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PubMedDate not supplied

Congenital malformations of the inner ear and the vestibulocochlear nerve in children with sensorineural hearing loss: evaluation with CT and MRI.

PURPOSE: The purpose of this work was to study the diagnostic value of CT and MRI in children with sensorineural hearing loss and to analyze anatomic abnormalities of the inner ear and the vestibulocochlear nerve in this patient group. METHOD: We evaluated 42 inner ears in 21 children with congenital deafness who had congenital inner ear malformations and who were candidates for cochlear implants. All patients were studied with high resolution MR and helical CT examinations. The MR study included a T2-weighted 3D fast SE sequence. We describe and tabulate the anatomic abnormalities. Special attention was given to abnormalities of the vestibulocochlear nerve. The field of view in the plane according to the length axis of the internal auditory canal (IAC) was 4 cm. Additional continuous parasagittal reformations perpendicular to the length axis of the IAC were studied with a field of view of 3 cm. RESULTS: CT and MRI allowed accurate identification of malformations of the inner ear in children with congenital deafness. We identified 99 malformations, with a majority of patients demonstrating multiple abnormalities. Common imaging findings were Mondini abnormality and Mondini variants (12/42) and fusion of the lateral or superior semicircular canal with the vestibule (12/42). MRI demonstrated in 9 of 21 patients a rudimentary or absent vestibulocochlear nerve in the auditory canal. CONCLUSION: CT and MRI are important modalities to analyze the inner ear in children who are candidates for cochlear implants. MRI with an extremely small field of view should be used to study possible abnormalities of the vestibulocochlear nerves. This may alter clinical care and allow cochlear implant placement in patients whose electrodiagnostic studies suggest that the implant should not be performed. The detailed analysis of abnormalities of the inner ear might establish prognostic factors.

Child↗
PubMed1985

[Measurement of inner ear circulation using radioactive indicators].

To clarify the possibility of measuring the inner ear blood flow by radionuclide imaging, we used a skull phantom and a scintillation camera and found that a concentration difference of at least 100: 1 between the inner ear and the background is needed for external detection. Similar concentration differences can be found in aminoglycosid antibiotics because of their special pharmacokinetic characteristics. We believe, therefore, that with an appropriate radioactive indicator, such as labelled aminoglycoside or labelled (99mTc, 123J)-inulin, it would be possible to measure the inner ear blood flow in a non-invasive and selective way.

Ear, Inner↗
PubMed2026

Distinct cerebellar and inner-ear phenotypes in Atoh1 promoter-proximal deletion mice.

OBJECTIVE: Atoh1 is essential for the development of the cerebellum and inner ear, but the in vivo role of its promoter-proximal region remains incompletely understood. We generated deletion lines targeting the Atoh1 promoter-proximal region containing C sites and examined their phenotypes in the cerebellum and inner ear. METHODS: Using the CRISPR-Cas9 genome editing method, mice with deletions in the Atoh1 promoter-proximal region containing C sites were generated, and four independent deletion lines were established. Gross morphology and histology of the cerebellum and inner ear were examined in 2-month-old mice. RESULTS: Four independent deletion alleles were obtained and designated line A to line D in ascending order of deletion size. In the cerebellum, gross examination and sagittal sections showed progressively more severe hypoplasia from line A to line D, accompanied by reduced foliation and disorganization of cortical architecture. The granule cell layer was progressively reduced, whereas Purkinje cells were relatively preserved. Behavioral abnormalities were detected only in the most severely affected line. In the inner ear, the maculae of the otolith organs were relatively preserved across all lines. The ampullary cristae were relatively preserved in lines A-C but showed hair-cell loss in line D. Cochlear phenotypes were more severe: line A retained relatively preserved inner hair cells with reduced outer hair cells, whereas lines B-D showed near-complete loss of hair cells and marked disruption of the organ of Corti in the analyzed regions. Descriptive quantitative analyses of available specimens supported progressive cerebellar hypoplasia, relative macular preservation, line D crista involvement, and severe cochlear hair-cell loss in lines B-D. CONCLUSION: Deletion of the Atoh1 promoter-proximal region produced distinct tissue-specific phenotypes in vivo. These findings suggest that the Atoh1 promoter-proximal region is differentially required in the cerebellum and inner ear and that its contribution varies among vestibular and cochlear sensory organs.

