Synaptophysin immunohistochemistry during vestibular hair cell recovery after gentamicin treatment

In the present study, morphometric and immunohistochemical techniques were used to evaluate the degree of synaptic recovery in the chinchilla crista sensory epithelia during various post-gentamicin-treatment periods of hair cell loss and recovery. For this purpose, two groups of animals were treated with Gelfoam pellets impregnated with 50 micro g of gentamicin implanted in the perilymphatic space within the otic capsule of the superior semicircular canal. Animals were sacrificed 1, 2 and 4 weeks after treatment. The degree of synaptic reinnervation was evaluated in the horizontal crista of the first group of animals using immunohistochemical techniques and antibodies against synaptophysin, a marker for synaptic reinnervation and synaptogenesis. Quantification of immunoreactivity in this group was made in the mid-region of the crista using the NIH 'Image' program. The second group of animals was used for quantification of the number of hair cells and supporting cells in the horizontal crista. In the normal sensory epithelium, synaptophysin immunoreactivity was found in the areas corresponding to the known distribution of afferent and efferent nerve terminals. Immunoreactivity was predominantly located within the afferent calyces of type I hair cells. No immunoreactivity was found in the supporting cells. Seven days after treatment there was a significant loss of hair cells and synaptophysin-stained area (SSA). In the mid-region of the crista the loss of synaptophysin immunoreactivity was quantitatively the greatest within the central zone of this region (93%) while the loss of hair cells was the smallest. These results suggest that afferent and efferent nerve terminals were also severely affected by the ototoxic treatment. Four weeks after treatment corresponding to the end of the recovery phase of gentamicin ototoxicity, there was a proportional increase in the number of hair cells and of the degree of SSA in the mid-region of the crista. The number of hair cells recovered to 58% with a recovery of SSA to 54% of normal. These results suggest that a greater fraction of synaptophysin expression within the sensory epithelium depends on the presence of afferent calyceal endings, which are greatly affected by gentamicin. Also, these results demonstrate a significant level of reinnervation of the newly regenerated hair cells, forecasting the potential for functionality of the regenerated hair cells.     

Beta-actin changes during hair cell regeneration in the chick basilar papilla]

OBJECTIVE: To investigate the changes of beta-actin and beta-actin mRNA expression during hair cell regeneration in the chick basilar papilla(BP) following gentamicin ototoxicity. METHODS: Thirty-six chicks were given muscular injection of gentamicin at dosage of 100 mg/kg.d for 10 consecutive days, and twelve additional chicks received injection of normal saline instead of gentamicin as controls. At 1, 3, 7, 14, 21 and 28 days after the treatment, six chicks in experimental group and two chicks in control group were sacrificed. Basilar papillas were prepared for immunohistochemistry and in situ hybridization study. beta-actin and beta-actin mRNA expression in the damaged region were histologically analyzed by computer image system. RESULTS: beta-actin immunoreactivity of BP changed significantly after treatment with gentamicin. From the first day to the fourteenth day after gentamincin, beta-actin immunoreactivity turned positive gradually. It approximated the normal response level at the fourteenth day after treatment of gentamincin. Then increasing rate of beta-actin immunoreactivity positive response level slowed from the fourteenth day after the treatment. At seventh day after treatment, beta-actin mRNA expression in BP increased to peak value, which preceded the peak expression of beta-actin in the regenerated hair cells. CONCLUSION: Nascent hair cells seem to mature 14 days after hair cell damage, which may play a role in auditory functional recovery.     

庆大霉素致豚鼠前庭毛细胞破坏后再生及功能恢复

为探讨哺乳动物前庭毛细胞破坏后能否再生及前庭功能能否恢复，以豚鼠为研究对象。实验组动物每日给予庆大霉素皮下注射，连续１０天，对照组动物给予等量生理盐水。于停药后的第２、４、１２和２４周分别处死动物，扫描电镜观察发现，停药２周椭圆囊和壶腹嵴毛细胞破坏最明显的区域可见到不成熟的毛细胞纤毛丛，至停药２４周后继续存在。与对照组相比，停药１２周毛细胞密度下降明显（Ｐ〈０．０１），停药后２４周时毛细胞密度较１     

Evidence for hair cell regeneration in the crista ampullaris of the lizard Podarcis sicula

We studied hair cell regeneration in the crista ampullaris of the lizard Podarcis sicula both in untreated animals and at early and late time intervals following a single high dose of gentamicin. The study was carried out using the S-phase marker 5-bromo-2'-deoxyuridine. Our ultrastructural and immunofluorescence studies showed that both apoptosis and hair cell regeneration happen in the lizard crista ampullaris in untreated animals, and that regenerative processes are greatly accelerated after treatment with the aminoglycoside antibiotic gentamicin. Our observations indicate that hair cell regeneration is strongly implicated in the repair of damaged sensory epithelium, and that new hair cells appear likely to arise from supporting cells.     

