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Biomedical subjects

E Stennert

Publications and source records attributed to E Stennert.

At least 37 records · Page 2Linked to original sources

[Temporal inconsistency of neuromyography of the facial nerve in healthy probands].

Facial neuromyography is an objective electrophysiologic measurement used to assess prognosis for recovery from facial paralysis. In the present study variability over time of the amplitude ratio in healthy subjects was investigated. Twenty healthy subjects underwent four neuromyographic tests at intervals of one week. The study group consisted of 12 males and 8 females. Ages ranged from 23 to 36 years. The stimulation intensity required for supramaximal stimulation was 14.6 mA on average. The mean of the intra-individual side-to-side difference of the evoked compound action potential was 32.5%. Results of the four repeated tests ranged from no to 80% side-to-side differences in the same individual. The hypothesis of symmetrical evoked facial compound potentials was not supported by our data. As with previous investigators we found significant side-to-side differences in healthy subjects. Furthermore, we could also show for the first time that the amplitude ratio was not constant in every individual at repeated measurements. We conclude that there is a physiological variability that must be taken into account in the interpretation of facial nerve neuromyography.

Adult↗

[Value of fine needle puncture cytology in neoplasms of the parotid gland].

BACKGROUND: In many parts of Germany fine-needle aspiration biopsy (FNAB) is still not part of the routine preoperative diagnostic evaluation of salivary gland neoplasms. Most opponents consider the study unnecessary and recommend that all salivary gland neoplasms should be excised. OBJECTIVE: Because of this an evaluated the ability of FNAB to provide an accurate diagnosis of parotid gland neoplasms. PATIENTS AND METHOD: Between January 1992 and October 1995, 336 patients referred for operative therapy of salivary gland neoplasms underwent retrospective analysis of preoperative FNAB compared with the excised tumor histology. RESULTS: Results showed that the FNAB had a sensitivity of 93.1%, a specificity of 99.2%, a positive predictive value of 93.1%, a negative predictive value of 99.2% and an accuracy of 98.6%. Complications were observed in less than 1%. DISCUSSION: Our findings demonstrated that the FNAB is a safe diagnostic tool that has a reliable sensitivity and high specificity for the assessment of salivary gland pathology. Since many malignant salivary gland neoplasms present with a virtual lack of symptoms indicating actual malignancy we believe that there is need for FNAB in routine preoperative diagnostic testing.

Adolescent↗

[Dependence of uni- and bilateral olfactory capacity on nasal airflow in patients with chronic rhinosinusitis].

OBJECTIVE: Olfactory dysfunction is a common finding in patients with chronic rhinosinusitis (CRS). The aim of this study was to investigate the relationship between olfaction and nasal flow as determined by active anterior rhinomanometry (AAR). METHODS: Thirty patients with CRS were included in this series. Patients' histories and subjective assessments of olfaction were documented with questionnaires. Smell tests, assessments of olfaction, AAR, and results of rhinoscopy were recorded, including odor identification, discrimination and thresholds measured with the "Sniffin' Sticks"-test. RESULTS: CRS influenced olfactory performances variably in the different tests: 10% of the patients had pathologic rates of odor discrimination, compared with 34% in odor identification and 73% in thresholds. Statistical analyses (using Spearman's test) indicated a significant correlation between nasal airflow and odor identification screening (r29 = 0.56, P < 0.01) and n-butanol-threshold (r29 = 0.44, P < 0.05), respectively. CONCLUSION: Olfactory performance in CRS was correlated to several parameters of nasal airflow measured with AAR. The n-butanol threshold test revealed the most frequent pathological results and may best be used for detecting olfactory disorders. However, because a number of factors may influence olfactory dysfunction in CRS, our findings must be evaluated in a lager series.

Adolescent↗

[Detection of nitric oxide synthases in physiological and pathophysiological processes of the nasal mucosa].

