实验性头外伤后前庭迷路的组织病理变化

用无依托式头外伤装置，造成豚鼠轻型头外伤模型。痛觉恢复后立即处死６只（Ｉ组），存活１５天处死５只（ＩＩ组）。颞骨火棉胶包埋，切片光镜观察，见两囊斑病变为大片耳石脱落、斑松解、剥离及感觉上皮空泡化、纤毛区大量球形体。１耳球囊斑脱落耳石靠近连合管。壶腹嵴病变为感觉上皮空泡化、上皮紊乱、松解，纤毛区大量球形体及嵴周嗜碱性颗粒附着。嵴周嗜碱性颗粒附着与嵴顶结石症病理变化一致。表明在头外伤后前庭病变，尤其是     

前庭学

毛区大量球形及晴周嗜碱性颗粒附着。峙周嗜碱性颗粒附着与峪顶结石症病理变化一致。表明在头外伤后前庭病变,尤其是两囊斑的损害明显。其继发性病变,如峪顶结石,连合管堵塞,可能是部份头外伤后听及前庭功能障碍的病理基础。图6参6(原提要),51247呼吸道合胞病毒致豚鼠前庭壶腹婚病变的超微结构观察(摘要)/钟刚毅…//中华耳鼻咽喉科杂志一1994,29(6)一373 实验观察,可以初步判断呼吸道合胞病毒感染中耳后也可导致前庭终器感觉细胞的损害。壶腹峙表面主要是纤毛改变,说明病毒感染导致纤毛的支持结构破坏。毛细胞的亚细胞结构病变最严重是在21…     

人前庭感觉上皮扫描电镜观察

为了解人前庭器官的超微结构，借助扫描电镜技术观察了５人（１０耳）的前庭感觉上皮。结果显示：①球囊斑呈“Ｌ”形，椭圆囊斑形如打开的贝壳；②Ⅰ型感觉细胞呈烧瓶样，Ⅱ型感觉细胞呈试管状；③感觉细胞纤毛排列呈阶梯状，动纤毛最长，且位于最长的静纤毛一侧，椭圆囊斑最长的静纤毛和动纤毛靠近微纹，其极性也向微纹，球囊斑则背离微纹，水平半规管壶腹嵴的动纤毛朝向椭圆囊侧，上、后半规管壶腹嵴则朝向半规管侧；④耳石形状大小不一致，呈现两端为锥形的圆柱状晶体。     

后壶腹神经切除术治疗良性头位性眩晕

【良性阵发性头位性眩晕的病因、病理和病理生理】良性阵发性头位性眩晕的病因尚不十分明确。Schuknecht在本病患者的颞骨切片中发现后半规管壶腹嵴顶内有嗜碱性沉着物,因此提出“顶石症”的学说。顶中的嗜碱性物质很可能来自椭圆囊斑的耳石,由于斑的变性变化而脱落。嗜碱性沉着物包埋在壶腹嵴顶以后,使顶也对重力敏感。(按壶腹嵴的适宜刺激原本为角加速运动。——译者) 椭圆囊斑和后半规管壶腹嵴之间存在着互相依赖关系,其根据是:(1)两者的第一级神经元     

人前庭感觉上皮扫描电镜观察

为了解人前庭器官的超微结构，借助扫描电镜技术观察了５人（１０耳）的前庭感觉上皮。结果显示：①球囊斑呈“Ｌ”形，椭圆囊斑形如打开的贝壳；②Ｉ型感觉细胞呈烧瓶样，Ⅱ型感觉细胞呈试管状；③感觉细胞纤毛排列呈阶梯状，动纤毛最长，且位于最长的静纤毛一侧，椭圆囊斑最长的静纤毛和动纤毛造近微纹，其极性也向微纹，球囊斑则背离微纹，水平半规管壶腹嵴的动纤毛朝向椭圆囊侧，上、后半规管过来腹嵴则朝向半规管侧；④耳右形状     

