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PubMed1975

Auditory localization and its clinical applications.

Factors of significance in the localization of sound are considered. The ability of hearing-impaired subjects to localize noise in the horizontal plane was examined with and without hearing aids, and also compared with the results for normally hearing subjects. The directional hearing was not found to be improved by the hearing aids used. The ability to localize sound has been used by several investigators as a diagnostic tool: poor directional hearing may be expected in patients with lesions of the cochlear nerve or the pontine region. However, other factors are also of significance and may impair the localization of sound. These problems are discussed.

Acoustic Stimulation↗

PubMedDate not supplied

Electrocochleographic analysis of the suppression of tinnitus by electrical promontory stimulation.

To investigate the origin, and evaluate the mechanism by which tinnitus is suppressed we performed electrical promontory stimulation (EPS) in 56 patients with tinnitus, and measured the compound action potential (CAP) using electrocochleography before and after EPS. In the group of patients in whom tinnitus was suppressed, the CAP amplitudes increased significantly, whereas the latencies showed no remarkable change. In the group of patients in whom tinnitus was not suppressed, both the CAP amplitudes and latencies exhibited no significant change. These data indicate that the effect on the cochlear nerve plays an important role in the suppression of tinnitus by EPS. The CAP reflects the number of the auditory nerve fibers which discharge synchronously. It is speculated that an increase of the CAP amplitudes is caused by synchronizing discharges of the auditory nerve fibers, and that the mechanism by which EPS suppresses tinnitus may be related to synchronizing these discharges.

Adult↗

PubMed1985

Auditory brainstem-evoked response after single-dose injection of lidocaine and tocainide.

In order to investigate the effects of tocainide and lidocaine on the auditory brainstem-evoked response (ABR), 10 healthy male subjects 20-40 years of age were given a single i.v. dose of 250 mg of tocainide and of 100 mg of lidocaine on separate occasions in a trial with a double-blind cross-over design. Neither drug produced any significant change in absolute or interpeak intervals, or in latency-intensity functions (wave V). The results fail to indicate that lidocaine and tocainide in the doses given influence the synaptic transmission and conduction velocity in the cochlear nerve or in the brainstem.

Adult↗

PubMedDate not supplied

The auditory evoked potentials of gerbils after temporary occlusion of the left carotid artery.

This study examined brain-stem auditory evoked potentials response (BAEP) changes in the gerbil after temporary occlusion of the left carotid artery. Fourteen adult gerbils were subjected to unilateral left carotid ligation for 30 min. BAEPs were registered before and 5 min after occlusion, then 5 min, 60 min, 120 min, 24 h, 7 days and 28 days after release of the clip. Waves I (cochlear nerve), III (superior olivary complex) and V (inferior colliculus) were examined. Results were analysed using paired Student's t-test. Transient ischaemia increased latencies of waves I, III and V and the changes were more severe 5 min after release of the clip. In the gerbil, BAEPs might be a suitable method to study cerebral ischaemia.

Animals↗

PubMed1994

Is the test of medial efferent system function a relevant investigation in tinnitus?

The present results are drawn from preliminary observations made in 28 patients suffering from unilateral, permanent, non-pulsatile tinnitus, who were systematically submitted to an investigation of their otoacoustic emissions in both ears. Spontaneous otoemissions (SOAE) were carefully looked for, before recording of transient evoked otoemissions (TEOAE). The effectiveness of the medial olivo-cochlear efferent system (MOC) was also tested. The comparison between TEOAE input/output curves obtained with and without contralateral stimulation allowed a global assessment of the functioning of MOC. Additional information relating to the MOC functioning at the precise frequency of tinnitus and/or around it, was available from the comparison of analogous curves obtained using distortion product otoacoustic emissions (DPOAE) instead of TEOAEs. The results show that: (1) when the amplitude of otoacoustic emissions differs between the two ears, the tinnitus is generally lateralized on the side where amplitude was the lowest, which seems to be related to a greater hearing loss; (2) no general law concerning tinnitus can be drawn from the global testing of MOC functioning; the only result is that the slope of TEOAE input/output function appears as a deciding factor for efficiency of MOC, the least efficiency almost always occurring on the side where the slope is greater, and (3) even in the case of proved global effectiveness of MOC activation, there is, at least in the vicinity and in at least one ear, a part of the cochlea where its functioning is altered. A better comprehension of the mechanisms underlying this symptom will probably come from exhaustive exploration of individual cases rather than a rougher investigation of large samples in which different aetiologies are likely to be mixed.

