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Biomedical subjects

Michael M Paparella

Publications and source records attributed to Michael M Paparella.

At least 19 recordsLinked to original sources
PubMed2004

Massive endolymphatic sac and vestibular aqueduct in Mondini dysplasia.

A postmortem study was performed on the bilateral temporal bones of a 90-year-old woman who had a lifelong profound hearing impairment. The histopathologic findings included severe Mondini dysplasia with unusual enlargement of the vestibular aqueducts and endolymphatic sacs. Dehiscent carotid arteries and dehiscent facial nerves were also present. The clinical and surgical aspects of the case are discussed based on the histopathologic findings. The physician should be prepared to diagnose congenital hearing impairment promptly to avoid complications during the clinical and surgical treatment of patients with Mondini dysplasia.

Aged↗
PubMed2004

Effects of aminoglycoside administration on cochlear elements in human temporal bones.

OBJECTIVE: Although there have been numerous reports on the relationship between the period of aminoglycoside administration and cochlear damage in animals, to date there have been no such studies in humans. The purpose of this study is to observe the early and late cochlear effects of aminoglycoside administration on hair cells, spiral ganglion cells, stria vascularis, and spiral ligament. METHODS: Specimens were divided into three groups. Group I included "normal" temporal bones with no histopathologic findings of otitis media and no history of otologic or ototoxic drug administration. Group II consisted of temporal bones that received aminoglycosides within 2 weeks before death and group III of temporal bones that had aminoglycosides from 2 weeks to 6 months prior to death. Patients in groups II and III received gentamycin, kanamycin or tobramycin. Temporal bones were excluded from groups II and III if patients had a history of otologic disease or other ototoxic drugs. All temporal bones were examined under light microscopy. Standard cytocochleograms and spiral ganglion cell reconstructions were done on all temporal bones. Morphometric measurements of areas of stria vascularis were made in all turns of the cochlea on mid-modiolar sections. Spiral ligament was divided into four segments according to the locations of different types of fibrocytes. The mean loss of fibrocytes in each segment was estimated. RESULTS: The percentages of intact outer hair cells in the basal turn were significantly greater in group I compared to groups II and III. The mean area of the stria vascularis in the apical turn was significantly less in groups II and III compared to group I. CONCLUSION: This study demonstrates that in a short period (within 2 weeks) after aminoglycoside administration, a decrease in hair cells and in the area of the stria vascularis occurred.

Administration, Topical↗
PubMed2004

Cellular changes of Reissner's membrane in Meniere's disease: human temporal bone study.

OBJECTIVE: To study the cellular characteristics of Reissner's membrane (RM) in temporal bones (TBs) from patients with endolymphatic hydrops with symptoms of Meniere's disease (EH/+MD) and TBs with endolymphatic hydrops without symptoms of Meniere's disease (EH/-MD) in an effort to understand the role of endolymphatic hydrops in MD symptoms. STUDY DESIGN: Comparative study of human TB histopathology. METHODS AND MATERIALS: Epithelial and mesothelial cellularity of RM from control TBs, TBs from patients with EH/+MD, and TBs from patients with EH/-MD were compared. The cellularity of epithelial and mesothelial cell nuclei (defined as number of cells/100 microm width of RM) were counted along the width of RM. The width of RM was measured from the vestibular crest of the spiral ligament to the limbus spiralis. RESULTS: The cellular densities of epithelial cells in the basal and middle turns of RM were significantly higher in the EH/+MD and EH/-MD groups compared with "controls." There was no difference in epithelial cellularity between EH/+MD and EH/-MD. There was a decrease in the number of mesothelial cells of RM in the basal turn in EH/+MD and EH/-MD groups (statistically significant only in EH/+MD group) when compared with controls. The number of mesothelial cells of RM in the middle turn in EH/+MD and EH/-MD groups were significantly decreased compared with normals. DISCUSSION: Similar findings in cellularity of RM in temporal bones with EH/+MD and EH/-MD suggest that pathophysiologic mechanisms other than hydrops may be responsible for symptoms in Meniere's disease.

Adolescent↗
PubMed2004

Age-related histopathologic changes in the human cochlea: a temporal bone study.