Smad4 条件基因敲除小鼠前庭终器形态学研究

目的研究Smad4条件基因敲除小鼠前庭终器形忿改变，探讨Smad4基因对于前庭发育的作用。方法利用建立的Smad4条件基测敲除小鼠模型．通过光镜观察Smad4（＋／＋）、Smad4（＋／-）与Smad4（-／-）三种基因型小鼠（0．5、1．5月龄）的球囊及囊斑、椭圆囊及囊斑、半规管及壶腹嵴、前庭神经节、内淋巴管与囊的形态结构、毛细胞的形态及排列缺失情况。通过扫描电镜观察球囊斑、椭圆囊斑和壶腹嵴的形态结构、毛细胞及纤毛的排列缺失情况。结果Smad4（-／-）小鼠个体及内耳明显小于Smad4（＋／＋）和Smad4（＋／-），而后面二者区别不大。所有小鼠的球囊及囊斑、椭圆囊及囊斑、半规管、前庭神经节、内淋巴管与囊的大小和结构正常，淋巴囊腔饱满，囊斑处的感觉上皮、耳石、毛细胞及纤毛排列整齐，没有发现明显的病变．三个基因型间没有差异。Smad4（-／-）小鼠壶腹嵴囊性变多且严重、后半规管壶腹嵴出现明显的副嵴、偶尔可见壶腹嵴感觉上皮空泡样变。壶腹嵴的毛细胞和支持细胞排列整齐，形态无明显改变，未见缺失。扫描电镜示球囊斑、椭圆囊斑、后、外、上半规管壶腹嵴正常，三个基因型之间没有差异。结论Smad4（-／-）小鼠的前庭终器有轻微病理改变，Smad4（＋／＋）与Smad4（＋／-）小鼠的前庭终器形态结构基本正常．表明Smad4对于前庭终器的发育影响可能不明显。     

前庭学

990986人前庭感觉上皮扫描电镜观察/孙建和…//中华耳鼻咽喉科杂志一1998,33(增刊)(英文版)一31一33 目的:了解人前庭器官的超微结构。方法:借助扫描电镜技术观察了5人(10耳)的前庭感觉上皮。结果:①球囊斑呈“L”形,椭圆囊斑形如打开的贝壳;②I形感觉细胞呈烧瓶样,l形感觉细胞呈试管状;③感觉细胞纤毛排列呈阶梯状,动纤毛最长,且位于最长的静纤毛一侧,椭圆囊斑最长的静纤毛和动纤毛靠近微纹,其极性也向微纹,球囊斑则背离微纹,水平半规管壶腹峙的动纤毛朝向椭圆囊侧,上、后半规管壶腹峙则朝向半规管侧;①耳石形状大小不一致,呈现两端为锥形…     

硫酸链霉素致豚鼠内耳前庭中毒超微结构观察

给29只豚鼠的腿部每天肌肉注射硫酸链霉素（300mg/ks)，分为给药10天、20天和30天3组，并同时记录旋转试验眼震持续时间。分别于10天、20天、30天处死动物扫描电镜和透镜电镜观察内耳前庭壶腹嵴和椭圆囊斑超微结构改变，与对照组进行比较。实验表明，硫酸链霉素对豚鼠内耳前庭的严重毒性作用是超微结构改变，主要表现为耳石形态改变、感觉纤毛脱落、感觉细胞中线粒体破坏、空泡形成及感觉细胞崩解等。     

