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1.
To determine whether any differences exist in potassium circulation between the scala vestibuli and scala tympani, we recorded the change in K+ activity in both scalae of the guinea pig cochlea at the basal and third turns, using a double-barrelled, K+-sensitive microelectrode after perfusion with artificial perilymph containing 20 mM KCl and 130 mM NaCl. K+ activity increased immediately after the start of perfusion and decreased after its completion. The rates of decrease of K+ activities were approximately 1.0 mEq/l per min in the scala vestibuli of the basal and third turns, also 1.0 mEq/l per min in the scala tympani of the basal turn, and approximately 0.5 mEq/l per min in the scala tympani of the third turn. The rate of decrease of K+ activity in the scala tympani was significantly slower in the third turn than in the basal turn. Blockage of the cochlear aqueduct depressed the rate of decrease of K+ activity in the scala tympani more in the basal turn than in the third turn. These results suggest that there is a difference in potassium circulation between the scala vestibuli and scala tympani, and that the cochlear aqueduct plays an important role in potassium circulation in the perilymph of the scala tympani.  相似文献   

2.
Although intratympanic (IT) administration of drugs has gained wide clinical acceptance, the distribution of drugs in the inner ear following IT administration is not well established. Gadolinium (Gd) has been previously used as a marker in conjunction with magnetic resonance imaging (MRI) to visualize distribution in inner ear fluids in a qualitative manner. In the present study, we applied gadolinium chelated with diethylenetriamine penta-acetic acid (Gd-DTPA) to the round window niche of 12 guinea pigs using SeprapackTM (carboxlmethylcellulose-hyaluronic acid) pledgets which stabilized the fluid volume in the round window niche. Gd-DTPA distribution was monitored sequentially with time following application. Distribution in normal, unperforated ears was compared with ears that had undergone a cochleostomy in the basal turn of scala tympani and implantation with a silastic electrode. Results were quantified using image analysis software. In all animals, Gd-DTPA was seen in the lower basal scala tympani (ST), scala vestibuli (SV), and throughout the vestibule and semi-circular canals by 1 h after application. Although Gd-DTPA levels in ST were higher than those in the vestibule in a few ears, the majority showed higher Gd-DTPA levels in the vestibule than ST at both early and later time points. Quantitative computer simulations of the experiment, taking into account the larger volume of the vestibule compared to scala tympani, suggest most Gd-DTPA (up to 90%) entered the vestibule directly in the vicinity of the stapes rather than indirectly through the round window membrane and ST. Gd-DTPA levels were minimally affected by the implantation procedure after 1 h. Gd-DTPA levels in the basal turn of scala tympani were lower in implanted animals, but the difference compared to non-implanted ears did not reach statistical significance.  相似文献   

3.
Computer-aided 3-D temporal bone anatomy for cochlear implant surgery   总被引:1,自引:0,他引:1  
To define anatomical relationships important in cochlear implantation, computer-aided three-dimensional reconstruction and measurement of middle and inner ear structures in six normal temporal bones were performed. Our findings were as follows: 1. When viewed from the posterior hypotympanotomy (facial recess) approach, the inferior 10% to 30% of the round window (RW) membrane was visible in only half the cases. 2. The most inferior portion of the basal turn of the scala tympani was not only inferior but also slightly anteriorly behind the RW membrane in more than half the cases. 3. The shortest distances from the aperture of the RW niche and from the margin of the RW to the stapes head were 2.38 +/- 0.33 and 2.15 +/- 0.22 mm, respectively. 4. The distance between the RW and the most inferior portion of the basal turn scala tympani was 5.15 +/- 0.34 mm. 5. The direction of the electrode advancement lay at a sharp angle to the inferior part of the RW (mean 31.9 +/- 3.6 degrees). 6. The direction from the RW to the most inferior portion of the basal turn scala tympani lay 16.0 +/- 5.3 degrees anteroinferior to the direction of the advancement of the electrode to the RW. 7. The distance between the margin of the RW and the basilar membrane of the cochlea was 0.58 +/- 0.10 mm at the superior aspect of the RW, and was 1.23 +/- 0.12 mm at the lateral aspect of the RW. 8. Dissecting away less than 1 mm (mean 0.7 +/- 0.27 mm) of the RW margin inferiorly or inferolaterally was enough to permit straight insertion of the electrode in most cases.  相似文献   

