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Mechanism of immune complex-mediated inner ear diseases.

Tissues of the stria vascularis of normal rabbits were collected as cochlear antigen and injected into the foot pad of guinea pigs. The mechanism of development of endolymphatic hydrops was studied by the tracer method. Damage to the capillary endothelium and an increase in vascular permeability were found in the stria vascularis. Therefore, we studied patients with a raised level of immunoglobulin (Ig) G-class circulating immune complexes (CICs). Hearing loss was found in 3 of 22 patients with significantly elevated IgG CIC levels (13.6%). The relationship between inner ear disease and the presence of CIC was considered to be very significant. The possible mechanism of CIC-mediated inner ear diseases is discussed.

Adult↗

Biological and clinical aspects of autoimmune inner ear disease.

The clinical presentation, diagnosis, and management of autoimmune inner ear disease are reviewed. Recent studies indicating an autoimmune etiology and pathogenesis are discussed, along with a comparative analysis of several promising new animal models. Further studies to define the natural history, pathogenesis, and diagnosis of the disease are suggested.

Animals↗

[Treatment of labyrinthine fistulas in chronic otitis media].

Labyrinthine fistulas (l.f.) are reported to be diagnosed in 3-12.9% of the chronic otitis media patients. Their most frequent location is the lateral semicircular canal. The other locations include posterior semicircular canal, superior s.c. and vestibular window. Surgical removal of the cholesteatoma matrix brings a high risk of the complete hearing loss in the operated ear. Preoperative diagnosis of the l.f. is not always possible. Authors present the analysis of the group of 18 patients with l.f. treated at the Otosurgery Department, Medical University of Lodz. In all patients the radical modified surgery has been performed. Postoperative results are strictly correlated to the l.f location and size. As a conclusion authors present an algorithm of the l.f. surgical treatment based on their experience.

Cholesteatoma, Middle Ear↗

[Electrocochleography and topographic diagnosis].

We present a group of 50 patients with retrocochlear pathology, divided on 41 (82 per 100) non tumoral and 9 (18 per 100) tumoral: 8 cerebello-pontine angle meningiomas and 1 intracranial cholesteatoma. The retrocochlear diagnosis of the pathology is assessed by the results of the audiovestibular explorations, specially the electrophysiology (early auditory evoked response, electrocochleography). The neuroradiologic explorations (TAC, MNR) define the tumoral or non tumoral nature of the pathology. We review some technical aspects of the common electrocochleographic practice, as actually is realised by the Bordeaux group; also, the different parameters of a retrocochlear pathologic response. In this group, the electrocochleography was necessary on 64 per 100 of the cases to obtain an electrophysiologic retrocochlear diagnostic.

Acoustic Impedance Tests↗