前庭毛细胞的反相激活模式

分布在内耳前庭各个终器的感觉毛细胞可分为两种类型,它们分别是I型毛细胞和II型毛细胞。这两种毛细胞无论是在静纤毛的长度,还是毛细胞细胞体的形状,或者神经末梢的连接方式以及与之相联系的前庭神经元都不一样。前庭毛细胞感受重力或体位改变刺激的机制是由于其插入到覆盖在其上方耳石膜或终帽内的纤毛随着这些辅助结构的惯性位移而发生弯曲,纤毛的弯曲引起毛细胞膜电位发生去极化或超极化改变,从而促使毛细胞的神经冲动信号发放增强或减弱。静纤毛朝着动纤毛的方向弯曲形成对毛细胞的兴奋性刺激,而静纤毛朝着背离动纤毛的方向弯曲则构成对毛细胞的抑制。球囊斑和椭圆囊斑都被从其中心穿越的一条狭窄的细胞带划分为两个区域,这条狭窄的细胞带被称之为微纹区,在椭圆囊斑微纹区两侧周边区毛细胞的动纤毛都排列在朝向微纹区的位置,而球囊斑微纹区两侧周边区毛细胞的动纤毛都排列在背离微纹区的位置,由此可见,每一个囊斑微纹区两侧毛细胞的极性正好完全相反。当机体沿着一个囊斑的平面从垂直于微纹区的方向产生一个加速运动时,该囊斑一侧周边区的毛细胞会因为静纤毛朝着动纤毛的方向弯曲使该侧毛细胞发生去极化而处于兴奋状态,而另一侧周边区的毛细胞却因静纤毛朝着离开动纤毛的方向弯曲使该侧毛细胞发生超极化而处于抑制状态。三个壶腹嵴上毛细胞的动纤毛都是朝着或背离椭圆囊的统一方向,其中外半规管壶腹嵴上每个毛细胞的动纤毛都是统一朝着椭圆囊,而上半规管和后半规管壶腹嵴上的每个毛细胞的动纤毛都是统一朝着半规管的方向。壶腹嵴是一个位于壶腹腔内的横位的马鞍形隆起,当其上方覆盖的胶状质终帽随着内淋巴液的流动发生相对位置移动时,壶腹嵴一侧的毛细胞纤毛必然会随着终帽顶部的偏移而发生方向一致的弯曲,从而使这半侧壶腹嵴毛细胞产生同步的去极化或超极化反应,然而壶腹嵴另外一侧毛细胞的纤毛却会因为内淋巴液在壶腹嵴上方推动终帽时在被壶腹嵴遮挡一侧的底部形成一个反方向的漩涡式回流使壶腹嵴另外一侧毛细胞的纤毛发生方向相反的弯曲,从而使壶腹嵴两侧毛细胞处于一侧兴奋而另一侧抑制的截然相反的不平衡状态。这意味着同样的加速运动方向对与之相对应的前庭终器两侧感觉上皮产生的是截然不同的刺激信号,从而造成该前庭终器两侧感觉上皮输入信号的不平衡。这种不平衡刺激模式经前庭周边神经元传入到前庭中枢神经系统,使整个从周边到中枢的前庭系统都是以这种不平衡刺激方式传递和感知机体的平衡状态。     

前庭器官超微结构研究及结构图构建

目的通过扫描电镜观察小鼠椭圆囊、球囊、壶腹超微结构,研究分析并据此构建前庭器官新的结构示意图。方法选取3个年龄段小白鼠各10只,分别是年轻组≤2个月、中年组2~12个月、老龄组>12个月。分离出椭圆囊、球囊、壶腹,采用扫描电镜技术样品制备方法制备样品,应用扫描电镜进行样品观察。结果扫描电镜下可以得到:①椭圆囊斑及球囊斑不同层面图片:表面为堆积并相互黏附的"表面耳石",表面耳石下是无结构胶状质;底层表面耳石深入到无结构胶质层里;无结构胶质层下面是毛细胞纤毛及"纤毛间耳石"层,不同纤毛束之间均有纤毛间耳石存在,立于支持细胞表面,表面平坦;蜂窝状胶质物质联接无结构胶质层、纤毛间耳石及毛细胞纤毛。②壶腹超微结构的图片:嵴帽是无结构的胶状质与壶腹外侧壁紧贴,但较易分离,嵴帽和壶腹外侧壁之间有纤细的晶状体物质,在壶腹嵴两侧壁上也有纤细晶体物质(壶腹嵴表面耳石);不同的毛细胞纤毛之间有耳石结构的存在(壶腹嵴纤毛间耳石)。结论通过对前庭器官扫描电镜的观察,发现了椭圆、球囊斑及壶腹的新结构成分,由此构建出新的前庭器官超微结构示意图。     

