern of endotoxin in the inner ear after injection of fluorescence-labelled endotoxin into the tympanic cavity and detection of fluorescence in the cochleae, vestibular end organs and facial nerves. This fluorescence was far more intense in the lower turns of the cochlea. These findings suggest that endotoxin can reach the inner ear by various routes, e.g. the round window, blood vessels or lymphatics, and/or interscala exchange, resulting in a disturbance not only of the cochlea but also of the vestibular end organs.

Animals↗

Middle ear pressure equilibration ability and spontaneous pressure changes in healthy ears with ventilation tubes.

CONCLUSION: The results of this study give support to the theory that opening the middle ear (ME) to the atmosphere leads to a deterioration in its pressure regulation capacity. However, this is probably not the reason why a perforation of the tympanic membrane becomes chronic. OBJECTIVE: Direct, continuous measurement is a method of studying ME pressure regulation. We found previously that subjects with chronic central perforation (CCP) had a negative ME pressure in the daytime, in contrast to subjects with healthy ears. In this study, in order to elucidate the cause of this negative pressure, measurements were performed in healthy ears with ventilation tubes (VTs). MATERIAL AND METHODS: A VT was inserted 1 week prior to the measurements in 18 subjects. A hearing protector was tightly fitted deep into the external ear canal and connected to a portable system consisting of a pressure transducer and a memory. RESULTS: The measurements revealed a mean ME pressure during the first 3 h of -27 daPa. Ten subjects showed an initial decrease in pressure leading to a considerable negative mean ME pressure and a poor ability to equilibrate pressure differences through the Eustachian tube, like the subjects with CCP.

Adolescent↗

Foam ear protectors for burnt ears.

Foam ear protectors were developed at the Royal Brisbane Hospital for use with selected patients with burns to the ears. The protectors assist in preventing pressure necrosis of the ear and damage to skin grafts. They permit visualization of the ears after grafting and allow the patient to sleep in a side-lying position if desired.

Adult↗

Immune response of the endolymphatic sac to horseradish peroxidase: immunologic route from the middle ear to the inner ear.

Twenty guinea pigs were immunized with horseradish peroxidase (HRP) intradermally and challenged with 5 mg of the same antigen in the tympanic bulla. The appearance of immunoglobulin-producing cells (plasma cells) in the inner ear structure was examined immunohistochemically in frozen sections. Four to 10 days following antigen challenge, 5 of the 20 animals showed significantly increased plasma cells in the subepithelial connective tissue of the endolymphatic sac (ES). Those cells showed positive reactions, mainly with IgG followed by IgM. The cells that reacted positively with IgA were few. Some of these plasma cells were considered to contain the specific antibody against HRP. The results indicate the role of the ES as a local immune response region for the inner ear complex, as well as the existence of an immunologic route from the middle ear cavity to the inner ear, particularly to the ES.

Animals↗

Middle ear pressure following tympanoplasty for various middle ear diseases. Pressure related to follow-up period and retractions.

In 512 ears with various middle ear diseases, the middle ear pressure was measured a minimum of 2 years and a maximum of 10 years after tympanoplasty. The findings were related to the length of the follow-up period and to retractions of the drum and/or in the epitympanum. The tympanometric findings were best in sequelae to otitis with dry perforations, poorest in cholesteatomas and adhesive otitis. Tubal function had not further deteriorated 4 years after the operation. There was a highly significant correlation between the middle ear pressure and the frequency of retractions, which also does not essentially increase--except in the cholesteatoma cases.

Acoustic Impedance Tests↗

A histopathological study of the inner ear after the administration of hyaluronan into the middle ear of the guinea pig.

Hyaluronan, 19 mg/ml, was administered into the middle ear cavity of guinea pigs. A control group was subjected to a sham operation. Fourteen days after administration the animals were killed and a macroscopic examination of all middle ears was performed. Surface preparations of the organ of Corti were made and examined by light microscopy. Hair cell loss along the length of the sensory epithelium was quantified. No toxic effect of hyaluronan could be detected either in the middle ear or in the sensory cells in the cochlea. Thus hyaluronan is potentially useful for facilitating middle ear surgery.

