[Immunologic disorders of the inner ear].
The 4 types of immunologic reactions are described. The diagnosis of immunoallergic disease of the inner ear is discussed.
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The 4 types of immunologic reactions are described. The diagnosis of immunoallergic disease of the inner ear is discussed.
Pathogenesis of viral labyrinthitis is still poorly understood despite the dimension of clinical problem. This study was undertaken in order to elucidate the pathogenesis of viral labyrinthitis by the immunohistochemical investigations of infected cochleas. HVJ (Sendai virus) and mumps virus have been used to create an animal model of viral labyrinthitis. The cochleas of adult guinea pigs with intralabyrinthine inoculation of virus through the round window membrane and with intravascular injection of virus were investigated by histopathological and immunohistochemical techniques (immunofluorescent and Avidin-Biotin-Peroxidase Complex method). Control animal received only the culture medium. Histopathologically, fibrosis of scala tympani, vacuolization of stria vascularis, cell infiltration in perilymph were observed in the animals with intralabyrinthine inoculation, whereas no significant changes were observed in those with intravascular injection. Immunohistochemical studies revealed that viral antigen of HVJ was found in stria vascularis (6/11), Reissner's membrane (5/11), Organ of Corti (2/11) and viral antigen of mumps was found in stria vascularis (3/11), Reissner's membrane (1/11), Organ of Corti (1/11) in inoculated side of cochlea. In animal with intravascular injection, viral antigen of HVJ was found in stria vascularis (4/6), Organ of Corti (1/6) and viral antigen of mumps was found in stria vascularis (5/18), Organ of Corti (2/18). Cochleas of control animal showed no evidence of viral antigen. Viral antigen of both viruses were found in stria vascularis, Reissner's membrane, and Organ of Corti. Of these, Stria vascularis showed stronger affinity to these viruses. The results of intravascular injection indicate that endolymphatic labyrinthitis may ensure as a result of viremia.
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Using a comprehensive psychoneurological examination including a number of paraclinical methods (EEG, REG, echoventriculometry, thromboelastography, audiography, etc.) the authors studied 160 war veterans who had sustained a closed craniocerebral injury of a mild or moderate degree during the Great Patriotic War. The following neuropathological syndromes most characteristic for its long-term period were identified: cochleo-vestibular disorders, oculomotor and optico-vestibular disorders, as well as vegetovascular, hypothalamic, Parkinsonism, dyssomnic, epileptic and hydrocephalohypertensive syndromes. The authors also describe a number of the features of these syndromes related to the type of the course of the long-term period of the injury and to the predominance in the clinical picture of the disease of posttraumatic or cerebrovascular disturbances.
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Acoustic tumor surgery provided an ideal model in which to study possible contralateral hearing loss following a destructive surgical procedure on the inner ear. Follow-up audiometric studies were performed on patients with unilateral acoustic tumors who had undergone resection of their tumors. Patients who had obvious causes for contralateral hearing loss, such as chronic otitis media, unrelated otologic surgery, and noise-induced hearing loss, were excluded from this patient population. A total of 380 patients had available pre- and postoperative audiograms. A mean air-conduction threshold (500, 1000, 2000 Hz) of greater than or equal to 20 dB was considered a significant hearing loss. After adjusting these losses for presbycusis, 1.3% of these patients still had a significant contralateral hearing loss. We discuss the possible causes for the development of contralateral hearing loss and examine the possibility that, following surgical manipulation and injury to the inner ear, immunocompetent cells become sensitized to previously unseen inner ear antigens, setting the stage for contralateral inner ear dysfunction. The similarities of this condition to sympathetic ophthalmia are discussed.
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