Atoh1↗
PubMed2006

Brain and inner-ear fluid homeostasis, cochleovestibular-type tinnitus, and secondary endolymphatic hydrops.

Secondary endolymphatic hydrops (SEH) has clinically been found to have a significant incidence of occurrence in patients with subjective idiopathic tinnitus (SIT) of a severe disabling type. The diagnosis is made clinically and has been established by integration in a medical audiological tinnitus patient protocol of the clinical history with results of electrodiagnostic cochleovestibular testing that fulfill the diagnostic criteria of inner-ear disease consistent with Ménière's disease. SEH is hypothesized to be a factor, not an etiology, influencing the clinical course of SIT. Alterations over time (i.e., delay in the homeostatic mechanisms in normnal function of the fluid compartments of the inner-ear perilymph, endolymph, or brain cerebrospinal fluid) result in endolymphatic hydrops and interference in normal function of the inner ear, with resultant inner-ear complaints that can be highlighted by tinnitus rather than by vertigo. The endolymphatic hydrops may be either localized or diffuse within the cochlear or vestibular labyrinth. The etiologies and mechanisms of cochleovestibular-type tinnitus are multiple and are influenced by the SEH. Classically, the tetrad of symptoms--episodic vertigo, fluctuating sensorineural hearing loss, tinnitus, and ear blockage--associated with the histopathological correlate endolymphatic hydrops has been diagnosed as Ménière's disease. Specifically, key etiological agents that have been identified as playing a role in the clinical course of tinnitus (e.g., noise exposure, stress) may serve as "triggers" or stressors (or both), resulting in interference in normal biochemical and physiological function of sensorineural structures in the inner ear or in neural structures in the brain. In both conditions, the alterations over time (i.e., delay) in the clinical manifestation of the tetrad of symptoms of inner-ear dysfunction, when highlighted by SIT rather than vertigo, otherwise fulfill the criteria for diagnosing SEH. The chief complaint of SIT, when presenting as one of the tetrad of inner-ear symptoms and otherwise diagnosed as Ménière's disease, has also been associated clinically with perfusion asymmetries in brain, identified by nuclear medicine brain imaging (single-photon emission computed tomography [SPECT] of brain), and reflects an interference in homeostasis in the blood-brain labyrinth or blood-brain barriers, with a resulting SEH. The medical significance of the SIT in some patients may be a gradual, progressive sensorineural hearing loss. The inclusion of SPECT of brain in SIT patients demonstrates a global approach for improving the accuracy of diagnosing the SIT symptom, for focusing on the contribution of central nervous system dysfunction to the development of SEH, and for understanding and influencing the clinical course of SIT.

Blood-Brain Barrier↗
PubMed2005

Contribution of fetal MRI to the diagnosis of inner ear abnormalities: report of two cases.

We report two cases of fetal inner ear abnormalities diagnosed by MRI. Cerebral MRI was performed on two fetuses, at 32 and 30 weeks gestation, following US that demonstrated multiple malformations suggestive of CHARGE syndrome in one fetus and ventriculomegaly and poor visibility of the posterior fossa in the other. MRI revealed vestibular hypoplasia and agenesis of the semicircular canals in one fetus and cystic cochleas, partial vermian agenesis and an occipital meningocele in the second fetus. Both pregnancies were terminated and there was good correlation between fetal MRI, ex utero CT and fetopathological findings. The inner ears should be carefully examined when performing fetal cerebral MRI because abnormalities of the inner ear may be associated with cerebral anomalies.

Abnormalities, Multiple↗
PubMed1997

Cell death in the inner ear associated with aging is apoptosis?

Programmed cell death (apoptosis) in the inner ear of senescence-accelerated mouse was identified using specific labeling of fragmented DNA (the TUNEL method). In spite of some inter-individual differences, the apoptotic cells were predominantly found in the phylogenetically newer part of the inner ear, the cochlea and the saccules. In the saccules, sensory hair cells as well as supporting cells were positively labeled. In the cochlea, positive staining was detected in inner and outer hair cells, pillar cells, Deiters' cells, interdental cells, the stria vascularis (marginal cells, intermediate cells, basal cells), and cells in Reissner's membrane. The present results suggest that age-related cell death, which may cause hearing impairment and dysequilibrium, is due to apoptosis occurring in the inner ear.

Aging↗
PubMed2004

[Cochlear implantation in patients with inner ear malformations].