Gentamicin induced nitric oxide-related oxidative damages on vestibular afferents in the guinea pig

Gentamicin is a well-known ototoxic aminoglycoside. However, the mechanism underlying this ototoxicity remains unclear. One of the mechanisms which may be responsible for this ototoxicity is excitotoxic damage to hair cells. The overstimulation of the N-methyl-d-aspartate (NMDA) receptors increases the production of nitric oxide (NO), which induces oxidative stress on hair cells. In order to determine the mechanism underlying this excitotoxicity, we treated guinea pigs with gentamicin by placing gentamicin (0.5 mg) pellets into a round window niche. After the sacrifice of the animals, which occurred at 3, 7 and 14 days after the treatment, the numbers of hair cells in the animals were counted with a scanning electron microscope. We then performed immunostaining using neuronal nitric oxide synthase (nNOS), inducible NOS (iNOS) and nitrotyrosine antibodies. The number of hair cells in the animals was found to decrease significantly after 7 days. nNOS and iNOS expression levels were observed to have increased 3 days after treatment. Nitrotyrosine was expressed primarily at the calyceal afferents of the type I hair cells 3 days after treatment. Terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) staining revealed positive hair cells 3 days after treatment. Our results suggest that inner ear treatment with gentamicin may upregulate nNOS and iNOS to induce oxidative stress in the calyceal afferents of type I hair cells, via nitric oxide overproduction.     

Uptake of amikacin by hair cells of the guinea pig cochlea and vestibule and ototoxicity: Comparison with gentamicin

The distribution of amikacin (AK), an exclusive cochleo-toxic aminoglycosidic antibiotic (AA), and of gentamicin (GM), which is both cochleo- and vestibulo-toxic, has been studied in cochlear and vestibular hair cells. Guinea pigs were treated during six days with one daily injection of AK (450 mg/kg/day) or GM (60 mg/kg/day). AAs were detected, using immunocytochemical technique with scanning laser confocal microscopy, in isolated cells from guinea pigs sacrificed from 2 to 30 days after the end of the treatments. Results demonstrate a rapid uptake (as soon as after 2-day treatment) of both AAs by cochlear and vestibular hair cells and a very slow clearance. Particularly GM and AK are detected in type I and type II hair cells of the utricles and cristae ampullaris. The presence of these two molecules with different toxic potentialities towards cochlear and vestibular hair cells indicates that the selective ototoxicity of aminoglycosides cannot be explained simply on the basis of particular uptake and accumulation in the different sensory hair cells.     

Calpain and caspase inhibitors protect vestibular sensory cells from gentamicin ototoxicity

OBJECTIVE: Apoptosis may play an important role in the mechanism of aminoglycoside ototoxicity. Caspases and calpains are regarded to be important factors in the regulation of cell death in the inner ear. We hypothesized that caspase or calpain inhibitors would protect hair cells from aminoglycoside ototoxicity. MATERIAL AND METHODS: In order to test this hypothesis we carried out a pilot study to determine if gentamicin (GM) would induce caspase and calpain immunolabeling in guinea pig hair cells Having confirmed this we carried out the main experiment using guinea pig vestibular organ culture to determine if caspase and calpain would protect the hair cells from GM ototoxicity. RESULTS: Immunoreactivity for caspase-3 and m-calpain was detected in the vestibular sensory cells and ganglia after GM treatment. Both caspase and calpain inhibitors protected hair cells against gentamicin ototoxicity. CONCLUSION: It is suggested that inhibition of apoptosis is essential in order to block aminoglycoside ototoxicity.     

