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At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

Distribution of choline acetyltransferase mRNA in the efferent vestibular neurons of the chinchilla.

The distribution of choline acetyltransferase messenger RNA (mRNA) among efferent vestibular neurons in the chinchilla was investigated. mRNA coding for choline acetyltransferase, the enzyme that synthesizes acetylcholine, was used as a marker for the cholinergic system. In order to retrogradely label the efferent vestibular neurons, Fluoro-gold was injected through the oval window into the inner ear of anesthetized young male chinchillas (6 to 12 months old). The animals were anesthetized and perfused through the heart 2 days post injection with 4% paraformaldehyde in phosphate buffer. Retrogradely labeled efferent vestibular neurons were mapped in brainstem sections prior to processing for in situ hybridization histochemistry using radiolabeled ribonucleic acid probes complementary to the 3' end of the choline acetyltransferase mRNA. At the levels of the ascending facial nerve and the genu of the facial nerve, we found that approximately 90% of the Fluoro-gold labeled cells in group E1 contained choline acetyltransferase mRNA. All of the group E2 cells that were labeled with Fluoro-gold were found to be cholinergic (contain choline acetyltransferase mRNA). Finally, 60% of the Fluoro-gold-labeled cells in the caudal pontine reticular nucleus contained choline acetyltransferase mRNA.

Animals↗
PubMed1984

Abnormalities of the facial nerve and middle-ear.

Anatomical variations of the facial nerve are of great concern to the surgeon performing ear surgery. An anomalous course of the facial canal in its vertical or horizontal segment has been described by several authors. This case is believed to represent the first case report of absence of the oval window, an inferiorly placed facial nerve and an abnormal stapes.

Adult↗
PubMedDate not supplied

Otologic manifestations of the hydantoin syndrome.

The temporal bones of a newborn infant with hydantoin syndrome showed multiple middle ear and inner ear anomalies. There was a constellation of bony and membranous defects involving the oval and round windows, cochlear ducts, cochlear aqueducts, endolymphatic ducts and sacs, and vestibular labyrinths. To the authors' knowledge, supernumerary vestibular sensory epithelial structures and an inner ear epidermoid cyst have not been previously reported. Wide communications between the subarachnoid space and inner ear were of surgical relevance.

Abnormalities, Drug-Induced↗
PubMed1995

Correlation of beta-2 transferrin and middle ear abnormalities in congenital perilymphatic fistula.

Congenital perilymphatic fistula (PLF) as a diagnosis for progressive, fluctuating, or sudden sensorineural hearing loss with or without vertigo is still controversial. Beta-2 transferrin is a protein that is unique to cerebrospinal fluid, aqueous humor, and perilymph. A recent pilot study demonstrated that beta-2 transferrin may be an objective test to determine the existence of a congenital PLF. The authors prospectively evaluated and recommended surgery for 43 children with suspected PLF over the past 3 years. A prospective, blinded study was performed by having the attending otolaryngologist evaluate the middle ear at the time of surgery for a PLF and any middle ear abnormalities. Samples of fluid were collected from the oval and round windows and were tested for beta-2 transferrin. Of 16 patients undergoing tympanoplasty or tympanomastoidectomy who served as controls, none were positive for beta-2 transferrin. Of the 43 patients undergoing exploratory tympanoplasty for PLF, 20 (46.5%) were considered to be negative for PLF on microscopic visualization; 23 (53.5%) were found to be positive. Of the 20 patients thought to be negative for PLF, 18 (90%) tested negative for beta-2, but 2 of these patients were positive for beta-2, and both had a congenital middle ear abnormality. Of the 23 patients found to have a PLF at surgery, 6 (26.1%) tested positive for beta-2, and all of these 6 had middle ear abnormalities. Of the 17 patients negative for beta-2, 9 had normal anatomy; 6 had middle ear abnormalities, and 2 had erosive changes. The authors conclude that beta-2 transferrin, an objective test, confirms the existence of congenital PLF in children, which is associated with middle ear abnormalities.

Adolescent↗
PubMed1990

Chondrogenic potential of tragal perichondrium: a cause of hearing loss following stapedectomy.