4.
In order to find out whether it is possible to visualize experimental endolymphatic hydrops in the cochlea with magnetic resonance imaging (MRI) at 4.7 T, we used 11 guinea pigs. Five normal guinea pigs were used as controls. Early manifestation of endolymphatic hydrops was evaluated in endolymphatic sac (ES)-intact animals (n = 6), and advanced manifestation in ES-damaged animals (n = 5) by means of MRI with gadolinium-diethylenetriaminepentaacetate-bismethylamide (Gd-DTPA-BMA) contrast agent. Hearing was tested with electrocochleography. The surface area of 3 partitions of the cochlea was used to quantify endolymphatic hydrops. The fine structure of the 3 partitions of the cochlea was visualized with MRI in all animals, as Gd-DTPA-BMA appeared mainly in the scala tympani and scala vestibuli. As early as 5 days after endolymphatic sac surgery, endolymphatic hydrops started to appear as visualized by MRI and also verified with histology. Severe damage to the inner ear barrier with Gd-DTPA-BMA leakage into the scala media was detected with MRI in 1 ES-damaged animal that had a 60-dB hearing loss. To conclude, endolymphatic hydrops can be visualized with high-resolution MRI by means of Gd-DTPA-BMA, and it is possible to quantify the extent of endolymphatic hydrops. Damage to the inner ear barrier or possible rupture of membranes can be shown with the assistance of Gd-DTPA-BMA.  相似文献   

5.
C Güldner  R Weiß  B Eivazi  S Bien  JA Werner  I Diogo 《HNO》2012,60(9):817-822

Introduction

Due to the increasing number of cochlear implantations (CI), postoperative radiological verification of the electrode position, e.g., with respect to quality control, plays a central role. The aim of this study was to evaluate the intracochlear position of deep inserted electrodes by cone beam computed tomography (CBCT).

Materials and methods

CBCT data sets (Accu-I-tomo, Morita, Kyoto, Japan) of 22?patients (28?ears operated between 2008 and 2011) were retrospectively analyzed. All patients underwent a CI (round window approach) with deep insertion of the electrode (Flex soft or standard electrode from MedEl?). CBCT data were analyzed for intracochlear position of the electrode (scala vestibuli, scala tympani, malposition between the scalae) and the certainty of this evaluation.

Results

All ears could be evaluated with the status certain or relatively certain in the basal turn of the cochlea. Thereby, the electrode array was inserted into the scala tympani in 93% (n?=?26). Primary insertion into the scala vestibuli and the scala media was observed in 3.5% of the ears, respectively. In the apical part of the cochlea, only 32% (n?=?9 ears) could be evaluated with relative certainty. The remaining 68% of cases could not be evaluated. Of the 32% interpretable cases in the apical part of the cochlea, 25% (n?=?7) were inserted into the scala tympani, 3.5% (n?=?1) into the scala vestibuli, and 3.5% (n?=?1) were malpositioned between the scalae.

Conclusion

The exact evaluation of the intracochlear position of the electrode by CBCT is only possible in the basal turn of the cochlea. In deep insertion, determination of the position in the medial and apical parts of the cochlea by CBCT is still not possible. Furthermore, the round window approach allows reliable implantation into the scala tympani.  相似文献   

6.
Math1基因导入成年大鼠前庭有效途径的探索   总被引:1,自引:1,他引:0  
目的探索Math1基因导人大鼠前庭简便有效的方法和途径,为前庭功能障碍基因治疗的相关研究提供参考。方法将20只成年Wistar大鼠分为缺失E1、E3基因片段且构建有Math1基因和增强型绿色荧光蛋白报告基凶的复制缺陷型腺病毒(adnovirus—Math1—enhanced green fluorescence protein,Ad—Math1—EGFP)鼓阶导入组和前庭阶导人组.Ad—Math1—EGFP导入组大鼠在右耳通过耳蜗底转鼓阶或前庭阶打孔的方法导人物理滴度为2.1×1011v.p/ml的上述腺病毒5μl。在导入3天、7天后分别将动物处死,进行GFP表达观察。结果导入Ad—Mathl—EGFP3天后,前庭阶导入组大鼠的前庭终末器官及耳蜗均出现明显的GFP阳性表达;而鼓阶导入组的表达则局限于耳蜗,7天后仍未见前庭终末器官的GFP阳性表达。结论耳蜗底转前庭阶打孔可以作为Math1基因导入大鼠前庭简便有效的途径。  相似文献   