Endothelial nitric oxide synthase upregulation in the cochlea of the guinea pig after intratympanic gentamicin injection

Single-shot transtympanic gentamicin therapy has become a popular treatment modality for Menieres disease despite the known possible ototoxic properties of this drug. It was shown recently that NO production and iNOS were upregulated after gentamicin application, which was interpreted as a possible effect of ototoxicity. In this study we analyzed the expression of eNOS after gentamicin application to determine a possible correlation of this enzyme with gentamicin-induced ototoxicity. We compared eNOS expression in gentamicin-treated and non-treated guinea pigs in the second turn of the cochlea, an area corresponding to speech perception in humans. Gentamicin (4 mg) was injected intratympanically into the middle ear of guinea pigs ( n =3) and the reduction of the hearing threshold level was determined by recording acoustic-evoked potentials (AEP) before and 5 days after gentamicin application. Morphological alterations in the organ of Corti were analyzed by light and electron microscopy. Gold-labeled anti-eNOS antibodies were counted in eight different cell areas for quantification of eNOS expression. Seven animals were analyzed as controls. After gentamicin application, a deterioration of hearing level was observed varying from 10 to 30 dB. A high degree of vacuolization was identified in the third row of outer hair cells. At the subcellular level, the subsurface cisterns in outer hair cells were dissociated from the basolateral cell membrane, and the mitochondrial membranes were frequently damaged. Statistically significant upregulation of eNOS was observed in all cell types analyzed. Depending on the various cell types the amount of gold-labeled eNOS antibodies was 2.5 to 5.7 times higher after gentamicin application. We observed significant eNOS upregulation after gentamicin application in the cochlea, in conjunction with cellular damages and decreased hearing.     

Effects of systemic versus local gentamicin on the inner ear in the Atlantic cod, Gadus morhua (L.), relevance for fish hearing investigations

Fish models are increasingly being used for hearing research investigations. Aminoglycoside antibiotics that are used for damaging the inner ear hair cells can have systemic side effects leading to death of study animals. This study aimed to compare two methods: (i) systemic (intravenous) and (ii) local (intrasaccular) gentamicin administration for induction of inner ear hair cell damage in the Atlantic cod, Gadus morhua (L.). Hair cell damage was assessed using scanning electron microscopy; hair cell density, prevalence of immature hair cells and kinocilia length were measured. Gentamicin-treated fish were compared with control and sham fish. Intravenous gentamicin led to dose-dependent mortality caused by nephrotoxicity. The only visible effect after treatment was more immature hair cells and shorter kinocilia, the effect on hair cell density was equivocal. Following intrasaccular gentamicin treatment, fish mortality was negligible, and hair cells were damaged regardless of dose. Here, we observed decreased hair cell density, high prevalence of immature hair cells, and significantly shortened kinocilia. Conclusion: intrasaccular injection is preferable to intravenous injection of gentamicin for the study of ototoxicity in the Atlantic cod.     

Protective effects of alpha-tocopherol against gentamicin-induced Oto-vestibulo toxicity: an experimental study

OBJECTIVE: Free radicals are involved in gentamicin ototoxicity and vestibular dysfunction and it has been demonstrated that free radical scavengers, such as alpha-tocopherol, are able to inactive free radicals, attenuating tissue damage This study was designed to investigate the possible protective effects of alpha-tocopherol against gentamicin-induced oto-vestibulo toxicity. MATERIAL AND METHODS: Adult albino guinea pigs were divided into four groups and were treated for 2 weeks as follows: Group A, controls; Group B, gentamicin plus corn oil; Group C, gentamicin only; and Group D, gentamicin plus alpha-tocopherol. To evaluate vestibular function, the animals underwent sinusoidal oscillations in the dark about their vertical and longitudinal axes to evoke horizontal and vertical vestibulo-ocular reflexes (VORs), respectively. Electrocochleographic recordings were performed using an implanted round window electrode. The compound action potentials (CAPs) at 2, 4, 8 and 16 kHz were measured every 5 days Morphological changes were analysed by means of scanning electron microscopy. RESULTS: Gentamicin induced a consistent reduction in VOR responses and a progressive high-frequency hearing loss of 50-60 dB sound pressure level. Alpha-Tocopherol co-therapy slowed the progression of hearing loss and significantly attenuated the final threshold shifts The impairment of vestibular function was reduced, as evidenced by an increased VOR gain. The massive loss of outer hair cells in the cochlear basal turn and of cristae ampullaris stereocilia in gentamicin-treated animals was not observed in the cochlea of animals protected with alpha-tocopherol. CONCLUSION: This study supports the hypothesis that alpha-tocopherol interferes with gentamicin-induced free radical formation, and suggests that this drug may be useful in preventing aminoglycoside oto-vestibulo toxicity.     

