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PubMedDate not supplied

Human cochlear aqueduct and its accessory canals.

The anatomy of the adult human cochlear aqueduct and its surrounding structures, and their normal variations at tomography, microdissection and plastic molding are described. The mean length of the aqueduct is 12.9 mm and the mean width of its funnel-shaped external aperture 4.2 mm. The mean width of the narrowest portion is 0.14 mm. No difference in aqueductal width was found between the youngest and oldest age groups. Complete bony obstruction was revealed at microdissection in 3 out of 82 specimens. In the remaining 79 the entire aqueduct was patent. The aqueduct usually runs parallel to the internal auditory canal when seen from above, and the AP projection is therefore most suitable for tomography. At tomography the entire aqueduct was visualized in 60% of the specimens. The isthmic portion was not visible in 40%. Major reasons for nonvisualization of the entire aqueduct are: 1) a luminal width less than 0.1 mm, 2) a high jugular fossa, 3) a posteriorly directed aqueductal convexity (10%), and 4) bony obliteration (4)%). Accessory canals close to and often wider than the aqueduct may complicate tomographic evaluation of the aqueductal patency. Nonvisualization of the aqueduct at tomography does not necessarily indicate nonpatency.

Adult↗
PubMed1997

[Evaluation of the cochlear aqueduct patency: comparison of 2 noninvasive techniques].

Variations in cephalo-rachidian fluid pressure can be transmitted to the middle ear through the cochlear aqueduct (CA). This gives us a non-invasive manner to evaluate any changes in fluid pressure by measuring middle ear impedance (impedancemetry). The present study compared two indirect methods for measuring intracranial pressure: a) impedancemetry during evoked jugulo-tympanic reflex (JTR) and b) study of the tympanic membrane (TM) fine motility using a MMS-10 analyzer. The latter is a new procedure involving the indirect evaluation of the fluid pressure. In fact, when the CA is open the labyrinthine fluid pressure is transmitted to the oval window, the stapes platina and, finally, to the tympanic membrane where it can be measured with an MMS-10 unit. This equipment can measure nanoliter shifts in the TM. In particular, comparison between the clinostatic and orthostatic tympanic motility measurements enable one to establish whether the CA is patent or not. In the present study 15 subjects were examined using both a) impedancemetry during jugular compression and b) analysis of the TM shift using an MMS-10 unit. In 14 of the 15 cases there was good correlation between the data obtained using both methods: in all but one case it proved possible to record a JTR-induced variation in impedance whenever the MMS-10 indicated that the CA was open. The results suggest that, in clinical practice, the two methods can be used in parallel for non-invasive monitoring of variations in intracranial pressure in patients with neurological involvement. On the other hand, in the E.N.T. field these techniques could be used to study inner ear pathologies causing dynamic alterations of the endolabyrinth fluids (endolymphatic hydrops, labyrinthine fistula).

Acoustic Impedance Tests↗
PubMedDate not supplied

Functional patency of the cochlear aqueduct.

The perilymphatic (PP) and cerebrospinal fluid (PCSF) pressures were investigated in relation to pressure variations in the ear canal, middle ear and intracranial compartment before and after occlusion of the cochlear aqueduct (CA). Experiments using intracranial infusion showed that the CA was responsible for a perfect hydrodynamic balance between the CSF and the perilymph. There are indications of additional pressure release factors but their capacities were not sufficient to prevent the appearance of a longstanding and substantial pressure gradient following occlusion of the CA. A gradual PP build-up, from zero to its original level after the CA was opened and occluded, indicated perilymph production within the labyrinth. Investigation of pressure transfer from the ear canal and middle ear to the perilymph showed that the CA was the major pressure release route from the cochlea. Occlusion of the CA reduced the compliance of the inner ear and severely reduced the pressure release capacity. In such a situation the inner ear is almost incapable of equilibrating ambient pressure changes.

Animals↗
PubMed1983

Cochlear aqueduct radiographic anatomy in temporal bone preparations and in sudden hearing loss.

Sudden sensorineural hearing loss appears to have many possible etiologic factors. Shea has presented work indicating that a large cochlear aqueduct (CA) is frequently present on the side of an idiopathic sudden sensorineural hearing loss (ISHL). However, Valvassori, on performing temporal bone tomographic studies on several hundred patients complaining of ISHL, has not found enlargement of the CA in a statistically significant number of these cases. In an attempt to resolve this discrepancy, a single blind study was performed utilizing temporal bone polytomography to evaluate the presence or absence of the CA in 22 adult patients. One-half of these patients had a history of ISHL, while the remaining patients had other complaints as an indication for tomography. In all cases, the CA was identified. The CA was felt to be enlarged in 1 patient suffering from ISHL, in the nonaffected ear of 1 patient with unilateral ISHL, and in 2 control patients. There was, therefore, no positive correlation between CA enlargement and the occurrence of ISHL. In order to further elucidate the radiologic anatomy of the CA, 9 pairs of adult temporal bones removed at autopsy were studied by polytomography after cannulation and injection of radiopaque material. Measurements of the dimensions of the CA and its radiographic anatomy are discussed and compared to measurements obtained from histopathologic evaluation of the temporal bone.

Adult↗
PubMed1994

The influence of vestibular and cochlear aqueducts on vestibular response to middle ear pressure changes in guinea pigs.