Morphometry of otoconia in the utricle and saccule of developing Japanese quail

The development of otoconia in the utricular and saccular maculae from initial embryonic formation to adult stages was examined in Japanese quails. Both the morphology and size of the otoconia were quantified at different developmental stages. It was observed that the otoconia were initially formed on embryologic stage E5 in the saccule and E6 in the utricle. Otolith mass areas increased in a sigmoidal growth pattern, with saccular otolith areas being smaller than the utricular mass areas. Saccular otolith masses reached adult values at embryonic stage E12 and utricular areas reached adult values at post-hatch day 7. Mature individual otoconia were characterized by a barrel shape with two trihedral faceted ends. However, initial formation of otoconia at E5 (saccular) and E6 (utricular) maculae was characterized by a double fluted morphology that consisted of an hourglass shape with extended fins forming trihedral angles of 120 degrees. Double fluted otoconia rapidly filled, so that by embryonic day 8 mature otoconia dominated the maculae for the remainder of development through adulthood. Thus, a progression from double fluted to mature forms was noted. Mature utricular otoconia in adult quails averaged 11 microm in length and 5 microm in width, with length/width ratios of approximately 2.5:1, for all size ranges. Saccular otoconia were smaller, having about 70% the size of utricular otoconia in both length and width. During development, the average size and range of individual otoconia increased nearly linearly for both otolith organs. In the utricular macula, large otoconia were concentrated in the lateral regions of the epithelium. In contrast, otoconia of various sizes were distributed uniformly across the surface of the saccular macula.     

Laser labyrinthectomy in humans

This paper describes the feasibility of labyrinthectomy of only the vestibular part using argon laser in humans. In animal experiments, the utricular and saccular maculae were completely destroyed using argon laser with the otoprobe of the HGM system via the oval window, following stapedectomy. The human utricular and saccular maculae can be approached in a similar manner. Several approaches to the nerves and ampullae of the anterior and lateral semicircular canals are discussed. The most appropriate method to abolish the function of the ampullae is to sever the ampullary nerves. This can be done through the widened oval window with the argon laser otoprobe. After laser application, the oval window is covered by a piece of perichondrium. A stapes prosthesis is placed on the long process of the incus. Laser singular neurectomy may be used to sever the nerve to the posterior ampulla.     

Age-related changes on the morphology of the otoconia

OBJECTIVES/HYPOTHESIS: Although there are numerous reports on otoconial morphology using field-emission scanning electron microscopy (FESEM), there are few reports regarding the changes of otoconial morphology with aging. The aim of the current study was to investigate changes in otoconial morphology in rats according to age, using FESEM. STUDY DESIGN: Laboratory study using experimental animals. METHODS: We investigated age-related changes in otoconial morphology using FESEM in three groups of rats: young (1 wk old), middle-aged (6 mo old), and aged (23 mo old). RESULTS: There was great size variation in utricular otoconia in the young and aged rats, but we found no clear regional separation of saccular otoconia in all groups based on size. In the oldest rats, the bodies of many otoconia in both maculae were pitted, fissured, penetrated, and eventually broken into several fragments. However, the terminal facets were smooth and the lines of intersection of facets were sharp, despite the degenerated bodies of the otoconia in this group. Giant otoconia were discovered frequently on the outer margin of the utricular maculae in aged rats. We directly observed weakened or broken linking filaments and otoconial fragments in the aged group. CONCLUSION: The oldest rats showed the most degeneration of otoconia and linking filaments with otoconial fragments. This study of age-related morphologic changes in otoconia might help us understand the origin of idiopathic benign paroxysmal positional vertigo.     

Impulse noise induced damage in the vestibular end organs of the guinea pig. A light microscopic study

Guinea pigs were exposed to the impulse noise from 90-300 rifle shots (peak 158 dB SPL, maximal energy content at 1.1 kHz). This exposure induced severe cochlear damage. The vestibular end organs also showed damage of varying degree. The ampullary cristae were most severely damaged, but changes were also seen in the utricular and saccular maculae. The changes appear to be primarily mechanical and to result from the effect of the acoustic pressure wave on the vestibular labyrinth.     

