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Results for “LABYRINTH DISEASES”

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Experimental infection of the guinea pig inner ear with Toxoplasma gondii.

Based on the question whether toxoplasma gondii is a potential pathogenetic factor in sudden deafness and vertigo (especially in the acquired form of Toxoplasmosis) we started a series of investigations, dealing with direct, local, hematogenous, and intracisternal infection of the guinea pig cochlea with toxoplasma gondii. Three of ten directly inoculated and one of five hematogenously infected guinea pigs showed a severe labyrinthitis in electron and light microscopy. Thus, we could demonstrate that toxoplasma gondii is a potent pathogenetic factor in acute inner ear disturbances in laboratory animals. Toxoplasmosis should always be considered in cases with sudden deafness and vertigo without obvious other cause. With a specific therapy the labyrinthine disturbances can apparently be successfully treated.

Animals↗

Cholesteatoma extending into the internal auditory meatus.

We report our experiences in managing a patient with cholesteatoma complicated by meningitis, labyrinthitis and facial nerve palsy. The antero-inferior half of the tympanum was aerated but the postero-superior portion of the tympanic membrane was tightly adherent to the promontry mucosa. An attic perforation was present at the back of the malleolar head. High-resolution computed tomography also uncovered a fistula in the lateral semicircular canal. Surgical exploration of the middle ear cavity demonstrated that both the vestibule and cochlea were filled with cholesteatoma, and the cholesteatoma extended into the internal auditory meatus through the lateral semi-circular canal fistula. The cholesteatoma was removed by opening the vestibule and cochlea with a preservation of the facial nerve. Post-operatively, an incomplete facial palsy remained, but has improved slowly. There is no sign of recurrence to date after a 3-year period of observation.

Adult↗

[Computed tomography and magnetic resonance imaging of acquired abnormalities of the inner ear and cerebello-pontine angle].

CT and MRI of acquired abnormalities of the inner ear and cerebello-pontine angle present themselves with very typical findings. The imaging should be adapted to the pathology looked for and either CT or MRI should be used alone or in combination. CT, especially high resolution CT (HRCT), provides an excellent bone contrast, while MRI has a much superior soft tissue contrast. Acute inflammatory changes of the inner ear are solely depicted by contrast-enhanced MRI. HRCT excellently depicts osseous changes of the inner ear and cerebellopontine angle such as chronic ossifying labyrinthitis occurring after acute labyrinthitis, otosclerotic or traumatic changes. Tumorous changes not yielding to bony changes are best delineated by MRI. Posttraumatic hemorrhage and chronic fibrotic changes within the labyrinth are depicted by MRI, only. In conclusion HRCT and MRI are excellent methods to delineate acquired abnormalities of the inner ear and cerebello-pontine angle. HRCT best depicts osseous changes while MRI best depicts soft tissue changes. HRCT and MRI are not concurrent methods but should better be used as complementary methods for imaging acquired abnormalities of inner ear and cerebellopontine angle.

Cerebellar Neoplasms↗

Genetic disorders of transporters/channels in the inner ear and their relation to the kidney.

Inner ear physiology is reviewed with emphasis on features common to renal physiology. Genetic disorders in transporters/channels for chloride (ClC-K), bicarbonate (Cl(-)/HCO(3)(-) exchanger), protons (H(+)-ATPase), sodium (ENaC, NKKC1, NBC3, NHE3), potassium (KCNQ1/KCNE1, Kcc4), and water (AQP4) in the inner ear and their relation to the kidney are discussed. Based on data from human disorders (with or without mouse counterparts) and mouse models (without human counterparts) this article focuses on the involvement of these transporters/channels in hearing loss.

Animals↗

Pathology of congenital syphilitic labyrinthitis.

An alarming increase in the incidence of syphilitic labyrinthitis has prompted us to review the pathology of this condition. The temporal bones of two patients with congenital syphilis of the ear were studied histopathologically. They showed diffuse osteitic changes in the otic capsule associated with severe hydrops and degeneration of the membranous labyrinth. The posterosuperior wall of the external auditory canal as well as the auditory ossicles showed numerous connective tissue filled spaces surrounded by thin bony trabeculae. These lesions probably represent healed luetic osteitis. There was severe degeneration of the sensorineural structures in the cochlea. A finding of particular interest was the infiltration and fibrous obliteration of the ductus endolymphaticus in both cases. The significance of these findings in relation to the pathophysiology and treatment of syphilitic labyrinthitis is emphasized.

Bone Resorption↗

Experimental cytomegalovirus infection: viremic spread to the inner ear.

The entry route of viruses into the inner ear is still controversial. Guinea pig cytomegalovirus (CMV) has been used to create an animal model of systemic infection as well as labyrinthitis. In this study, seronegative guinea pigs were administered intracardiac inoculations of varying doses of guinea pig CMV. After three or eight days, the animals were killed and necropsy specimens examined for viral antigen. In the specimens examined three days after inoculation, no label was seen in the cochlea. However, label was found in the spleen with doses of 100 microL, and also in the liver in animals inoculated with 300 microL of virus. After eight days, an animal that received 200 microL of the virus showed labeling in the modiolar blood vessels and perivascular infiltrates. Two of the four animals that received 300 microL of the virus showed labeling in spiral ganglion cells. None of the animals showed viral antigen within the stria vascularis, nor were there signs of acute labyrinthitis. At eight days, animals inoculated with greater than 100 microL of virus showed labeled cells in multiple organs. These data suggest that the entry route of guinea pig cytomegalovirus into the inner ear might involve viremic spread to modiolar blood vessels and subsequent spread to spiral ganglion cells.

Animals↗

Management of iatrogenic facial nerve palsy and labyrinthine fistula in mastoid surgery.

A 6-year review of complications of mastoid surgery between June 1995 and June 2001 revealed five cases with serious iatrogenic complications from mastoid surgery, of which four were facial nerve palsy and two were labyrinthine fistula. One of these patients had concomitant facial nerve palsy and labyrinthine fistula. There were two cases of complete facial nerve palsy (House Brackmann grade VI) and two cases of incomplete palsy (House Brackmann grades IV and V). The second genu was the site of injury in three of the four cases. Of the four cases with facial nerve palsy, two patients had full recovery (House Brackmann grade I), one recovered only to House Brackmann grade III, and one was lost to follow-up. Both patients with labyrinthine fistula had postoperative vertigo and profound sensorineural hearing loss. The site of iatrogenic fenestration was the lateral semicircular canal in both cases.

Adult↗

Labyrinthitis.

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Aged↗

Histopathological findings in the inner ear caused by measles.

An otopathological analysis of three cases of viral labyrinthitis was performed. Six temporal bones cut in serial sections were available for this study. According to the degree of degenerative changes in various parts of the inner ear two types of morphologically distinct labyrinthitis after measles are presented: the first one with the port of entrance through the internal auditory meatus and characterized by, first and most significantly, changes in the spiral ganglion cells; and the second, as described previously by Lindsay, with the port of entrance of the virus in the inner ear through the stria vascularis, with degenerative changes in various structures within the endolymphatic duct.

Aged↗

Labyrinthine sequestrum (a case report).

An unusual case of a labyrinthine sequestrum is presented. During mastoidectomy on a patient with chronic recurrent mastoiditis, a large sequestrum in the labyrinth was found. Four years earlier he had been treated for a posterior fossa abscess, which had followed acute otitis media. An extensive ablative and drainage procedure of the pars superior and pars inferior with preservation of the facial nerve was indicated in this patient.

Child↗