Nitric oxide (NO) can play an important role in the regulation of vascular tone and neurotransmission, as well as in non-specific immunoreactions and inflammation in a variety of tissues. Increased quantities of nitric oxide in respired air can be measured during inflammatory processes. However, the exact role and precise sources of NO under physiological and pathophysiological conditions within the airways remain to be defined. Three isoforms of NO-synthases can be distinguished: two constitutive (neuronal and endothelial) Ca(2+)-dependent cNOS and one inducible Ca(2+)-independent iNOS (NOS II). Constitutive NOS (NOS I and III) release a basal amount of NO under physiological conditions. The inducible form once expressed can catalyse the generation of large quantities of NO. Many kinds of cells, such as macrophages, neutrophils, endothelium and smooth muscle cells, are capable of expressing NOS II. Since all isoforms of NO-synthase seem to be present in nasal tissues and the expression of iNOS under inflammatory conditions seems to be responsible for excessive production of NO, the distribution of NOS-isoforms (especially NOS II) in normal and inflammatory nasal tissue, as well as the exact requirements for expression of iNOS remain to be proven. Non-inflamed fresh human nasal mucosa from the middle turbinate was compared immuno-histologically with nasal mucosa having the typical findings of chronic polypoid rhinosinusitis (i.e., polypoid middle turbinates and polyps of the middle nasal duct). In order to gain more information about the mechanisms of acute inflammation, non-inflamed vital turbinates were incubated in vitro with the proinflammatory substances bacterial lipopolysaccharides (LPS) and tumor necrosis-factor (TNF) for 30, 60, 90, 120, 180 and 240 min. Subsequent to exposure to NADPH-diaphorase and immunostaining with specific antibodies to each NOS-isoform, clearly increased or initiated expressions of inducible NOS (iNOS) in blood vessels, glands, macrophages and epithelium of chronically inflamed and LPS-incubated nasal tissue became apparent in comparison to the non-inflamed controls. In contrast, NOS III/NOS I seemed to be not affected. The onset of immunohistochemically recognizable NOS II expression was observed after 90 min incubation with of LPS/TNF-alpha. Polypoid tissue showed a strong increase in submucosal thickness and a high infiltration of iNOS-positive leukocytes (granulocytes and macrophages) compared to the LPS-incubated non-inflamed specimens. These findings implicate NOS II generated nitric oxide as a key agent for causing swelling, secretion and obstruction in patients with acute and chronic polypoid or allergic rhinitis. These findings also suggest that molecular NO has to be considered in the pathophysiology of chronic polypoid rhinosinusitis.

Chronic Disease↗

[Anatomy of the glottis and subglottis in the pediatric larynx].

BACKGROUND: The morphological development of the human larynx during the first years of life has previously not been studied in detail and has mainly been described on a qualitative basis. This study seeks to provide detailed morphometric data on the regular anatomy of the vocal cords, the subglottic airway and the tracheal airway dimensions gained from plastinated whole organ serial sections of 43 infant larynges and to determine morphological changes with age. Such information may be useful for the understanding of pediatric airway disease or for laryngeal surgery in children. MATERIAL AND METHODS: The larynges of 43 children aged 1 to 60 months were plastinated. Whole organ serial sections were obtained by cutting the resulting specimen with a diamond band saw. Morphometry of whole-organ sections was accomplished using a high resolution, computer-based image analyzer. The total length of the glottis, length of the cartilaginous and ligamentous glottis, subglottic cartilaginous cross-section, subglottic airway and tracheal airway were determined for each specimen. RESULTS: The subglottic airway increases considerably in size during the first 2 years of life (from 13 to 28 mm2 in the means). Further growth seems to follow a linear mode. The relative proportion of the mucosal lining of the subglottic airway decreases likewise. While it occupies approximately 50% of the subglottic cartilaginous cross-section during the first two years of age, its relative proportion decreases to some 30 to 40% between age three to five. Other than in adults, and comparable to most mammals, the cartilaginous glottis accounts for 60 to 75% of the vocal folds' length in children under two years of age. The anterior ligamentous part of the glottis outsizes its posterior cartilaginous portion during the third year of life. CONCLUSION: This study supplies detailed morphometric data on the growth and structure of the human larynx during the first years of life that have not been available to date. Previous studies on the anatomical configuration of the infant larynx have focused on the the perinatal larynx, the prepuberal and puberal larynx, and the development of collagen fibres in the developing larynx. The human larynx has undergone significant evolutionary adaptations. Among them are the descent of the larynx, the capability of vocal fold adjustment in length, tension and shape, and the prominent configuration of the membranous part of the vocal folds as opposed to the cartilaginous part. The infant larynx is not just a miniature of the adult organ. It shows differences in its position relative to the vertebrate column, in the composition of cartilages and soft tissues, and in environmental adaptation. The present study is the first to supply detailed morphometric data on the growth and structure of the human larynx during the first five years of life and on the morphological changes of the larynx during this period. From these data it seems that some of the adaption of the human larynx as opposed to other vertebrates are not fully developed at birth, but undergo postnatal maturation. The relative proportions of the cartilaginous and membranous parts of the vocal folds clearly demonstrate this maturation process: While the posterior "respiratory" glottis accounts for some sixty to 75% of the total glottic length in newborns, its relative proportion decreases throughout the first years of life and finally equals the proportions of the adult larynx. Other than in adults, and in accordance with the literature, no sexual dimorphism of the larynx could be detected in this series of infant larynges. Morphometric data on the growth and structure of the human vocal folds and the subglottic airway during childhood are presented. Plastinated whole organ serial sections were used in the study to show the infant laryngeal morphology. The study provides quantitative anatomical data of clinical interest that light up the anatomy of the pediatric airways.