Adult↗

PubMed2001

Vasoactive treatment for hearing preservation in acoustic neuroma surgery.

OBJECT: Delayed hearing loss following surgery for acoustic neuroma indicates anatomical and functional preservation of the cochlear nerve and implies that a pathophysiological mechanism is initiated during surgery and continues thereafter. Intraoperative brainstem auditory evoked potentials (BAEPs) typically demonstrate gradual reversible loss of components in these patients. METHODS: Based on this BAEP pattern, a consecutive series of 41 patients with unilateral acoustic neuromas was recruited into a prospective randomized study to investigate hearing outcomes following the natural postoperative course and recuperation after vasoactive medication. Both groups were comparable in patient age, tumor size, and preoperative hearing level. Twenty patients did not receive postoperative medical treatment. In 70% of these patients anacusis was documented and in 30% hearing was preserved. Twenty-one patients were treated with hydroxyethyl starch and nimodipine for an average of 9 days. In 66.6% of these patients hearing was preserved and in 33.3% anacusis occurred. CONCLUSIONS: These results are statistically significant (p < 0.05, chi2 = 5.51) and provide evidence that these surgically treated patients suffer from a disturbed microcirculation that causes delayed hearing loss following removal of acoustic neuromas.

Adult↗

PubMed2004

Magnetic and electrical stimulation of the auditory cortex for intractable tinnitus. Case report.

Tinnitus is a distressing symptom that affects up to 15% of the population for whom no satisfactory treatment exists. The authors present a novel surgical approach for the treatment of intractable tinnitus, based on cortical stimulation of the auditory cortex. Tinnitus can be considered an auditory phantom phenomenon similar to deafferentation pain, which is observed in the somatosensory system. Tinnitus is accompanied by a change in the tonotopic map of the auditory cortex. Furthermore, there is a highly positive association between the subjective intensity of the tinnitus and the amount of shift in tinnitus frequency in the auditory cortex, that is, the amount of cortical reorganization. This cortical reorganization can be demonstrated by functional magnetic resonance (fMR) imaging. Transcranial magnetic stimulation (TMS) is a noninvasive method of activating or deactivating focal areas of the human brain. Linked to a navigation system that is guided by fMR images of the auditory system, TMS can suppress areas of cortical plasticity. If it is successful in suppressing a patient's tinnitus, this focal and temporary effect can be perpetualized by implanting a cortical electrode. A neuronavigation-based auditory fMR imaging-guided TMS session was performed in a patient who suffered from tinnitus due to a cochlear nerve lesion. Complete suppression of the tinnitus was obtained. At a later time an extradural electrode was implanted with the guidance of auditory fMR imaging navigation. Postoperatively, the patient's tinnitus disappeared and remains absent 10 months later. Focal extradural electrical stimulation of the primary auditory cortex at the area of cortical plasticity is capable of suppressing contralateral tinnitus completely. Transcranial magnetic stimulation may be an ideal method for noninvasive studies of surgical candidates in whom stimulating electrodes might be implanted for tinnitus suppression.

Adult↗

PubMed1998

[An experimental study of tumor cell infiltration into temporal bones--route into the inner ear from the arachnoid space].