Animals↗

[The mechanics and function of the middle ear. Part 1: The ossicular chain and middle ear muscles].

The revelation of a sophisticated micro-mechanism within the ossicular chain--the gliding of the joints results in a characteristic change of the ossicular movement--extended our conception of the function of the ossicular chain. Contrary to our former ideas of the transmission of sound during hearing, the ossicles do not rotate around an axis, which runs through the center of mass of the malleus and anvil. The imaginary rotational axis is located outside the ossicles, resulting in a more piston-like vibration of the complete chain. The ossicular joints are rigid. This acoustic function of the ossicular chain must rigorously be separated from its behaviour at changes of static, ambient air pressure. The middle ear, working as a sensitive pressure receptor also reacts to these pressure changes with comparatively huge displacements of the drum membrane (visible in pneumatic otoscopy). Only now the malleus rotates around its axial ligaments. These movements cause a gliding motion in the malleus-incus joint, which results in a predominant up- and downward movement of the anvil; the incudo-stapedial joint glides, too, and the stapes (and the inner ear) are decoupled. This micro-mechanism explains several anatomical features of the middle ear construction, as there are the vertical alignment of the incudo-stapedial joint, the suspension of the anvil, the design of the malleus joint, etc. It also accounts for the peculiar anatomical arrangement of the middle ear muscles. Their function can be interpreted as preserving the intact cartilage of the ossicular joints.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Experimental changes of the pH in the middle ear and its effect on the internal ear (author's transl)].

Irrespective of their highly differing pH-value many pharmaca are nowadays applied to the middle ear. Animal experiments are to answer the question, weather changes in the pH-value of the middle ear may cause internal ear damages, With local application of different buffers (2.3-9.1 pH) into the tympanic cavity, the membrane of the round window was examined by means of the surface preparation technique, the pH-value of the perilymph was measured and the hair cells of the organ of corti were counted and histologically evaluated. With the reduction of the pH-value in the middle ear from 4.0 to 2.3 an increasing damage of the round window membrane could be detected. The pH-value of the perilymph, however, showed only a slight statistical variation, which cannot be guaranteed. After multiple applications of extremely acid buffers into the tympanic cavity directly before the round window membrane, a small but statistically significant reduction in the pH-value of the perilymph could be noticed. Hair cell damages at the organ of corti could in no case be observed.

Administration, Topical↗

Damage to the middle ear and the inner ear in underwater divers.

Postmortem human tissue from recently deceased divers was processed histologically to assess any inner and middle ear damage that could have resulted from the effects of pressure during diving. The following new findings are particularly noteworthy. In one diver, ascent while breath holding resulted in the rupture of the ear drum and blood in the middle ear, in addition to pulmonary barotrauma. In a second diver, following inner ear decompression sickness, new bone growth, similar to that described earlier in experimental studies with the squirrel monkey, was observed in the arms of one of the semicircular canals. These observations are further confirmation that otologic disorders can be a serious threat to divers.

Barotrauma↗

High resolution imaging of the mouse inner ear by microtomography: a new tool in inner ear research.

A newly developed desktop microtomograph was used to evaluate whether it is suitable for visualizing the three-dimensional (3D) morphology of the mouse inner ear (at a micrometer level) and whether it is applicable as a fast screening tool to detect hereditary abnormalities in this organ. To this end, the epistatic circler, a mutant mouse showing abnormal circling behaviour, was used as a model. The inner ears were dissected out, formaldehyde-fixed, and scanned at maximal resolution along the longitudinal axis. After segmentation, stacks of tomographic images were used for 3D reconstruction of the bony labyrinth. Finally, the obtained data were correlated with subsequent conventional histological examination. The spatial resolution (8 microm) achieved by this instrument, was found to be far superior to that obtained by conventional computer tomography (CT) and magnetic resonance (MR)-imaging equipment. The technique provides detailed tomographic images of the bony labyrinths and enables an adequate 3D reconstruction of the inner ear structures in this small mammal. In addition, it allows a screening for pathologic specimens prior to the more time- and labour-consuming histological techniques, which are still essential to gather information at a (sub)cellular level. This imaging technique can be regarded as a valuable tool in future research on hereditary inner ear abnormalities.