Adult↗

[Antiphlogisitc-rheologic infusion therapy of acute idiopathic facial paralysis. Experiences and results of 344 cases].

Antiphlogistic-rheologic infusion therapy is a widespread and well-established treatment modality for acute idiopathic facial paralysis (AIFP) in many German centers of otorhinolaryngology. However, there is still a lack of convincing data concerning this regimen's functional results and side effects. The medical records of 344 patients who were treated for AIFP between 1987 and 1997 were analyzed retrospectively. In 239 cases there was reliable information on functional outcome. Therapy consisted uniformly of intravenous infusion with prednisolone (250 mg initially, then tapering over 18 days) and simultaneous administration of dextran and pentoxifylline. From 239 patients with non-recurrent palsy having received treatment within 12 days after onset, 92.1% recovered completely without sequelae. In case of incomplete palsy (House-Brackmann grade II-V), normal facial function was restored in 97.7% of cases. Results were significantly better in the group in which therapy had been started within 3 days after onset of palsy. Adverse effects occurred rarely and were transient and mild in most cases. High-dose prednisolone in combination with low-molecular dextran and pentoxifylline for AIFP is a safe treatment modality leading to recovery rates superior to the most optimistic observations of the natural course of Bell's palsy. In the absence of a definitive controlled trial, the present study, although retrospective, is considered valid to show the effectiveness of our protocol. In the light of our data and of other publications, early treatment with corticosteroids in sufficient dosage seems appropriate, while therapeutic nihilism in AIFP does not seem justified.

Adolescent↗

[Historical development of facial nerve surgery with special reference to hypoglossal-facial nerve anastomosis].

In the ancient times, Aristotle, Herophilos, and Galen discovered basic anatomical structures. Paul von Aegina, in the seventh century A.C., had the idea of a nerve suture, which was first performed in an animal 1000 years later by the Italian surgeon Gabriele Ferrara. Systematic investigations on nerve crossing date to the beginning of the nineteenth century and were conducted by Jean Pierre Flourens. Within 1 week in summer 1864, two French surgeons (Laugier and Nélaton) independently carried out the first nerve sutures in humans. Their observations of an immediate functional recovery of the appropriate muscles after suturing were discussed controversially in scientific circles. The first cross nerve suture of the facial nerve (accessory-facial anastomosis) was first performed by Sir Charles Ballance in 1895. In 1901, the German Werner Koerte was the first surgeon to perform a hypoglossal-facial anastomosis in humans. Surprisingly, the theoretical speculations on the good functional recovery, which was noted after these observations, remain up-to-date.

Anastomosis, Surgical↗

[Morphological connections between the Hypoglassal and facial nerve in the brain stem of the rat].

BACKGROUND AND OBJECTIVE: The perfect coordination and synchronization of hypoglossal and facial muscles during chewing, swallowing, breathing, and vocalization requires particular concomitant activities of the facial muscles. In contrast, no direct connection between the facial and hypoglossal nucleus on the level of the brain stem has been detected until now. PATIENTS/METHODS: Facial and hypoglossal nuclei of rats were identified on the basis of their antidromic field potential recorded after peripheral stimulation of the corresponding nerves. Stereotactically single or double fluorescence tracer injections (Biotin-Dextran, Fluorescine-Dextran, Rhodamine-Dextran, Fluoro Gold) were placed into the nuclei. RESULTS: Retrograde tracer injections into the facial nucleus consistently labeled small neurons in the hypoglossal nucleus. In reverse experiments the injection of anterograde tracers into the hypoglossal nucleus labeled fine caliber varicose nerve fibers, but no somata in the facial nucleus. Synchronous injections of different tracers into the facial and hypoglossal nucleus produced a small, but constant number of double-labeled cells in the parvocellular reticular formation. CONCLUSIONS: Both, hypoglossal interneurons projecting to the facial nucleus and neurons of the parvocellular reticular formation double-projecting to the facial and hypoglossal nucleus might play an important role in coordinated orofacial movements. Moreover, both populations of neurons might be responsible for the excellent postoperative results after hypoglossal-facial anastomosis.