Tragal perichondrium is a widely used tissue seal in the oval window following stapes surgery. Autogenous and easily accessible, it is a suitable substance to cover the vestibule in total stapedectomy, and to seal around the prosthesis in small-fenestra stapedotomy. The incidence of complications from the use of perichondrium in this manner is exceedingly low. We report a case where tragal perichondrium in the oval window resulted in the proliferation of cartilage. The cartilage displaced the stapes prosthesis, resulting in a conductive loss. Although the chondrogenic potential of perichondrium is known, we are not aware of other reports implicating this as a cause of failure in stapes surgery. The pertinent clinical and experimental literature regarding chondrogenesis is reviewed. This information suggests that the formation of cartilage from perichondrium in the oval window might be influenced by mechanical trauma and tissue orientation.

Adolescent↗
PubMed1999

[Traumatic perilymphatic fistula of round and oval windows (four cases reported)].

OBJECTIVE: To explore the diagnosis and treatment to traumatic perilymph fistula (PLF) of round and oval window. METHOD: Traumatic PLF was diagnosed by the traumatic history of head, neck and ear, the examinations of auditory and vestibular function, and the exploratory tympanotomy. The PLF of round and oval windows were repaired by fascia graft or tragus perichondrium and gelform. Four cases with traumatic PLF of round and oval window were reported in this paper, which included 2 cases hitten by hand, 1 by brick, 1 insulted by middle ear surgery. Exploratory tympanotomy was performed from one and half to nine months after injury. One case was misdiagnosed as Meniere's disease before confirming PLF. Exploration and repair of PLF underwent in all cases. RESULT: The symptom of vertigo relieved in all cases after surgery, while the hearing recovery was not evident. CONCLUSION: 1. Traumatic PLF is unrare, hence, traumatic PLF should be alerted if patients suffer from vertigo and hearing impairment after head and ear injury. 2. The features with vertigo attacks, fluctuating hearing loss and tinnutis should be distinguished from Meniere's disease. 3. Early exploratory tympanotomy and repair of PLF are effective for relieving vertigo and improving hearing.

Adult↗
PubMedDate not supplied

CT cisternography in congenital perilymphatic fistula of the inner ear.

Perilymphatic fistulas of the inner ear constitute abnormal leaks of perilymphatic fluid into the middle ear or mastoid air cell system and represent a rare cause of otorrhea. We report the case of a 5-month-old child presenting with sudden otorrhea. High resolution CT cisternography showed a malformation of the middle ear and a passage of contrast-enhanced CSF into the tympanic cavity through the left oval window. Surgery confirmed a tear of the tympanic membrane as well as a stapes malformation with aplasia of the crura and an associated perilymphatic fistula through a defect in the stapes footplate. The fistula was closed with adipose tissue from the ear lobe.

Cerebrospinal Fluid Otorrhea↗
PubMed1992

Evaluation of perilymphatic fistulas by middle ear endoscopy.

Transtympanic endoscopy provides a unique opportunity to view the undisturbed contents of the middle ear. Fiberoptic and rigid endoscopes have been used for thorough examination of the middle ear without the need for local anesthetics or surgical trauma. Endoscopy is now routinely used in the evaluation of a perilymphatic fistula and the patient is awake during an intermittent forceful Valsalva maneuver. Oval and round windows in both ears of five cats were studied endoscopically to evaluate surgically created fistulas. Excellent visualization of the defect was obtained in all instances. Endoscopy is a useful office technique for the evaluation of perilymphatic fistula. It reduces the need for surgical exploration and provides a satisfactory examination of the middle ear. Obliteration of the window niche can even be performed through the myringotomy using autologous blood.

Adult↗
PubMed1983

[Differential diagnostic problems in cerebellopontile angle tumors? A case report].

A patient, suffering from otosclerosis of the right ear, was stapedectomized in 1977. Due to bleeding into the oval window during surgery, a persistent deficit of inner ear performance occurred, causing vertigo and hearing loss of high frequencies, in the right ear. As vertigo increased over the years, the patient underwent extensive otological and neurological examinations without result. Because of anamnestic data all interest was focussed on the right ear, and even gas cisternography was performed on the right side only. Due to a left-side sudden hearing loss, the patient came to the Freiburg ENT Hospital in 1981. ERA examinations and, finally, gas cisternography revealed a tumour--meanwhile confirmed by surgery (acoustic neurinoma)--of the left cerebello-pontine angle. As a consequence of this it must be pointed out that in all cases of unilateral or bilateral loss of hearing of the inner ear and vertigo of unclear etiology, ERA investigations and bilateral gas cisternography should be performed.

Audiometry↗
PubMed2001

Endoscope-guided round window fistula repair.