OBJECTIVE: To describe clinical experiences with multi-channel cochlear implantation in patients with bilateral inner ear malformations. METHODS: Among 410 patients who received multi-channel cochlear implantations from 1996 to 2004 in Beijing Tongren Hospital, 82 patients were diagnosed with inner ear malformations and implanted. A retrospective analysis was performed about the surgical characteristics and mapping characteristics after implantation. RESULTS: (1) All patients had auditory sensations. (2) Gusher was more common than the normal cochlear implantation. (3) The electrodes were inserted in the "cochleostomy" in full length of 80 Patients, but 2 pairs of electrodes remained outside of "cochleostomy" in 2 patients. (4) No serious complications occurred after implantation. (5) The impedance of the electrodes, the T level and C level were similar with the normal cochlear implantation. The results had no significant difference in compare with normal cochlear group (P > 0. 05). (6) The abilities of speech discrimination and spoken language were improved through rehabilitation. CONCLUSIONS: The cochlear implantation can be performed safely in inner ear malformations. The outcome of hearing rehabilitation for patients with inner ear malformations are similar to those children with normal cochlear structure followed the multi-channel cochlear implantation.

Adolescent↗
PubMed1992

[Establishment of immunofluorescence for the testing serum antibodies against inner ear tissues and its clinical application].

A modified Sainte-Marie technique for processing the inner ear tissues of guinea pigs was described in this paper. The inner ears were fixed over night in 95% cold ethanol, decalcified 7-10 days in 10% EDTA-Na2 at 4 degrees C, and embedded in paraffin. The deparaffinized sections were exposed 15 min in 95% ethanol precooled to 4 degrees C to fix the serum antibodies of patients and labeled antibody respectively. The sections were counterstained with Evans-blue. This method is simple, rapid, and sensitive, and antigenicity. Also, the specificity was enhanced and the preservation of fluorescence was prolonged. By means of this method, antibodies against inner ear tissue were found in the serum of 18 out of 30 patients with Meniere's disease, sudden deafness or uncertain forms of progressive sensorineural hearing loss. The results suggest that autoimmune response may play an important role in some inner ear disease.

Adolescent↗
PubMed1989

Effects of round window membrane rupture on cochlear blood flow and inner ear pressures.

Effects of round window membrane rupture on cochlear blood flow and inner ear pressures were investigated using non-radioactive microspheres and a servo-micropipet system in guinea pigs. When perilymphatic pressure was raised through a glass capillary tube inserted into the perilymphatic space, both endolymph pressure and perilymph pressure rose. When these inner ear pressures were raised to relatively high levels, cochlear blood vessels could be compressed and endocochlear potential decreased to a negative value due to the interruption of cochlear blood flow. However, in the case when the round window membrane was ruptured by further increase in perilymph pressure, the inner ear pressures decreased and restoration of cochlear blood flow and endocochlear potential was observed. When the round window membrane was ruptured with a fine needle under ordinary inner ear pressures, cochlear blood flow did not change significantly.

Animals↗
PubMed2005

Expression of full-length Cochlin p63s is inner ear specific.

OBJECTIVE: The COCH gene mutated in DFNA9, murine an autosomal dominant hereditary hearing impairment, encodes Cochlin. Cochlin is also suggested to be the self-antigen of autoimmune sensorineural hearing loss. We previously reported that Cochlin constitutes 70% of the inner ear proteins and is classified into three types of isoform, p63s, p44s, and p40s. To study the specificity of expression of Cochlin isoforms in various organs, here we have investigated expression of the COCH gene at both the transcriptional and translational level. METHODS: COCH gene expression was studied by RT-PCR and Southern blot analysis. Cochlin isoforms were studied by Western blot analysis using an isoform specific antibody. RESULTS: At the transcriptional level, COCH mRNA was detected only in the inner ear by RT-PCR. Southern blot analysis of RT-PCR products detected a high level of COCH mRNA in the inner ear, lower level in spleen, and very low levels in the cerebrum, cerebellum/brain stem, eye, liver and kidney. At the translational level, Western blot analysis showed that a set of isoform, p63s, p44s, and p40s was detected at high levels only in the inner ear. In contrast, multiple proteins were detected at much lower levels in other organs tested. Notably, full-length Cochlin p63s was detected only in the inner ear. CONCLUSION: Our findings demonstrate that the COCH gene is expressed preferentially in the inner ear and that expression of full-length Cochlin p63s is specific to the inner ear. These results will be central to understanding the function of Cochlin and its role in the pathophysiology of DFNA9.