Animals↗

Involvement of nitric oxide synthase in the physiology and pathophysiology of facial nerve function and dysfunction.

To date few reports have discussed the presence and function of nitric oxide (NO) in structures of the facial nerve. We performed nicotinamide adenine dinucleotide phosphate (NADPH-d)-diaphorase-histochemistry and immunohistochemistry on the intratemporal portion of the facial nerve, including the geniculate ganglion, of guinea pigs using specific antibodies to the three known isoforms of NO synthase and soluble guanylyl-cyclase (sGC). Normal facial nerves were compared to those treated intratympanically with bacterial lipopolysaccharides (LPS) and tumor necrosis factor-alpha (TNF-alpha). Both constitutive NOS isoforms and sGC could be detected in the bipolar ganglion cells of normal animals, while the inducible isoform (iNOS or NOS II) was not found. Endothelial NOS (NOS III) and sGC were present in blood vessels and were predominantly found in the perineurial sheath and less in the endoneurium. sGC could be detected in all fibers in a cross section of the facial nerve. LPS and TNF treatment led to the detection of iNOS in the perikaryia of the geniculate ganglion and the perineural sheath. These findings imply that NO may be involved in neurotransmission at least in the visceroafferent system. NO regulates vascular tone of nutrient blood vessels in the perineural sheath and endoneurium. The presence of sGC indicates that NO acts via its second messenger cGMP. NOS II expression may be a contributing factor to facial nerve palsy via two different mechanisms: NOS II-generated NO may lead to an overstimulation of the visceroefferent nerve fibers and motor fibers of the facial nerve. Dysregulation in facial nerve blood vessels could lead to edema and elevated pressure on the nerve within its osseous canal.

Animals↗

Transoral laser surgery for early glottic carcinoma.

This prospective study evaluates the oncological results of transoral laser surgery (TLS) for glottic carcinoma categorized Tis, T1 and T2 in a large, unselected group of 285 consecutive patients from a university-based referral center that uses transoral laser surgery as the standard approach to these tumors. Patients were treated between 1 January 1987 and 31 December 1996. Thirty-three patients had Tis disease, 174 T1 tumors and 113 T2. Main outcome measures were local control with initial therapy, ultimate local control, regional control, organ preservation, overall survival and cause-specific survival. The 5-year uncorrected actuarial survival for all 285 patients was 71.1%, and cause-specific actuarial survival was 98.7%. Local control with initial treatment was 85.9%, ultimate local control with salvage for local treatment failures 98.5%, and regional control 98.4%. In all, 94.3% had their larynges preserved after 5 years. Although favorable oncological results for early laryngeal carcinoma treated with laser surgery are supported this study, no definitive recommendations can be given for the best single treatment. Partial laryngectomies lead to the highest local control rates reported so far, radiotherapy is believed to preserve voice best and laser surgery is associated with time- and cost-effectiveness, low morbidity, fair local control rates and excellent re-treatment options in case of local failure. All specialists dealing with the treatment of early glottic carcinoma should be able to offer these different treatment modalities to their patients and to deal specifically with each patient's individual needs and preferences.

Carcinoma, Squamous Cell↗

Bell's palsy: a 10-year experience with antiphlogistic-rheologic infusion therapy.