Hearing loss and inner ear changes in a patient suffering from severe gentamicin ototoxicity

Summary The long-term histological effects of gentamicin ototoxicity could be studied in a human being in relation to the audiometric impairment. The possible sequence of degeneration of hair cells, supporting cells, nerve fibers, stria vascularis, spiral ganglion cells, and vascular supply is discussed.     

The protective effect of brain-derived neurotrophic factor after gentamicin ototoxicity.

HYPOTHESIS: Brain-derived neurotrophic factor (BDNF) influences the process of hair cell recovery in the vestibular sensory epithelium of the chinchilla after local application of gentamicin (GM). BACKGROUND: Hair cell regeneration in the inner ear after GM ototoxicity has been demonstrated. However, the mechanisms responsible for this recovery have yet to be completely elucidated. This report examines the protective and proliferative effects that BDNF exerts on vestibular hair cells in experiments designed to further elucidate the mechanisms of hair cell regeneration. METHODS: The inner ears of three separate groups of chinchillas were treated with GM only, GM and BDNF simultaneously, and GM followed by BDNF 1 week later. The numbers of hair and supporting cells in the horizontal cristae of each group were then estimated at 1, 2, 4, and 8 weeks, and the data were compared. RESULTS: Type I hair cells after GM treatment completely disappeared. After simultaneous BDNF and GM treatment, their numbers decreased to 23% at 1 week and progressively disappeared by week 8. When BDNF was applied 1 week after GM administration, type I hair cells recovered to 12% at week 4 and 28% at week 8. Type II hair cells after GM treatment decreased to 15%, but recovered to 83% 4 weeks later. Simultaneous administration of BDNF and GM prevented the ototoxic effects of GM alone. When BDNF was administered 1 week after GM, type II hair cell recovery was accelerated and was greater than after GM alone (81% versus 18%). Supporting cells after GM treatment decreased to 74% at 1 week after treatment, recovered to 91% at 2 weeks, and remained at 86% at 4 weeks and 85% at 8 weeks. With the simultaneous administration of BDNF and GM, supporting cells significantly decreased at 2 weeks after treatment (63%), but recovered to normal by week 8. CONCLUSIONS: These results suggest that BDNF provided simultaneously with GM minimizes the ototoxic effect of GM on type II hair cells. The increase in the number of new hair cells when BDNF is provided after ototoxic damage is evidence of the proliferative capacity of this neurotrophic factor.     

Gentamicin is Primarily Localized in Vestibular Type I Hair Cells after Intratympanic Administration

Intratympanic (IT) gentamicin injections are effective in the control of episodic vertigo due to Ménière’s disease. Histological studies in animals have found that the loss of type I vestibular hair cells far exceeds that of type II cells after IT gentamicin treatment. The objective of this study was to determine whether this selective toxicity for type I hair cells might be due to selective concentration of the drug by these cells. Gentamicin was localized within the vestibular epithelium by both direct and indirect methods. Gentamicin conjugated to Texas Red® was used as a direct tracer, and anti-gentamicin antibody provided an indirect means of localization. Conjugated or unconjugated gentamicin was injected into the left tympanic space of chinchillas. The animals were killed and fixed 1 or 3 weeks post-treatment. Confocal fluorescence microscopy was used to determine the localization of gentamicin in semicircular canal cristae. Results from the animals killed within 1 week of administration showed that numerous type I hair cells still remained throughout the epithelium. The mean intensity in grayscale units (0–255) of anti-gentamicin labeling for type I hair cells was 28.14 (95% CI 24.60–31.69), for type II hair cells was 17.09 (14.99–19.20), and for support cells was 5.35 (5.34–5.46; p < 0.001, ANOVA). Anti-gentamicin antibody labeling appeared in the majority of type I hair cells throughout their cytoplasm, but with greater intensity at the apex (p < 0.001). Intensity of fluorescence with Texas-Red conjugated gentamicin was 25.38 (22.83–27.94) in type I hair cells, 15.60 (14.73–16.48) in type II cells, and 12.62 (12.06–13.17) in support cells (p < 0.001, ANOVA). These results suggest that type I hair cells are more susceptible to gentamicin because they more avidly take up or retain the drug in the early period after administration.     