In humans, metastatic tumors which invaded the temporal bones have been studied in regard to the relationship between histopathologic findings and clinical symptoms. On the other hand, there is no experimental study using an animal model for tumor infiltration into the temporal bone. This study was designed to establish such an animal model and examine the temporal bones histopathologically. Rat thymic lymphoma cell (FTL-A2) were inoculated into the cisterna magna of Wistar rats. The animals were decapitated under deep anesthesia with pentobarbital sodium from the 1st to 8th day after inoculation. Their heads were fixed with Heiden-hain SuSa solution, decalcified, dehydrated, embedded in celloidin, and sectioned horizontally at a thickness of 25 microns. These were stained with hematoxylin and eosin, and histologically examined by light microscopy. Inoculated tumor cells showed active viability in the arachnoid space at a rate of 98%. Two major routes of tumor cell infiltration into the inner ear were found: the cochlear aqueduct and the internal auditory canal. At the early stage after the inoculation, tumor cells infiltrated the scala tympani through the cochlear aqueduct. Invading the fiber of the cochlear nerve, tumor cells infiltrated Rosenthal's canal via the tractus spiralis foraminosus, and passed through Rosenthal's canal and the osseous spiral lamina into the scala tymani. However, tumor cells did not infiltrate the organ of Corti through the habenula perporata. Tractus spiralis foraminosus and habenula perforata functioned as a barrier against tumor infiltration. In a few cases, tumor cells infiltrated over the macula cribrosa into the subepithelial space of the utricule and saccule. The macula cribrosa functioned as a barrier.

Acoustic Maculae↗

PubMed1991

[Phase spectral analysis of auditory brainstem response in cats].

In order to apply the phase spectral analysis of auditory brainstem response (ABR) to the clinical diagnostic test, the following studies in cats were performed. At first, the phase spectra of normal ABRs were investigated under adequate stimulus intensities. In addition the component synchrony measures (CSM) of ABRs were calculated at each stimulus level. Moreover the waveforms and phase spectra of ABRs were investigated before and after the destructions of cochlear nerve and brainstem auditory pathways in cats. The results were as follows; (1) In normal ABRs, the phase spectra were mainly composed of three frequency components at 0-300Hz (component A), 300-900Hz (component B) and 900-1500Hz (component C). The CSMs of component A represented the degree of synchrony for a slow component of the ABR and the CSMs of components B and C represented the degree of synchrony for a fast component. (2) A decrease in stimulus intensity resulted in a decrease in each average of the CSMs of the three components. (3) A greater decrease of the CSM occurred if ipsilateral destruction was performed in a peripheral lesion. Lesions of the auditory pathway were followed by a decrease of the CSM of component C to contralateral stimulation. These results suggest that the phase spectral analysis of ABRs has significant clinical value in the detection of brainstem lesions.

Animals↗

PubMed1996

[Sound lateralization testing based on interaural intensity difference discrimination and interaural time difference discrimination in acoustic neurinoma patients--comparison of ABRS].

Sound lateralization is considered useful in diagnosing retrocochlear lesions. Interaural time difference (ITD) discrimination has been considered more important than interaural intensity difference (IID) discrimination in diagnosing retrocochlear lesions. The purpose of this study was to determine whether testing sound lateralization by IID and ITD discrimination is useful in patients with acoustic neurinomas (AN). Twenty patients (15 to 74 years old) with unilateral AN were studied by testing IID and ITD discrimination using a self-recording device by delivering 500 Hz band noise through head-phones. Auditory brainstem response (ABR) testing and magnetic resonance imaging (MRI) were also performed in all patients. IID discrimination abnormalities were found in 25% of all patients, and ITD discrimination abnormalities in 85%. Five patients (25%) showed both IID and ITD discrimination abnormalities. One of the three patients with both normal IID and ITD discrimination showed waves I and V, and two of them showed waves I, III and V. One of the five patients with both IID and ITD discrimination abnormalities showed no response, two of them showed only wave I, the other two showed waves I, III and V. Two patients with latency prolongation between waves III and V had both IID and ITD discrimination abnormalities, and seven patients with latency prolongation between waves I and III had normal ITD discrimination or slightly abnormal ITD discrimination and normal IID discrimination. Three of the four patients with large tumors (> 3 cm) had both IID and ITD discrimination abnormalities, while two patients with small ear tumors (< 1 cm) had both normal IID discrimination and normal ITD discrimination. Normal ITD discrimination or slightly abnormal ITD discrimination was found in the majority of patients with wave III. Impairment of ITD discrimination was well correlated with wave III abnormalities. Patients with latency prolongation between waves III and V showed a high degree of ITD discrimination abnormality. Impairment of IID discrimination was related to a high degree of cochlear nerve damage or brainstem damage. We emphasize that IID discrimination is important in the neurological diagnosis of AN, in addition to ITD discrimination. Sound lateralization testing was a useful screening test for diagnosing AN, because tumor size influenced lateralization in every patient, and ITD discrimination was closely correlated with the ABR findings.