Animals↗

Hypothelia, syndactyly, and ear malformation--a variant of the scalp-ear-nipple syndrome?: Case report and review of the literature.

The scalp-ear-nipple syndrome is a rare autosomal dominant condition that involves lesions of the scalp, malformed external ears, and absence of rudimentary nipples and breasts. We report a case of a woman with hypothelia, bilateral mildly malformed ears, and syndactyly of the hands and feet, and review the literature on the hypothelia/athelia phenotype. This case may represent a mild phenotype of the scalp-ear-nipple syndrome or a newly recognized entity.

Abnormalities, Multiple↗

Simultaneous intravenous and intramiddle-ear dosing to determine cefditoren influx and efflux clearances in middle ear fluid in freely moving chinchillas.

This study was conducted to determine cefditoren (CDTR) transport kinetics between plasma and middle ear fluid (MEF) by characterizing influx (CLin) and efflux (CLout) clearances expressed in terms of unbound concentrations and their ratio. Simultaneous intravenous bolus and intramiddle-ear dose were administered to two groups of chinchillas: normal control and infected. In vivo microdialysis was employed to determine protein-unbound CDTR levels in MEF. Compartmental and noncompartmental analysis was performed. Parameters determined in both groups were compared to assess the effect of infection and inflammation on CDTR distribution kinetics. CLin and CLout estimates obtained by compartmental and noncompartmental analysis agreed well. The calculated CLin/CLout ratio was 0.76 +/- 0.23 and 0.56 +/- 0.25 in normal (n = 9) and infected (n = 6) animals, respectively. The 95% confidence interval of this ratio in both groups does not include unity. Statistical tests showed no difference (p > 0.05) in CLin, CLout, and their ratio between the two groups. In conclusion, middle ear infection and inflammation does not affect CDTR distribution. The CLin/CLout ratio determined in chinchillas compares well with values estimated from data in pediatric patients. An active efflux mechanism in middle ear mucosa may be involved in CDTR distribution in MEF.

Animals↗

Age effects and size effects in the ears of gekkonomorph lizards: inner ear.

Audiograms have indicated greater auditory sensitivity in larger than in smaller geckos; part of this difference, interspecifically and intraspecifically, is explained by middle-ear proportions. To investigate the contribution of the inner ear to the variation in sensitivity, we examined it in museum specimens representing 11 species and three subfamilies. We measured papilla basilaris length, and, when intact, the saccular otoconial mass. Papilla length approximated 1% of rostrum-anus length in large geckos but 2% in small geckos; in some species some inter-aural difference was indicated. Over the lumped material, relative papilla length varied as a function of body length, with highly significant correlation. Similar relations prevailed within each subfamily. However, intraspecifically the correlation of papilla basilaris length with animal size was usually nonsignificant. Hair cell populations assessed from SEM photographs were larger in the larger species but intraspecifically did not relate to an individual's size. Hence interspecifically, the dependence of auditory sensitivity on animal size seems supported by inner-ear differences but intraspecifically this relation derives only from the middle ear. Otoconial mass, as measured by its volume, was correlated with animal length both interspecifically and intraspecifically.

Age Factors↗

Microbiology of middle ear effusions from 292 patients undergoing tympanostomy tube placement for middle ear disease.