The ductus reuniens and utriculo-endolymphatic valve in the presence of endolymphatic hydrops in guinea-pigs

Described in the foregoing are postoperative changes in the ductus reuniens and the utriculo-endolymphatic valve of the membranous labyrinth of the inner ear upon obstruction of the endolymphatic duct in normal guinea-pigs. The ductus reuniens was postoperatively dilated more than three times that of the normal ear, and dilated to a maximum degree within the first 12 hours. The utriculo-endolymphatic valve was found to be open two days after the operation, and there was a tendency for the number of animals with an open valve to increase with time. At three weeks and also at two months after the operation, there were some animals whose utricles were compressed by the dilated saccules, and as a result, their utricular ducts and utriculo-endolymphatic valves appeared narrowed.     

Attachment of the utricular and saccular maculae to the temporal bone

The present investigation concerns the true morphology of the attachment of the two otolith receptor organs the utricular and the saccular maculae in two and three dimensions. By applying a new visualization method, which utilized the application of X-ray microtomography and a method of contrast enhancement based on en-bloc staining in osmium tetroxide, we were able to overcome problems of artefact production such as tissue distortion and loss of valuable information that was present in previous studies. A series of more than 1000 axial sections were obtained for each of the specimens, which subsequently formed the basis for detailed 2D and 3D visualizations. Our interpretations of these data reveal that the saccular maculae are closely attached to the curved bony surface of the temporal bone as traditionally believed, but the utricular macula is attached to the temporal bone only at the anterior region of the macula.     

X-ray microanalytic studies on developing otoconia

The onset of otoconial development in the macula utriculi in CBA/CBA mice occurs on the fifteenth and sixteenth gestational days. Our study was concentrated on the early secretion of calcium in the areas of otoconial formation. The epithelial origin of otoconia is documented. Protrusions from supporting cells in the utricular and saccular epithelia contain very large quantities of calcium in addition to the normal cytoplasmic content of elements. The cell protrusions have an elemental composition clearly differing from that of otoconia as well as from neighbouring utricular cells with protrusions. A directed flow of calcium to developing otoconia from the supporting cells of the maculae is suggested.     

Histopathologic features of the temporal bone in usher syndrome type I

Temporal bones of 2 patients with Usher syndrome type I were examined using light microscopy. In both patients, findings from histopathologic examination of the cochlea were characterized by degeneration of the organ of Corti, which was most marked in the basal turn, atrophy of the stria vascularis, and a decrease in the number of spiral ganglion cells. The cochlear nerve appeared to be diminished. The sensory epithelium of the saccular and utricular maculae of patient 1 was normal for age. The left temporal bone of patient 2, classified as Usher syndrome genetic subtype USH1D or USH1F, demonstrated the typical signs of severe cochleosaccular degeneration. Present cases and cases from the literature were reviewed in search of an explanation for the above-described differences in histologic findings.     

An ultrastructural study on vestibular sensory cells in a new-mutant mouse.

The ultrastructural characteristics of the vestibular epithelium and light microscopical study of the central nervous system of a strain of new-mutant mice were analyzed. For the vestibular study, we used 72 homozygotes with ages ranging from 10 days to 18 months. The most striking findings observed in these mice were the disarray of the stereocilia of the utricular and saccular maculae and disintegration of the saccular otoconia. Many hair cells displayed abnormality of the stereocilia such as reduced number, disorganized distribution, and giant cilia, although the hair cell cytoplasm, including the nerve terminals, became fully developed. Demineralization of the saccular otoconia was age dependent, and a complete loss of the saccular hair cells was demonstrated. In conjunction with the disarray of the outer hair cells of the cochlea, morphological manifestation of the gene abnormality of these mice was related to immaturation of the stereociliary tufts. Because no morphological abnormality was observed in the central nervous system, the abnormal behavior in these mice was primarily correlated with morphological abnormalities of the vestibule.     

The Cogan syndrome

Cogan's Syndrom is the clinical entity of non syphilitic interstitial keratitis with vestibuloauditory symptoms. Although the disease is not rate the pathohistological findings in temporal bones are only reported twice. Our communication deals with observations made on a temporal bone out of O. Mayer's collection. The most striking findings are: the endolymphatic hydrops, the degeneration of the organ of Corti, the pathology of the ductus reuniens, the fibrosis within the cisterna perilymphatica, the destruction of the maculae and the most uncommon ossification within the scala vestibuli of the basal turn. The vessels seem to show signs of angitis.