7.
OBJECTIVE: To study the surface microstructure of the scala tympani and scala vestibuli in humans and cats using scanning electron microscopy. DESIGN: Cochleas from 8 humans and 4 cats were harvested and the otic capsule and soft tissue removed before the cochleas were prepared for scanning electron microscopy. Micrographs were taken of the bony surface of both the scala tympani and scala vestibuli in each cochlear turn. The diameter and density of the micropores (canaliculi perforantes) and the thickness of the osseous spiral lamina (OSL) adjacent to Rosenthal's canal was measured. RESULTS: The human cochlea exhibits numerous canaliculi on the surface of the scala tympani, particularly associated with the OSL. There was a large range of diameters in the modiolar region of the OSL (0.2-23.0 micro m). The OSL was also very thin, with a mean thickness of 26.8 micro m in the base, tapering to 8.4 micro m in the apical turn. Far fewer canaliculi were evident in the scala vestibuli. Examination of the cat cochleas showed a similar distribution of canaliculi to that seen in the human; however, they were smaller in diameter and the OSL was thicker than in the human cochleas. CONCLUSIONS: The OSL is a thin and highly porous bony lamina that would appear to provide an open and extensive fluid communication channel between the scala tympani and Rosenthal's canal. These findings have important implications for the design and application of perimodiolar cochlear implant electrode arrays and may provide a potential route for drug- and cell-based cochlear therapies delivered via the scala tympani.  相似文献   

8.
In individuals with severe-to-profound hearing loss, cochlear implants (CIs) bypass normal inner ear function by applying electrical current directly into the cochlea, thereby stimulating surviving auditory nerve fibers. Although cochlear implants are able to restore some auditory sensation, they are far from providing normal hearing. It has been estimated that up to 75% of the current injected via a CI is shunted along scala tympani and is not available to stimulate auditory neurons. The path of the injected current and the consequent population of stimulated spiral ganglion cells are dependent upon the positions of the electrode contacts within the cochlea and the impedances of cochlear structures. However, characterization of the current path remains one of the most critical, yet least understood, aspects of cochlear implantation. In particular, the impedances of cochlear structures, including the modiolus, are either unknown or based upon estimates derived from circuit models. Impedance values for many cochlear structures have never been measured. By combining the hemicochlea preparation, a cochlea cut in half along its mid-modiolar plane, and the four-electrode reflection-coefficient technique, impedances can be measured for cochlear tissues in a cochlear cross section including the modiolus. Advantages and disadvantages of the method are discussed in detail and electrical impedance measurements obtained in the gerbil hemicochlea are presented. The resistivity values for the cochlear wall in Ωcm are, 528 (range: 432–708) for scala media 3rd turn, 502 (range: 421–616) for scala tympani 3rd turn and scala vestibuli 2nd turn, 627 (range: 531–759) for scala media 2nd turn, 434 (range: 353–555) for scala tympani 2nd turn and scala vestibuli basal turn, 434 (range: 373–514) for scala media basal turn, and 590 (range: 546–643) for scala tympani basal turn. The resistivity was 455 Ωcm (range: 426–487) for the modiolus.  相似文献   

9.
After the oral administration of 50% glycerol (12 mL/kg), serum, CSF and inner ear fluids from scala tympani perilymph, scala vestibuli perilymph, and scala media endolymph were collected from normal guinea pigs under sodium pentobarbital anesthesia (25-35 mg/kg). The sodium and potassium concentrations were determined by microflame photometry. Increases in sodium concentrations were found in CSF, scala tympani perilymph, scala vestibuli perilymph, and cochlear endolymph. No significant change was observed in the serum. These sodium increases were considered to be due to the dehydration caused by the osmotic action of glycerol. Potassium concentration was increased only in scala tympani perilymph. Oral administration of glycerol was found to be more gradual and effective in dehydration compared to intravenous injection.  相似文献   