灯盏花对庆大霉素内耳毒性的防护作用

目的　探讨灯盏花对庆大霉素耳毒性的防护作用。方法　选用听力正常豚鼠 4 0只 ,随机分为 2组 :非治疗组 (庆大霉素组 ) ;治疗组 (庆大毒素 +灯盏花组 )。两组皆肌肉注射庆大霉素注射液 (12 0mg·kg-1·d-1) ,治疗组同时腹腔注射灯盏细辛注射液 (4 5mg·kg-1·d-1)连续 10天。分别于停药后第 1、7、14、2 1天随机抽取一定数量的豚鼠处死行毛细胞及血管纹的电镜及光镜观察 ,于处死前行畸变产物耳声发射 (DPOAE)、听性脑干反应 (ABR)检测。结果　非治疗组耳蜗功能和结构损害严重 ,外毛细胞的外形及核已固缩 ,血管纹毛细血管数量随用药后时间的延长逐渐稀少、管径狭窄。治疗组耳蜗功能和结构损伤较轻 ,除可见轻度胞质水肿及线粒体固缩外 ,外毛细胞基本正常 ,血管纹毛细血管管径有所增宽 ,DPOAE振幅和ABR波潜伏期、阈值两组比较有显著性差异 (P <0 .0 1)。结论　灯盏花对庆大霉素耳毒性有一定的防护作用     

The Cochlear Ribbon Synaptic Response to Aminogiycoside Ototoxicity in C57BL/6J Mice

Objective To investigate the early change of cochlear ribbon synapses on inner hair cells in response to aminoglycoside ototoxicity. Methods C57BL/6J mice received intraperitoneal injection of gentamicin (100 mg/kg/day), and the apical coil organ of Corti was examined on the 4th, 7th and 10th day (n=10). Litter-mates without gentamicin treatment served as controls (n=10). RIBEYE on the presynaptic membrane and AMPA receptors on the postsynaptic membrane were labeled with CtBP2 or GluR2/3 respectively. Three di-mension reconstruction was conducted using the 3DS MAX 8.0 software. Results There were no disruptions of outer or inner hair cells in all groups. However, the number of ribbon synapses on cochlear inner hair cells increased significantly within 7 days after gentamicin exposure (P<0.01), followed by a significant de-crease after 7 days.Conclusion During the early stage of aminoglycoside ototoxicity, increased population of cochlear ribbon synapses may indicate a significant down-regulation of synaptic function.     

Peripherin as a marker for degeneration of spiral ganglion neurons after aminoglycoside ototoxicity

Conclusion. Our data show that temporary appearance of atypical type 1 neurons, like type 3 neurons, might be another degenerating form of spiral ganglion neurons (SGNs); peripherin might be a marker of degenerating neurons. Objectives. Further morphological and biochemical studies on surviving SGNs after loss of hair cells might offer clues for preventing their degeneration. Materials and methods. We observed the ultrastructural features of surviving SGNs and analyzed the peripherin immunoreactivity at 4, 10, or 20 weeks after systemic injection of neomycin in rats. Results. Type 3 neurons, similar to type 1 neurons but unmyelinated, appeared in the spiral ganglion by 4-week survival, and showed a survival advantage in remaining SGNs by longer surviving periods. We observed neurons packed with dense intermediate filament and with multiple layers of dense myelin sheath (atypical type 1 neurons) in the degenerating neurons. Atypical type 1 neurons were observed among the degenerating neurons in the 4- and 10-week survival groups, but disappeared in longer surviving animals. By means of immunohistochemistry, only smaller SGNs of normal rats were strongly stained by anti-peripherin antibody, whereas increased immunoreactivity was observed in both large and small remaining neurons after neomycin treatment, especially in 10- and 20-week survival animals.     

5-磷酸二酯酶抑制剂对庆大霉素所致豚鼠耳毒性影响的研究

目的 探讨5-磷酸二酯酶(PDE5)抑制剂对庆大霉素所致豚鼠耳毒性的听功能及耳蜗形态学的影响.方法 采用随机数字表法将36只豚鼠分为空白对照组、庆大霉素组和PDE5抑制剂组,每组各12只;其中空白对照组未给予特殊处理,庆大霉素组和PDE5抑制剂组给予连续腹腔注射庆大霉素120 mg·kg-1·d-13周后,庆大霉素组继...     