Acoustic Stimulation↗

PubMed1999

Combined rupture of Reissner's membrane and round window: an experimental study in guinea pigs: experimental double-membrane rupture.

OBJECTIVE: Hearing loss caused by combined rupture of Reissner's membrane and the round window (RW) membrane (the double-membrane rupture) may differ depending on the site of the lesion on Reissner's membrane. The purpose of this experimental study was to reveal the relationship between the hearing impairment and the site of the lesion on Reissner's membrane. BACKGROUND: According to experimental studies on perilymphatic fistula (PLF), profound hearing loss is not induced by rupture of RW alone, but by the double-membrane rupture. However, the mechanism responsible for hearing loss in the double-membrane rupture remains unclear. METHODS: Compound action potentials (CAPs) of the cochlear nerve in response to tone pip stimuli (1, 2, 4, and 8 kHz) were recorded before the lesion, 90 minutes after the Reissner's membrane rupture, and 90 minutes after subsequent laceration of the RW. Reissner's membrane was ruptured at one of the four turns for comparison. RESULTS: The double-membrane rupture caused a more severe increase in CAP thresholds than seen with separate ruptures, when the Reissner's membrane was ruptured at the second turn. Such pronounced increase in threshold was not seen in ears with the rupture at other turns. CONCLUSIONS: The double-membrane rupture causes varying degrees of hearing loss depending on the site of the lesion of Reissner's membrane. When the Reissner's membrane was ruptured at the second turn, the most severe hearing loss was detected.

Animals↗

PubMed1999

Neuronally modulated transcription of a glycine transporter in rat dorsal cochlear nucleus and nucleus of the medial trapezoid body.

Neurotransmitter transporters limit transmitter concentration at the postsynaptic membrane by removing neurotransmitters from the synaptic cleft. Not only do neurotransmitter transporters contribute to the regulation of synaptic transmission, but they themselves might be dynamically regulated by neuronal activity of the neurons in which they are expressed. In this experiment, we investigated the question of whether the transcription of two different glycine transporters, Glyt1 and Glyt2, is influenced by neuronal activity. These transporters are found in the dorsal cochlear nucleus (DCN) and medial nucleus of the trapezoid body. Glyt1 and Glyt2 mRNA were measured by using hybridization histochemistry and a semiquantitative reverse transcription polymerase chain reaction. Decreases in auditory primary afferent activity, caused by either unilateral labyrinthectomy or disruption of the middle ear ossicles, caused a reduction in Glyt2, but not Glyt1 mRNA in the ipsilateral DCN and in the contralateral medial nucleus of the trapezoid body. Acoustic stimulation at either 10 kHz or 40 kHz was used to provide controlled increases in primary afferent activity, evoking localized increases in Glyt2 mRNA in clusters of neurons in the DCN. The location of these clusters corresponded to the regions of the auditory tonotopic map devoted to these frequencies. The duration of changes in Glyt2 mRNA evoked by unilateral labyrinthectomy, measured with the reverse transcription polymerase chain reaction, was 5-10 days. These data provide the first example of in vivo regulation of transporter transcription by neuronal activity.

Amino Acid Transport Systems, Neutral↗

PubMed2000

[A case of brain stem infarction with bilateral hearing loss].