10.
Summary Serum, cerebrospinal fluid (CSF), scala vestibuli perilymph, and scala tympani perilymph were collected from 85 normal guinea pigs both before and after i.v. administration of glycerol (1 ml/kg), and the sodium and potassium concentrations were assessed using a microflame photometer. Marked increases in sodium concentrations were observed in scala tympani perilymph and CSF, while there was a slight decrease in the serum and there was no significant change in scala vestibuli perilymph. These increases in sodium concentrations are considered to occur in the dehydration process in the body fluids mentioned above. On the other hand, increase in the potassium concentrations was found only in scala vestibuli perilymph and thus cannot be explained by simple dehydration process. This potassium elevation in scala vestibuli perilymph should be understood by further experiment on endolymph. It became evident that scala vestibuli perilymph differs from scala tympani perilymph and CSF in the dynamics of electrolytes after glycerol administration. In this regard, the nature of the scala vestibuli as fluid space should be studied in future. The above findings obtained in the present study may imply the significance in elucidating the glycerol effect on hearing of endolymphatic hydrops case.This study was funded in part by a grant from the Ministry of Education, Science, and Culture, Japan  相似文献   

11.
目的观察血管内皮细胞生长因子(vascularendothelialgrowthfactor, VEGF)能否改变血迷路屏障和血外淋巴屏障的物质转运作用。方法11只300 ~900g雌雄兼并的杂色豚鼠在甲苯噻嗪(16mg/kg)和氯氨酮(60mg/kg)基础麻醉下接受手术,通过圆窗膜(明胶海绵吸附)将VEGF(6耳)或磷酸盐缓冲液(PBS, 5耳)投放至内耳。用T1对比剂二乙烯三胺五乙酸双甲酰胺钆(gadolinium diethylenetriamine pentaacetate bismethylamide, Gd DTPA BMA)作为内耳屏障转运示踪剂,用4 7T场强, 40cm孔径的BrukerBiospecAvance47 /40试验磁共振系统进行豚鼠耳蜗二维磁共振成像观测,用Paravision软件进行图像密度分析,用AdobePhotoshop6 0软件进行图像呈示。结果圆窗膜投放PBS未影响血外淋巴屏障渗透性变化。圆窗膜投放VEGF可显著增强处理侧血外淋巴屏障渗透性,VEGF处理的耳蜗鼓阶内Gd DTPA BMA转运显著增加(P<0 01 ), VEGF处理的耳蜗前庭阶内Gd DTPA BMA转运也显著增加(P<0 01)。VEGF处理的耳蜗中阶内Gd DTPA BMA转运无明显增加(P>0 05)。结论VEGF显著增强血外淋巴屏障的物质转运作用并可能有利于内耳在各种有害环境下的代偿及修复。  相似文献   

12.
The classic approach for cochlear implant surgery includes mastoidectomy and posterior tympanotomy. The middle cranial fossa approach is a proven alternative, but it has been used only sporadically and inconsistently in cochlear implantation.ObjectiveTo describe a new approach to expose the basal turn of the cochlea in cochlear implant surgery through the middle cranial fossa.MethodFifty temporal bones were dissected in this anatomic study of the temporal bone. Cochleostomies were performed through the middle cranial fossa approach in the most superficial portion of the basal turn of the cochlea, using the meatal plane and the superior petrous sinus as landmarks. The lateral wall of the internal acoustic canal was dissected after the petrous apex had been drilled and stripped. The dissected wall of the inner acoustic canal was followed longitudinally to the cochleostomy.ResultsOnly the superficial portion of the basal turn of the cochlea was opened in the fifty temporal bones included in this study. The exposure of the basal turn of the cochlea allowed the visualization of the scala tympani and the scala vestibuli, which enabled the array to be easily inserted through the scala tympani.ConclusionThe proposed approach is simple to use and provides sufficient exposure of the basal turn of the cochlea.  相似文献   

13.
A 58-year-old man, in whom the cochlear implant (CI) had been inserted into the left ear, had right middle-ear cancer. The CI was removed immediately before receiving subtotal removal of right temporal bone. Four months later, the CI was again inserted in his left cochlea. Because of obliterated scala tympani, the 22 active electrodes of the CI were placed into the scala vestibuli. After the surgery, the patient complained that he experienced rotary vertigo and “jumbling of vertical direction” of objects on walking. Using rotation test, we evaluated vestibular function of remaining left ear. Numerous horizontal nystagmus beats were induced during earth-vertical axis rotation, whereas vertical downbeat nystagmus was scarcely induced during off-vertical axis rotation. The horizontal vestibulo-ocular reflex (VOR) was almost normally induced by sinusoidal stimulation at 0.8 Hz. These data suggest that the scala vestibuli insertion of CI would be not so invasive against the lateral semicircular canal.  相似文献   