Basic fibroblast growth factor protects auditory neurons and hair cells from glutamate neurotoxicity and noise exposure

Objective To determine the protective effects of basic fibroblast growth factor (bFGF) on cochlear neurons and hair cells in vitro and in vivo.

Material and Methods In Experiment I, cultured spiral ganglion neurons (SGNs) prepared from postnatal Day 3 mice were exposed to 20 mM glutamate for 2 h before the culture medium was replaced with fresh medium containing 0, 25, 50 or 100 ng/ml bFGF. Fourteen days later, all cultures were fixed with 4% paraformaldehyde and stained with 1% toluidine blue. The number of surviving SGNs was counted and the length of the neurites of the SGNs was measured. In Experiment II, in vivo studies were carried out with guinea pigs in which bFGF or normal saline was injected intramuscularly to assess possible protective effects of bFGF on cochlear hair cells and to accelerate the recovery of the auditory brainstem response (ABR). The ABRs were measured before, immediately after and 2 and 4 weeks after exposure to noise.

Results Exposure to 20 mM glutamate for 2 h resulted in an inhibition of neurite outgrowth of SGNs and an increase in cell death. Treatment of the cultures with bFGF led to promotion of neurite outgrowth and an increase in the number of surviving SGNs. In Experiment II, significant (p<0.05) differences in ABR thresholds were observed between the groups injected with bFGF and saline (t=2.689) at 4 weeks after noise exposure. Cochleae were removed and hair cell loss analyzed in surface preparations prepared from all experimental animals. Acoustic trauma caused loss of 240 and 2160 inner hair cells in the groups injected with bFGF and saline, respectively. Similarly, more outer hair cells were lost in the normal saline injection group (99 291) than in the group treated with bFGF (70 377).

Conclusions Our results demonstrate that bFGF protects SGNs against glutamate neurotoxicity in vitro. In addition, treatment with bFGF protects hair cells from acoustic trauma.     

水杨酸盐预防庆大霉素耳毒性的试验研究

目的 探讨大剂量应用庆大霉素时,观察水杨酸钠是否仍有预防耳毒性的作用。方法 选33只健康雄性豚鼠。随机分为A(11只)、B(11只)、C(11只)三组。A组腹腔注射药物庆大霉素+水杨酸钠;B组腹腔注射庆大霉素;C组腹腔注射生理盐水。每组动物用药前、用药后第2、4、6、8、10天分别行双耳ABR的阈值测试。耳蜗铺片光镜下毛细胞记数,分别用SPSS软件进行统计学处理。结果 体重:A组体重平均增加10.2克,B组体重平均减少5.2克,对照组体重平均增加16.5克,A组与B组比较差异有显著性(P<0.01)。ABR检查:第10天A组平均阈值为43.15±6.96,较B组平均83.93±19.33有显著改善(P<0.01),A组与对照组比较无显著性差异(P>0.05)。毛细胞计数:A组比B组损伤毛细胞数减少有显著性差异(P<0.01),B组毛细胞损伤明显增加,与对照组相比有显著性差异,A组与对照组无显著性差异。结论 提示在临床上为了在短期内控制细菌感染采用大剂量的庆大霉素时,仍可用水杨酸来预防其耳毒性。     

Quantitative Study of Vestibulotoxicity Induced by Gentamicin or Cisplatin in the Guinea Pig

Although aminoglycoside vestibulotoxicity is well established, the question of cisplatin vestibulotoxicity is controversial. The goals of this study were 1. to determine whether cisplatin induces vestibulotoxicity as measured histologically, and 2. to compare the vestibulotoxicity between gentamicin and cisplatin. Guinea pigs' vestibular end-organ hair bundles in control, gentamicin, and cisplatin groups were compared. In the lateral cristae of the cisplatin group, hair bundles decreased 21% on the central apex portion. In the gentamicin group, a slight decrease (17%) of hair bundles on the striola from the utricular maculae was observed, as was severe damage on the entire cristae, especially on the central apex (70%). These results indicate that gentamicin and cisplatin may not influence vestibular function of the otolithic membrane. However, gentamicin may severely damage and cisplatin may slightly damage the crista ampullaris hair bundles.