OBJECTIVE: Treatment of idiopathic peripheral facial paralysis has remained controversial in many aspects. The authors report their experience with a protocol based on high-dose prednisolone with intravenous low-molecular-weight dextran and pentoxifylline. For this regimen, the term antiphlogistic-rheologic infusion therapy (ARIT) has been coined. STUDY DESIGN: Retrospective case-series review. SETTING: University-based hospital of otorhinolaryngology/head and neck surgery. PATIENTS: 334 patients suffering from sudden facial paralysis of unknown cause. INTERVENTION: Treatment consisted uniformly of prednisolone in a starting dosage of 250 mg tapering over 18 days and accompanying infusion of dextran and pentoxifylline. MAIN OUTCOME MEASURES: Facial nerve function after 6 months, adverse effects of therapy and comorbidity. RESULTS: From 239 patients with nonrecurrent palsy having received treatment within 12 days after onset, 92% recovered completely (House-Brackmann [HB] Grade I) without sequelae. In incomplete palsy (HB Grade II-V), normal facial function was restored in 97% of cases. Results were significantly better in the group in which therapy had been started within 3 days after the onset of palsy. Other factors such as old age, hypertension, or diabetes did not seem to influence the functional outcome in this series. Serious adverse effects requiring termination of therapy were observed in 1.2% of cases. CONCLUSION: ARIT for Bell's palsy is safe and leads to recovery rates superior to the most optimistic observations of the natural course.

Adolescent↗

Expression of inducible nitric oxide synthase (iNOS/NOS II) in the hydropic cochlea of guinea pigs.

Immunohistochemical investigations of the guinea pig cochlea, using a specific antibody to the inducible isoform of NO synthase (iNOS/NOS II), have been performed 3 weeks after closure of the right endolymphatic duct (n=7). Endolymphatic hydrops, the morphological substrate of Meniere's disease, became evident by distension of the Reissner's membrane. iNOS expression could be noted in endothelium, spiral ganglion cells, in nerve fibers, in supporting cells of the organ of Corti and cells of the spiral ligament. Temporal bones of non-operated controls (n=6) as well as of sham-operated animals (n=3) did not show structures positive to iNOS. These findings imply that iNOS-generated NO could be involved in the pathophysiology of cochlear dysfunction in Meniere's disease.

Animals↗

Changes of the compound action potential (CAP) and the expression of inducible nitric oxide synthase (iNOS/NOS II) in the cochlea under the inflammatory condition(1).

In this study, the effect of endotoxin on the guinea pig cochlea has been examined electrophysiologically and immunohistochemically. Bacterial lipopolysaccharide (LPS, 5 mg/ml, 0.2 ml) was injected into the middle ear trans-tympanically. The electrocochleograms were measured before, immediately upon, and 3, 6 and 12 h after the injection continuously with an electrode inserted into the facial canal. After each measurement, some of the animals were killed with an intracardiac perfusion of fixative, temporal bones were removed and were immunohistochemically examined for inducible nitric oxide synthase (iNOS/NOS II). On serial paraffin section, iNOS could be detected first after 3 h in the lateral wall, the supporting cells of the organ of Corti and in cells of the spiral ganglion and was observed up to 12 h. After the injection of LPS, the threshold of compound action potential became significantly worse after 12 h in the LPS group. These changes became evident first at higher frequency (8 kHz). These results suggest that iNOS-generated NO is involved in the cochlea dysfunction under inflammatory conditions.

Action Potentials↗

2[F]-fluoro-2-deoxy-D-glucose positron emission tomography is a sensitive tool for the detection of occult primary cancer (carcinoma of unknown primary syndrome) with head and neck lymph node manifestation.

BACKGROUND: The neck lymph nodes are a common site of metastases from carcinoma of unknown primary (CUP syndrome). 2[(18) F]-fluoro-2-deoxy-D-glucose positron emission tomography (18-FDG-PET) has been shown to be a sensitive tool for detecting primary malignant lesions as well as metastatic spread. We have prospectively investigated the sensitivity of 18-FDG-PET in detecting occult primary carcinomas with manifestation in the head and neck lymph nodes. METHODS: From May 1994 to July 1998, in 723 patients a cancer of the head and neck was diagnosed at the University of Cologne ENT outpatient clinic. The routinely performed staging procedures were chest radiography; full blood count; cervical and liver ultrasound; endoscopy of the nasopharynx, oropharynx, hypopharynx, larynx, and esophagus; and laboratory analyses. After the staging workup, in 27 of 723 patients (3.7%) CUP syndrome had to be presumed because the primary cancer could not be detected. In these patients 18-FDG-PET was performed, and images were reconstructed with a transmission-emission fusion technique. RESULTS: In 7 of 27 patients (26%) 18-FDG-PET revealed an unknown primary: in 2 a bronchial carcinoma, in 2 a nasopharyngeal carcinoma, in 1 a squamous cell carcinoma of the parotid gland, in 1 a squamous cell carcinoma of the hypopharynx, and in 1 a carcinoma of the tonsil. In 4 of 7 patients the occult primary tumor was removed surgically. In 8 of 27 patients therapeutic strategy was changed as a result of the 18-FDG-PET findings. CONCLUSION: 18-FDG-PET should be performed in all patients with CUP syndrome after conventional diagnostic workup fails to identify the primary.