Animals↗
PubMed2004

Identification and characterization of choline transporter-like protein 2, an inner ear glycoprotein of 68 and 72 kDa that is the target of antibody-induced hearing loss.

The Kresge Hearing Research Institute-3 (KHRI-3) antibody binds to a guinea pig inner ear supporting cell antigen (IESCA) and causes hearing loss. To gain insight into the mechanism of antibody-induced hearing loss, we used antibody immunoaffinity purification to isolate the IESCA, which was then sequenced by mass spectroscopy, revealing 10 guinea pig peptides identical to sequences in human choline transporter-like protein 2 (CTL2). Full-length CTL2 cDNA sequenced from guinea pig inner ear has 85.9% identity with the human cDNA. Consistent with its expression on the surface of supporting cells in the inner ear, CTL2 contains 10 predicted membrane-spanning regions with multiple N-glycosylation sites. The 68 and 72 kDa molecular forms of inner ear CTL2 are distinguished by sialic acid modification of the carbohydrate. The KHRI-3 antibody binds to an N-linked carbohydrate on CTL2 and presumably damages the organ of Corti by blocking the transporter function of this molecule. CTL2 mRNA and protein are abundantly expressed in human inner ear. Sera from patients with autoimmune hearing loss bind to guinea pig inner ear with the same pattern as CTL2 antibodies. Thus, CTL2 is a possible target of autoimmune hearing loss in humans.

Animals↗
PubMed2002

Otoancorin, an inner ear protein restricted to the interface between the apical surface of sensory epithelia and their overlying acellular gels, is defective in autosomal recessive deafness DFNB22.

A 3,673-bp murine cDNA predicted to encode a glycosylphosphatidylinositol-anchored protein of 1,088 amino acids was isolated during a study aimed at identifying transcripts specifically expressed in the inner ear. This inner ear-specific protein, otoancorin, shares weak homology with megakaryocyte potentiating factor/mesothelin precursor. Otoancorin is located at the interface between the apical surface of the inner ear sensory epithelia and their overlying acellular gels. In the cochlea, otoancorin is detected at two attachment zones of the tectorial membrane, a permanent one along the top of the spiral limbus and a transient one on the surface of the developing greater epithelial ridge. In the vestibule, otoancorin is present on the apical surface of nonsensory cells, where they contact the otoconial membranes and cupulae. The identification of the mutation (IVS12+2T>C) in the corresponding gene OTOA in one consanguineous Palestinian family affected by nonsyndromic recessive deafness DFNB22 assigns an essential function to otoancorin. We propose that otoancorin ensures the attachment of the inner ear acellular gels to the apical surface of the underlying nonsensory cells.

Amino Acid Sequence↗
PubMed1999

Gene therapy in the inner ear. Mechanisms and clinical implications.

The application of gene therapy to the inner ear is an emerging field of study. Most studies report the expression of marker genes (e.g., galactosidase) within the tissues of the cochlea. The first biologic response of an inner ear tissue (i.e., auditory neurons) to transduction by a gene therapy vector expressing a therapeutic gene (a herpes amplicon vector containing a BDNF gene) was observed in spiral explants obtained from early postnatal rat cochleae. This study was important because it demonstrated the feasibility of a gene augmentation approach to treat traumatized cochleae. Long-term expression of transduced or transfected genes in cochlear tissues have been obtained with adenovirus, adeno-associated virus, and herpes amplicon vectors. The herpes amplicon vector (i.e., HSVbdnflac) that evoked a biologic response in vitro has also been successfully used to support the survival of auditory neurons in vivo following loss of the auditory hair cells (i.e., loss of trophic factor). Gene therapy has been successfully applied to the cochlea of a laboratory animal, and future studies will define the types of vectors and therapeutic genes that will work best for the treatment of inner ear diseases in the clinic.

Adenovirus E1 Proteins↗
PubMed2000

Induction of inner ear fate by FGF3.