OBJECTIVES: Previous reports on aging of human cochlea included subjects with ear diseases or ototoxic drugs. We studied spiral ganglion cells, hair cells, and lateral wall of cochlea from subjects without ear disease or ototoxic drugs. STUDY DESIGN: This study included 39 temporal bones from 24 subjects aged 1 day to 86 years. We assessed standard cytocochleograms, mean loss of fibrocytes in spiral ligament, and areas of stria vascularis. RESULTS: Losses of outer hair cells and fibrocytes were significantly greater in children, adults, and the elderly compared with infants. Spiral ganglion cell loss was significantly greater in adults and elderly compared with infants and children. Areas of stria vascularis of infants were significantly larger than the elderly. CONCLUSIONS: Degenerative changes of outer hair cells occur in children but spiral ganglion cells remain the same until around 20 years. Degeneration of stria vascularis due to aging appears to be slower than spiral ligament. EBM RATING: C.

Adolescent↗
PubMed2004

Otologic manifestations of metastatic tumors to the temporal bone.

The temporal bone appears to be affected by metastatic tumors in rather characteristic clinical presentations. More effective cancer treatments have interrupted the course of the disease, allowing more time for metastatic spread. This has increased the importance of prompt diagnosis in a group of diseases that may mimic external auditory canal or middle ear infections. In this paper, we review the distinctive patterns of involvement and presentation of metastatic tumors of the temporal bone, with emphasis on measures that should be taken to ensure early diagnosis.

Ear Diseases↗
PubMed2004

Cochlear changes in chronic otitis media.

OBJECTIVES/HYPOTHESIS: The objective was to describe the morphological changes in the cochlea in chronic otitis media. STUDY DESIGN: Retrospective human temporal bone analysis. METHODS: Fifteen temporal bones with unilateral chronic otitis media were selected and compared with contralateral normal temporal bones. Standard cytocochleograms and spiral ganglion cell reconstructions were performed on all temporal bones. Spiral ligament was divided into four segments according to the locations of different types of fibrocytes. The average loss of fibrocytes in each segment was estimated. Morphometric measurements of areas of stria vascularis and spiral ligament were made in all turns of the cochlea on mid modiolar sections. RESULTS: Loss of outer and inner hair cells was common in the basal turn of the cochlea in temporal bones with chronic otitis media compared with control ears. There was no difference in the number of spiral ganglion cells in the chronic otitis media and contralateral ears. The areas of stria vascularis and spiral ligament in the basal turn decreased significantly in the ears with chronic otitis media compared with control ears. There were no significant differences between the ears with chronic otitis media and the contralateral ears for any of the regions characterized by the presence of types I-IV fibrocytes. CONCLUSION: The results of the study are consistent with the hypothesis that chronic otitis media causes cochlear disease.

Adolescent↗
PubMed2004

Cochleosaccular dysplasia: a morphometric and histopathologic study in a series of temporal bones.

OBJECTIVE: The objective of this study was to perform a morphometric analysis of a series of temporal bones with cochleosaccular dysplasia to clarify the extent of inner ear changes in this disease. STUDY DESIGN: This human temporal bone histopathologic study of a series of deaf-mute cases involves morphometric analysis, including stria vascularis and spiral ligament area measurements and spiral ganglion and hair cells counts. SUBJECTS: Thirteen temporal bones were selected from 35 with deaf mutism based on the histopathologic findings described by Scheibe. Twenty normal age-matched control subjects were used for comparisons. RESULTS: All temporal bones had the main histopathologic findings described by Scheibe, as well as severe affected stria vascularis. Seven temporal bones had cystic areas in the stria and three had concretions. Cross-sectional strial areas in temporal bones with cochleosaccular dysplasia were smaller than normal in all cochlear turns; however, no difference was found in spiral ligament cross-sectional areas. Reissner's membrane was hydropic in three temporal bones and the organ of Corti was absent in at least one cochlear turn in five. Concretions were present in the macula of seven temporal bones. Twelve temporal bones showed some level of spiral ganglion cell loss. No hair cells were observed in any temporal bone. A familial history of deafness was found in three cases. CONCLUSION: Pathologic findings were variable and limited to the saccule and scala media. The variation, perhaps, reflects the different etiologies involved in the origin of cochleosaccular dysplasia.