OBJECTIVE: Endoscope-guided round window membrane repair was performed to evaluate whether the approach is feasible in the treatment of a round window fistula. STUDY DESIGN: Retrospective case review. SETTING: Tertiary care academic center. PATIENT: A 27-year-old man had been scuba diving 6 days previously in the Australian Great Barrier Reefs. He had poor hearing with tinnitus in the left ear and a vertiginous sensation. INTERVENTION: A myringotomy was incised, and a tympanoscope was introduced into the middle ear cavity. With the patient under general anesthesia, the middle ear and the oval and round window areas were examined with a tympanoscope. In endoscopic visualization, a round perforation could be seen in the round window membrane. After detection of the round window perforation, a small piece of temporal fascia was obtained to seal the membrane perforation. RESULTS: One month after the operation, the patient's hearing was significantly better. The myringotomy had healed. CONCLUSION: A transmyringeal endoscopic procedure for round window fistula repair is feasible and combines the best features of minimally invasive surgery and aural endoscopy.

Adult↗
PubMed2001

Craniofacial, temporal bone, and audiologic abnormalities in the spectrum of hemifacial microsomia.

OBJECTIVES: To evaluate the clinical, audiologic, and temporal bone computed tomograpic findings in patients with hemifacial microsomia and to use the OMENS (each letter of the acronym indicates 1 of the following 5 dysmorphic manifestations: O, orbital asymmetry; M, mandibular hypoplasia; E, auricular deformity; N, nerve involvement; and S, soft tissue deficiency) grading system to assess possible correlations between the severity of dysmorphic features with the type of abnormalities in the temporal bone and with degree of hearing deficit. DESIGN: Retrospective study. SETTING: Tertiary care children's hospital. PATIENT: Forty patients with hemifacial microsomia. RESULT: Mandibular hypoplasia and auricular abnormalities were the most common clinical manifestations, present in 39 patients (97%) and 38 patients (95%), respectively. Conductive hearing loss was noted in 35 patients (86%) and sensorineural hearing loss in 4 patients (10%). Facial nerve weakness was present in 20 patients (50%). Twenty patients had unilateral aural atresia, 12 patients had unilateral aural stenosis, and 7 patients had bilateral anomalies. Moderate hypoplasia or atresia of the middle ear was noted in 36 patients (90%) and ossicles were malformed in 30 patients (75%). Hypoplasia of the oval window was the most common inner ear abnormality. CONCLUSIONS: Severity of craniofacial features (total OMENS score) significantly correlated with the degree of temporal bone abnormality, but no correlation was noted with the degree or type of hearing loss. We recommend the following: (1) use of the OMENS classification system for documentation and analysis of dysmorphic finding in hemifacial microsomia; (2) complete audiologic evaluation in all patients with hemifacial microsomia regardless of the type of craniofacial abnormalities; and (3) temporal bone computed tomography for further evaluation of hearing deficit.

Adolescent↗
PubMed1977

The facial nerve coursing across the oval window area.

A case of unilateral conductive deafness since birth is described. At exploration of the middle ear, the facial nerve was found to have an anomalous course across the oval window region, the stapedial crura ending on the uncovered facial nerve. This case is believed to represent the 9th case to be recorded. This anomaly may be due to failure of union between the branchial part and otic capsule part of the stapes, in combination with a defective development of the laterohyale resulting in a partially absent facial canal.

Child↗
PubMed1992

Congenital anomalies limited to the middle ear.

Congenital anomalies of the middle ear are occasionally encountered during surgery for conductive hearing loss and are unexpected in patients with no other deformities. We reviewed 12 such patients operated on at The New York Eye and Ear Infirmary from 1985 through 1989. Nine of the patients (75%) had unilateral conductive hearing loss whereas three (25%) had bilateral symptoms. One had bilateral congenital middle ear anomalies. Three patients (25%) had anomalies limited to the malleus and scutum. Five patients (47%) had agenesis of the oval window. After reconstructive surgery, 72% of patients had hearing improvement ranging from 13 to 38 dB. The etiology of these anomalies is discussed and their evaluation and surgical indications are presented.

Adolescent↗
PubMed1991

Lightning and its effects on the auditory system.

Patients struck by lightning can present with a wide variety of unusual otologic problems including burns to the external auditory canal, tympanic membrane rupture, middle ear injury, and sensorineural hearing loss. Four patients who incurred various otologic problems, including one patient with previously unreported bilateral oval window fistulas following lightning injury, are presented. Audiologic, otologic, and surgical findings are reviewed as well as patient follow-up and outcome.

Adult↗