14.
OBJECTIVE: To use the improved resolution available with 64-slice multidetector computed tomography (MDCT) in vivo to localize the cochlear implant electrode array within the basal turn. STUDY DESIGN: Sixty-four-slice MDCT examinations of the temporal bones were retrospectively reviewed in 17 patients. Twenty-three implants were evaluated. SETTING: Tertiary referral facility. PATIENTS: All patients with previous cochlear implantation evaluated at our center between January 2004 and March 2006 were offered a computed tomographic examination as part of the study. In addition, preoperative computed tomographic examinations in patients being evaluated for a second bilateral device were included. INTERVENTION: Sixty-four-slice MDCT examination of the temporal bones. MAIN OUTCOME MEASURE: Localization of the electrode array within the basal turn from multiplanar reconstructions of the cochlea. RESULTS: Twenty-three implants were imaged in 17 patients. We were able to localize the electrode array within the scala tympani within the basal turn in 10 implants. In 3 implants, the electrode array was localized to the scala vestibuli. Migration of the electrode array from scala tympani to scala vestibuli was observed in three implants. Of the 7 implants in which localization of the electrode array was indeterminate, all had disease entities that obscured the definition of the normal cochlear anatomy. CONCLUSIONS: Sixty-four-slice MDCT with multiplanar reconstructions of the postoperative cochlea after cochlear implantation allows for accurate localization of the electrode array within the basal turn where normal cochlear anatomy is not obscured by the underlying disease process. Correlating the position of the electrode in the basal turn with surgical technique and implant design could be helpful in improving outcomes.  相似文献   

15.
High-resolution magnetic resonance imaging of the human temporal bone.   总被引:2,自引:0,他引:2  
A magnetic resonance imaging (MRI) system (Hitachi, Naka, Japan) with a superconductive magnet running at 2.11 T was used to obtain 2-mm-thick slices of fixed, decalcified and celloidin-embedded human temporal bone. The temporal bone was then sectioned and stained for routine histological evaluation. Both the MR images and the histological sections were in the mid-modiolar slice plane, and comparable images and sections were analyzed to confirm the identity of the inner-ear structures visualized on the MR images. The cochlear duct, scala tympani, scala vestibuli and basement membrane of all three cochlear turns were clearly imaged on MRI. In addition, the vestibule and three semicircular ducts were also clearly seen. This study raises the possibility of some day using MRI for the diagnosis of inner-ear diseases.  相似文献   

16.
Cochlear partition displacement responses to rising and falling frequency sweeps were inferred from cochlear microphonic potentials recorded from three basal turn locations in the guinea pig cochlea. Relative phase measures of microphonic potentials recorded from the three locations suggested that displacements of the partition toward either scala vestibuli or scala tympani occurred closely together in time for rising sweeps and were dispersed in time for falling sweeps. These differences in peripheral response patterns to sweeps may explain, in part, asymmetric neural discharges elicited from higher neural centers.  相似文献   

17.
Perilymph pharmacokinetics was investigated by a novel approach, in which solutions containing drug or marker were injected from a pipette sealed into the perilymphatic space of the lateral semi-circular canal (LSCC). The cochlear aqueduct provides the outlet for fluid flow so this procedure allows almost the entire perilymph to be exchanged. After wait times of up to 4 h the injection pipette was removed and multiple, sequential samples of perilymph were collected from the LSCC. Fluid efflux at this site results from cerebrospinal fluid (CSF) entry into the basal turn of scala tympani (ST) so the samples allow drug levels from different locations in the ear to be defined. This method allows the rate of elimination of substances from the inner ear to be determined more reliably than with other delivery methods in which drug may only be applied to part of the ear. Results were compared for the markers trimethylphenylammonium (TMPA) and fluorescein and for the drug dexamethasone (Dex). For each substance, the concentration in fluid samples showed a progressive decrease as the delay time between injection and sampling was increased. This is consistent with the elimination of substance from the ear with time. The decline with time was slowest for fluorescein, was fastest for Dex, with TMPA at an intermediate rate. Simulations of the experiments showed that elimination occurred more rapidly from scala tympani (ST) than from scala vestibuli (SV). Calculated elimination half-times from ST averaged 54.1, 24.5 and 22.5 min for fluorescein, TMPA and Dex respectively and from SV 1730, 229 and 111 min respectively. The elimination of Dex from ST occurred considerably faster than previously appreciated. These pharmacokinetic parameters provide an important foundation for understanding of drug treatments of the inner ear.  相似文献   