Adolescent↗
PubMed2004

Temperature-sensitive SV40-immortalized rat middle ear epithelial cells.

The proliferation and differentiation of middle ear epithelial cells are essential in both normal and diseased middle ears. The normal situation involves physiologic growth and renewal of the epithelium, and the diseased situation involves pathological changes of the epithelium such as mucous cell metaplasia and ciliated cell proliferation in otitis media. In this study, we used a temperature-sensitive large T antigen (the SV40 mutant) to transduce and immortalize the primary culture of middle ear epithelial cells. SV40-immortalized middle ear epithelial cells have been cultured for more than 50 passages and are stable morphologically. Their nonimmortalized parent cells died at the second passage. Immortalized middle ear epithelial cells carrying the SV40 mutant show a monolayer, cobblestonelike morphology. The cell line expresses characteristic middle ear mucosal molecules such as mucins, keratins, and collagens. It also responds to temperature changes; namely, cells proliferate at 33 degrees C, when the SV40 antigen is active, and differentiate at 39 degrees C, when the SV40 antigen is inactive. Therefore, we conclude that a temperature-sensitive middle ear epithelial cell line has successfully been established.

Animals↗
PubMed2004

Abnormal direction of internal auditory canal and vestibulocochlear nerve.

Several internal auditory canal (IAC) anomalies have been reported. To our knowledge, only one case with an abnormal direction of the IAC has been reported in an infant with Pierre Robin syndrome. In this paper, we present the first report of two non-syndromic cases with abnormal IAC direction.

Aged↗
PubMed2003

Effect of parenteral aminoglycoside administration on dark cells in the crista ampullaris.

OBJECTIVE: To observe the early and late effects of the parenteral administration of aminoglycosides on the dark cells of ampullae in the inner ear. STUDY DESIGN: Comparative study of the histopathologic characteristic of human temporal bones. SUBJECTS AND METHODS: Sixty-three temporal bones from 44 subjects (age range, 16-81 years) were examined by light microscopy. Three groups of temporal bones were selected for this study: group 1, 30 "normal" temporal bones from 22 subjects (mean age, 59 years; age range, 25-81 years) with no history or histopathologic findings of otologic disease or ototoxic drug use; group 2, 14 temporal bones from patients who received aminoglycoside treatment within 2 weeks before death; and group 3, 19 temporal bones from patients who received aminoglycoside treatment between 2 weeks and 6 months before death. RESULTS: The mean +/- SD number of dark cells in group 1 was 15.0 +/- 2.47; in group 2, it was 17.3 +/- 1.93 in the subjects who received gentamicin sulfate and 15.0 +/- 3.08 in those who received kanamycin sulfate and tobramycin; in group 3, it was 14.6 +/- 1.67 in the subjects who received gentamicin and 15.2 +/- 2.31 in those who received kanamycin and tobramycin. The overall difference between the 3 groups was not statistically significant (P =.07). The cytologic characteristics of dark cells were similar in all 3 groups. The number of dark cells showed a decline with increasing age in group 1. CONCLUSIONS: The result of this study suggests that the treatment period was probably too short to destroy the dark cells. Therefore, long-term aminoglycoside therapy may be necessary to get a more permanent result.

Adolescent↗
PubMed2003

Expression of mucins in mucoid otitis media.

A hallmark of mucoid otitis media (MOM, i.e., chronic otitis media with mucoid effusion) is mucus accumulation in the middle ear cavity, a condition that impairs transduction of sounds in the ear and causes hearing loss. The mucin identities of mucus and the underlying mechanism for the production of mucins in MOM are poorly understood. In this study, we demonstrated that the MUC5B and MUC4 were major mucins in MOM that formed distinct treelike polymers (mucus strands). The MUC5B and MUC4 mRNAs in the middle ear mucosa with MOM were up regulated 5-fold and 6-fold, compared with the controls. This upregulation was accompanied by the extensive proliferation of the MUC5B- and MUC4-producing cells in the middle ear epithelium. Further study indicated that the mucin hyperproduction was significantly linked to CD4+ and CD8+ T cells and/or CD68+ monocyte macrophages. It suggests that MUC5B and MUC4 expression may be regulated by the products of these cells.

CD4-Positive T-Lymphocytes↗