The responses of primary vestibular neurons and perilymphatic pressure changes to middle ear pressure were investigated in guinea pigs with obstructed vestibular or cochlear aqueduct (closed VA or closed CA group) in order to clarify the influence of VA and CA on pressure-induced vestibular response. Although the neural response rates and the amount of perilymphatic pressure change in the closed VA group resembled those in the control group, these values in the closed CA group were higher than in the control group. Patency of the CA had a more significant effect on the vestibular response to middle ear pressure change than patency of the VA.

Animals↗
PubMed1982

Spontaneous cerebrospinal fluid otorrhea in association with a congenital defect of the cochlear aqueduct and Mondini dysplasia.

Unrecognized spontaneous cerebrospinal fluid (CSF) otorrhea led to recurrent bacterial meningitis in three children. The underlying cause of the spontaneous CSF otorrhea was proved to be a congenital cystic dilatation of the cochlear aqueduct and Mondini dysplasia of the temporal bone. The CSF leak recurred in all patients after an initial surgical attempts to close the defects through a tympanotomy. A suboccipital approach was used successfully to obliterate the CSF fistulas in two children; a translabyrinthine approach was used in the other. A search of the literature revealed that Mondini dysplasia is a congenital anomaly that can commonly cause spontaneous CSF otorrhea in children. The authors discuss the management of this uncommon entity on the basis of a literature review and their own experience.

Adolescent↗
PubMed1989

[The cochlear aqueduct and congenital perilymphatic fistula. An initial report].

The authors present 3 preliminary case reports of congenital perilymphatic fistula and describe their approach, which in the presence of clinical symptoms composed of progressive or fluctuating deafness, should suggest the diagnosis of congenital perilymphatic fistula leading to examination of the cochlear aqueduct by high resolution computed tomography. An anomaly detected on the CT scan, particularly on the intermediate and internal segments, is a decisive argument in the decision to operate on these congenital perilymphatic fistulae.

Adolescent↗
PubMed1979

[Blockage of cochlear aqueduct for examination of perilymph (guinea pig) (author's transl)].

To prevent the perilymph (guinea pig) from contamination with CSF during the sampling the aqueductus cochleae (AC) was blocked by injection of tissue adhesive into the meningeal aperture. The control of an exact blockage of AC was carriedout by examination of perilymph-outflow after opening the cochlea (injection of fluorescein-Na into the CSF-space), analysis of perilymph-protein-concentration, macroscopic and microscopic examination of the temporal bones. In all cochleae we have found the same morphological structures, notwithstanding whether the AC was blocked (for a time from 30 min to 7 weeks) or not: The cochlear aqueduct is filled with a mesh of mesenchymal tissue, which grows more dense towards the cochlear aperture andcontinues into the round window membrane. From scala tympani the AC is always limited by one layer of cells forming a sort of membrane (under light microscope). It seems possible that CSF moves in the inner of the round window membrane between AC and subepithelian space of middle ear mucosa, whereas perilymph of scala tympani is not in direct contact with the flow of CSF. The scala tympanic side of the round window membrane may be a big area for diffusion and there also may be an exchange between CSF and perilymph. The outflow of CSF into the cochlea after experimental opening of the cochlea is an artifact, caused by damage of pressure equilibration between CSF-space and cochlea. 30 min and 5--7 weeks after blockage no morphologicaland electrophysiological alterations from those of the control ears were to be seen. The protein concentration, however, increased significantly 5--7 weeks after blockage from normally about 200 mg/100 ml toalmost the double especially in the scala tympani (see Table 1).

Action Potentials↗
PubMed1991

Repair of a cerebrospinal fluid perilymph fistula primarily through the middle ear and secondarily by occluding the cochlear aqueduct.

A 35-year-old man had a 5-year history of fluctuating hearing loss in his only hearing ear. History and diagnostic tests indicated a perilymph fistula, a diagnosis subsequently confirmed by exploration. Primary and secondary repairs temporarily ameliorated symptoms. A spinal fluid to middle ear fluid pathway was identified by radioactive tracer. A patent cochlear aqueduct indicated on computed tomography scan was found and repaired through a posterior cranial fossa approach. Hearing was preserved, remaining relatively stable during the 2-year follow-up period.

Adult↗
PubMed1987

[Scanning electron microscopy studies of the structure of tissue in the cochlear opening of the cochlear aqueduct].

The structure of the internal and external tissue of the cochlear opening of the cochlear aquaeduct was examined by light microscopy on semithin sections and by scanning electron microscopy. The whole area is filled with a net of mesenchymal cells. The cell axes are randomly orientated inside the aquaeduct. On the outside of the cochlear aquaeduct fibrocytic tissue fills a space which is triangular in cross-section between the basal part of the cochlea wall of the tympanic scala and the middle portion of the round window membrane. In this area the direction of the net is uniform and it gives the impression of anchorage of the round window membrane on the perilymphatic side. The rim bordering the perilymphatic space is a dense net but not fully closed. The scanning electron microscopic pictures taken perpendicular to this border structure show clearly a texture of mesenchymal cells with open spaces. No closed "membrana limitans" was found. The possible function of the fixation of the round window membrane to the perilymphatic space giving rise to an asymmetric perilymph movement is discussed with regard to the physiology of sound transmission.

Animals↗