Adenocarcinoma↗

[Regeneration after delayed nerve suture].

The influence of the time delay of a nerve suture on axonal regeneration after nerve lesion is still unknown. We used the rat as an animal model and studied the influence of a 14- and 224-day delayed hypoglossal-facial nerve anastomosis (HFA) and compared results to immediate HFA. After injection of horseradish peroxidase into the whiskerpad we counted the retrogradely labelled neurons in the hypoglossal nucleus 7-112 days after operation to quantify the axonal reinnervation. Additionally, the amplitude of the evoked compound action potential of the whiskerpad was measured after hypoglossal nerve stimulation. By 112 days after immediate HFA only 931 +/- 27 hypoglossal neurons reinnervated the muscle (for 75% of normal innervation). After 14 days delayed HFA reinnervation was accelerated and enhanced with 1293 +/- 81 (104%) neurons. Even after 224 days delayed HFA reinnervation was possible, with 760 +/- 80 neurons (61%) present. We conclude that short-term delayed nerve suture improves axonal reinnervation.

Anastomosis, Surgical↗

Expression of inducible nitric oxide synthase (iNOS/NOS II) in the cochlea of guinea pigs after intratympanical endotoxin-treatment.

Since NO is believed to be involved in cochlear physiology, presence of the constitutive isoforms of nitric oxide synthase (NOS), and the target enzyme of NO, soluble guanylyl cyclase (sGC) in structures of the mammalian cochlea have been demonstrated. To date, no reports have been published regarding the detection of the inducible isoform (NOS II) in the cochlea. In order to show the capability of iNOS expression in cochlear tissue, a mixture of proinflammatory bacterial lipopolysaccharides (LPS) and tumor necrosis factor alpha (TNF-alpha) was injected into the tympanic cavity of guinea pigs, vs. saline-solution as control. Paraffin sections of LPS/TNF-alpha treated and saline-treated cochleae (6 h) were examined immunohistochemically with specific antibodies to neuronal, endothelial and inducible NOS and to sGC. Initiated expression of iNOS in the cochlea was observed in the wall of blood vessels of the spiral ligament (SL) and the modiolus, in supporting cells of the organ of Corti, in the limbus, in nerve fibers and in a part of the perikarya of the spiral ganglion after LPS/TNFalpha-treatment. iNOS was not detected in saline-treated control tissue. Expression of both constitutive NOS-isoforms (endothelial and neuronal NOS) and of sGC showed no significant differences in both experimental groups. Endothelial eNOS and neuronal bNOS were detected co-localized in ganglion cells, in nerve fibers, in cells of the SL and in supporting cells of the organ of Corti, but not in sensory cells. Strong labeling for bNOS became evident in the endosteum of the cochlea, while in the endothelium of blood vessels and in the epithelium of the limbus only eNOS could be labeled. sGC could be detected in SL, in supporting and sensory cells of the organ of Corti, in nerve fibers, ganglion cells, in the wall of blood vessels and in the limbus-epithelium. While small amounts of NO, generated by bNOS and eNOS, seem to support the cochlear blood flow and auditory function as well as neurotransmission, high amounts of iNOS-generated NO could have dysregulative and neurotoxic effects on the inner ear during bacterial and viral infections of the middle and inner ear.

Animals↗

Expression of inducible nitric oxide-synthase in the vestibular system of hydropic guinea pigs.

Immunohistochemical investigations of the guinea pig vestibular system, using a specific antibody to the inducible isoform of NO-synthase (iNOS/NOS II), have been performed 3 weeks after surgical closure of the right endolymphatic duct (n = 7). Endolymphatic hydrops (ELH) of the right temporal bone became evident by excavation of the Reissner's membrane in all seven animals. Those animals revealed iNOS-expression in ganglion cells, in the wall of blood vessels and in nerve fibers of the right vestibular system, while the corresponding left temporal bones and temporal bones of non-operated controls (n = 6) as well as of sham-operated animals (n = 3) did not show any iNOS-positive structures. iNOS-generated NO could be involved in the pathophysiology of vestibular dysfunction in Meniere's disease.

Animals↗