OBJECTIVE: Otitis media is one of the most commonly diagnosed childhood illnesses. Ideally, culture directed therapy for otitis media would be available, however, the common approach is to treat infections with antibiotics that cover the most common pathogens. The objective of this study is to describe the pathogens cultured from the middle ear effusions (MEE) of patients that underwent tympanostomy tube placement for middle ear disease, compare these results with previous studies, and assess for trends suggestive of changes in the microbiology of these patients. METHODS: Patients were invited to participate after the decision to place ventilation tubes had been made. A standard anterior-inferior myringotomy was made for placement of the ventilation tube. After myringotomy, patients had their ears suctioned and all effusions were collected for microbiologic analysis. RESULTS: A total of 292 patients were enrolled in the study, a total of 270 MEE samples were taken. Haemophilus influenzae and Moraxella catarrhalis were seen in 24 of 148 (16.2%) and 15 of 148 (10.1%), respectively. Neisseria meningitidis, Staphylococcus aureus and Corynebacterium species were each identified in 11 of the 148 pathogens isolated (7.4%). Streptococcus pneumoniae was identified in 6 of the 148 isolated pathogens (4.1%). CONCLUSION: Despite a high number of non-pathogenic bacteria, and a high number of culture negative effusions, we demonstrated pathogen rates consistent with other reports in the literature. Future directions include using more specific techniques such as PCR to better understand the microbiology of middle ear effusions.

Candida↗

The zebrafish dog-eared mutation disrupts eya1, a gene required for cell survival and differentiation in the inner ear and lateral line.

To understand the molecular basis of sensory organ development and disease, we have cloned and characterized the zebrafish mutation dog-eared (dog) that is defective in formation of the inner ear and lateral line sensory systems. The dog locus encodes the eyes absent-1 (eya1) gene and single point mutations were found in three independent dog alleles, each prematurely truncating the expressed protein within the Eya domain. Moreover, morpholino-mediated knockdown of eya1 gene function phenocopies the dog-eared mutation. In zebrafish, the eya1 gene is widely expressed in placode-derived sensory organs during embryogenesis but Eya1 function appears to be primarily required for survival of sensory hair cells in the developing ear and lateral line neuromasts. Increased levels of apoptosis occur in the migrating primordia of the posterior lateral line in dog embryos and as well as in regions of the developing otocyst that are mainly fated to give rise to sensory cells of the cristae. Importantly, mutation of the EYA1 or EYA4 gene causes hereditary syndromic deafness in humans. Determination of eya gene function during zebrafish organogenesis will facilitate understanding the molecular etiology of human vestibular and hearing disorders.

Animals↗

Expression of P-glycoprotein in inner ear capillary endothelial cells of the guinea pig with special reference to blood-inner ear barrier.

Expression of P-glycoprotein (P-gp) was detected immunohistochemically in the guinea pig inner ear using mouse anti-P-gp monoclonal antibody C219. P-gp was found only in the capillary endothelial cells of the cochlea and vestibule. The pattern of P-gp immunostaining in the inner ear was similar to that of the brain. The present investigation suggested that P-gp expression in inner ear capillary endothelial cells might play an important role in the blood-inner ear barrier by acting as an extrusion pump.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

FGFs control the patterning of the inner ear but are not able to induce the full ear program.

FGF2 or FGF8 applied ectopically, close to the developing otic placode enhances transcription of a subset of ear marker genes such as Nkx5-1, SOHo1 and Pax2. Other ear expressed genes (Dlx5 and BMP4) are not up-regulated by FGFs. Ectopic FGFs lead to an increase in size of the vestibulo-cochlear ganglion. This phenotypic change is due to an increased recruitment of epithelial cells to the neuronal fate rather than to an enhanced proliferation. We also observed an induction of additional, vesicle-like structures upon ectopic FGF treatment, but this induction never led to enrolment of a full ear program. We further demonstrate that FGF8 is expressed in two separate, short waves, first at the otic placode stage and later at the vesicle stage. Both activities correspond to critical morphogenetic events in ear development. We propose that FGF8 is an important regulator of otocyst patterning.

Animals↗