Loss-of-function experiments in avians and mammals have provided conflicting results on the capacity of fibroblast growth factor 3 (FGF3) to act as a secreted growth factor responsible for induction and morphogenesis of the vertebrate inner ear. Using a novel technique for gene transfer into chicken embryos, we have readdressed the role of FGF3 during inner ear development in avians. We find that ectopic expression of FGF3 results in the formation of ectopic placodes which express otic marker genes. The ectopically induced placodes form vesicles which show the characteristic gene expression pattern of a developing inner ear. Ectopic expression of FGF3 also influences the formation of the normal orthotopic inner ear, whereas another member of the FGF family, FGF2, shows no effects on inner ear induction. These results demonstrate that a single gene can induce inner ear fate and reveal an unexpectedly widespread competence of the surface ectoderm to form sensory placodes in higher vertebrates.

Animals↗
PubMed1984

[Hormonal control of the inner ear. Fiction or reality?].

The aetiology of numerous functional disorders of the inner ear is still unknown. In particular, it is unclear whether these hearing disorders are a result of a primary damage to the sensory or secretory epithelium, or perhaps a result of a disturbed cochlear control mechanism. In the kidney, ion transport is controlled by hormonal influence mediated by an adenylate cyclase mechanism. Adenylate cyclase has been localized biochemically and cytochemically in the inner ear. Its activity can be increased with vasopressin and parathormone. Thus the question has been raised whether cellular metabolism and transport in the inner ear is indeed controlled by hormonal influence. The results of the electronmicroscopic-cytochemical localization studies of adenylate cyclase in the lateral wall of the cochlea and in the endolymphatic sac are presented, and their possible physiological significance is discussed.

Adenylyl Cyclases↗
PubMed2001

[Feasibility of inner ear gene transfer after middle ear administration of an adenovirus vector].

BACKGROUND: Several groups demonstrated in animal experiments that gene transfer is a feasible tool for inner ear intervention. Various approaches for inoculation of vectors have been successfully used for inner ear gene therapy. One possible way to reduce the risk of hearing loss following the opening of the cochlea for application of the vector into the perilymphatic space is to deliver vectors through the round window. This study was designed to determine whether middle ear application of an adenoviral vector is a feasible approach to inoculate vectors and lead to transduction of cells in the inner ear. METHODS: A unilateral middle ear application of an adenoviral vector was performed in 4 guinea pigs directly on the round window membrane (RWM) and in 4 additional animals by placing a cotton patch soaked with the vector solution on the RWM. The expression of a reporter gene (lacZ) was used to localize vector-transduced cells. RESULTS: Only one out of 8 animals showed cochlear expression of the reporter gene, whereas all 8 animals showed strong lacZ expression in the middle ear mucosa, in the RWM and in the mucosa surrounding the stapes. CONCLUSION: Our results indicate that the RWM presents a close barrier, almost completely preventing the adenovirus to diffuse into the perilymphatic space. Therefore middle ear application of an adenoviral vector cannot be used to induce inner ear gene transfer. However, middle ear application of a viral vector may be useful for developing treatment for diseases of the middle ear mucosa.

Adenoviruses, Human↗
PubMed1999

Decalcification by ascorbic acid for immuno- and affinohistochemical techniques on the inner ear.

An ascorbic acid decalcifying solution was applied to immuno- and affinohistochemical studies on the inner ear. Rat inner ears fixed in 4% paraformaldehyde in PBS or in 2% acetic acid in ethanol solutions were adequately decalcified in an ascorbic acid solution, at a temperature of 4 degrees C. The decalcifying solution was prepared with 1% ascorbic acid and 0.84% sodium chloride in distilled water (pH 2.5-2.6). The decalcification time was in a direct relationship to the specimen calcification. In this study, two neuroactive substances (gamma-aminobutyric acid and calcitonin gene-related peptide), neurofilaments, and the galectine endogenous lectin were successfully detected immunohistochemically.

Animals↗
PubMed1990

Type II collagen-induced inner ear disease: critical evaluation of the guinea pig model.

Guinea pigs systematically challenged with type II collagen were examined electrophysiologically, histologically, and immunologically for inner ear lesions. Some functional, morphologic, and immunologic changes could be demonstrated. Evidence of possible immunoglobulin deposition in the basilar membrane, the perivascular region, as well as in other inner ear tissue were present. Immunologic and histopathologic simulations to inner ear diseases in humans and to the inner ear antigen-induced animal model were found. The results are discussed in light of the original model introduced by Yoo et al and the reexamination findings reported by Harris et al. The discrepancies in the results are argued, and the impact of this experimental model on human autoimmune inner ear disease is analysed.

Animals↗