18.
Radial communication between ST and SV was measured in the sealed cochlea by monitoring the dispersal of an ionic tracer, trimethylphenylammonium (TMPA) injected in the form of a minute bolus. Tracer movements were recorded by a pair of ion-selective electrodes sealed into the injected and non-injected scalae close to the injection site. Measurements were made in the basal or third turn of the guinea pig cochlea. In the third turn, radial communication occurred rapidly with a ST half time from ST to SV of 25 min and from SV to ST of 26 min. In the basal turn the communication was markedly slower, with a ST half time from ST to SV of 170 min and from SV to ST of 240 min. However, the difference between the basal and third turns can be shown to arise almost totally from differences in cross-sectional area of the perilymphatic scalae. When normalized with respect to scala cross-section, the process of tracer movement across the spiral ligament is similar in the basal and third turns. These results demonstrate that radial communication between scala tympani and scala vestibuli is an important route which must be considered in studies involving perilymph.  相似文献   

19.
It has been widely believed that drug entry from the middle ear into perilymph occurs primarily via the round window (RW) membrane. Entry into scala vestibuli (SV) was thought to be dominated by local, inter-scala communication between scala tympani (ST) and SV through permeable tissues such as the spiral ligament. In the present study, the distribution of the ionic marker trimethylphenylammonium (TMPA) was compared following intracochlear injections or applications to the RW niche, with or without occlusion of the RW membrane or stapes area. Perilymph TMPA concentrations were monitored either in real time with TMPA-selective microelectrodes sealed into ST and SV, or by the collection of sequential perilymph samples from the lateral semi-circular canal. Local inter-scala communication of TMPA was confirmed by measuring SV and ST concentrations following direct injections into perilymph of ST. Application of TMPA to the RW niche also showed a predominant entry into ST, with distribution to SV presumed to occur secondarily. When the RW membrane was occluded by a silicone plug, RW niche irrigation produced higher concentrations in SV compared to ST, confirming direct TMPA entry into the vestibule in the region of the stapes. The proportion of TMPA entering by the two routes was quantified by perilymph sampling from the lateral semi-circular canal. The TMPA levels of initial samples (originating from the vestibule) were markedly lower when the stapes area was occluded with silicone. These data were interpreted using a simulation program that incorporates all the major fluid and tissue compartments of the cochlea and vestibular systems. From this analysis it was estimated that 65% of total TMPA entered through the RW membrane and 35% entered the vestibule directly in the vicinity of the stapes. Direct entry of drugs into the vestibule is relevant to inner ear fluid pharmacokinetics and to the growing field of intratympanic drug delivery.  相似文献   

20.
OBJECTIVE: To investigate the pharmacokinetics of gadolinium in the perilymphatic fluid spaces of the cochlea in vivo using high-resolution MRI to obtain information concerning perilymph formation. MATERIAL AND METHODS: A Bruker Biospec Avance 47/40 experimental MRI system with a magnetic field strength of 4.7 T was used. Anesthetized pigmented guinea pigs were injected with the contrast agent Gd-diethylenetriaminepentaacetic acid-bismethylamide and placed in the magnet. The signal intensity of Gd in the tissues was used as a biomarker for dynamic changes in the perilymphatic fluid. RESULTS: The most rapid uptake of Gd in the perilymphatic fluid spaces occurred in the lower part of the modiolus, followed by the second turn of the scala tympani. Within the scala tympani, the distribution of Gd in the basal turn was significantly lower than that in the other turns. Destruction of the cochlear aqueduct was followed by an increase in Gd uptake in the perilymph instead of a reduction. CONCLUSIONS: These findings offer further evidence that the pervasive perilymphatic fluid derives from the cochlear blood supply via the cochlear glomeruli, which are in close proximity to the scala tympani within the modiolus, and the capillary in the spiral ligament. Cerebrospinal fluid communicates with perilymph via the cochlear aqueduct but is not the main source of perilymph. These findings are of relevance to the treatment of inner ear diseases, as well as to our understanding of the flow and source of perilymphatic fluid.  相似文献   

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