The study case was a 66-year-old man who had bilateral neurosensory hearing impairment due to brain stem infarctions. He noticed mild hearing loss, frequent vertigo and tinnitus. About one month later, his hearing took a sudden turn for the worse, and he suffered from dysarthria, dysphagea and abasia. Neurological examination revealed pseudobulber palsy, left hemiparesis, cerebeller ataxia, disturbance of pain and temperature sensation on the right face and left side of the body. Brain stem auditory evoked potentials (BAEPs) showed a delayed small wave V with the abscence of previous waves on the right side and no significant waves on the left side. Brain magnetic resonance images (MRI) revealed infarctions in the bilateral middle cerebellar peduncles, including in the right lateral portions of pons, and the right lower pontine base. We believe that not only peripheral, but also central auditory pathways adjacent to infarctions were damaged. Magnetic resonance angiography (MRA) showed severe stenosis or occlusion of left vertebral artery and basilar artery. We concluded that hypoperfusion of the vertebrobasilar artery territories caused ischemia of the cochlear nerve and the auditory tracts in the brain stem, which resulted in bilateral hearing loss.

Aged↗

PubMed2000

[Ototoxic mechanism of aminoglycoside antibiotics--role of glutaminergic NMDA receptors].

Recent studies have indicated that glutamatergic NMDA receptors in the cochlea may be involved in ototoxic effects of aminoglycosides in animal subjects. Aminoglycoside antibiotics enhance the function of NMDA receptors by interaction with a polyamine modulatory site. Accordingly, high doses of aminoglycosides may increase calcium entry through the NMDA receptor-associated channel and promote degeneration of hair cells and cochlear nerve fibers. In line with the above, a polyamine site antagonist, ifenprodil as well as a high-affinity channel blocker, dizocilpine (MK-801) attenuates ototoxic effects of aminoglycosides in rats. Notably, ifenprodil as well as low-affinity channel blockers (e.g. memantine and amantadine) may be safely used in humans. Taken together, the above findings seem to open new avenues of research on selective pharmacotherapy of aminoglycosides-induced ototoxicity in humans.

Aminoglycosides↗

PubMed2001

Expression of the Kv3.1 potassium channel in the avian auditory brainstem.

The Shaw-like potassium channel Kv3.1, a delayed rectifier with a high threshold of activation, is expressed in the time coding nuclei of the bird auditory brainstem. In both barn owls and chickens, Kv3.1 mRNA was expressed in the cochlear nucleus magnocellularis (NM) and the nucleus laminaris (NL). Western blot analysis showed that an antibody raised against the synthetic peptide sequence of rat Kv3.1 (rKv3.1) specifically recognized the same 92 kDa protein bands in both rat and chicken synaptosomal preparations. Immunohistochemical analyses using this anti-rKv3.1 antibody revealed a prominent gradient in Kv3.1 immunoreactivity along the tonotopic axis of the barn owl NM and NL and a less prominent gradient in the chicken. The precise localization of the Kv3.1 immunoproduct was resolved by electron microscopy. In both the owl and the chicken, Kv3.1 was targeted postsynaptically in NM and NL. The major difference in localization of Kv3.1 protein between the two birds was the expression of Kv3.1 in the NM axons and terminals in the region of the barn owl NL. This location of Kv3.1 channels supports its postulated function in reducing the width of action potentials as they invade the presynaptic terminal. The presynaptic localization may be a specialization for enabling neurons in owl NM to transmit high-frequency temporal information with little jitter.

Alternative Splicing↗

PubMedDate not supplied

A hypothesis of epiarachnoidal growth of vestibular schwannoma at the cerebello-pontine angle: surgical importance.

AIMS: The purpose of this study is to clarify the rearrangement of the arachnoid membrane on the vestibular schwannoma during its growth in relation to adjacent neurovascular structures for a better understanding of dissecting plane of arachnoid during surgery. METHODS: Arachnoid membrane over the tumour was investigated during surgery with suboccipital transmeatal approach in twenty-six tumours. All microsurgical procedures were recorded with a video and reviewed. The tumour growth was classified into five stages depending upon the tumour diameter in the cerebello-pontine (CP) angle: Stage 1; purely intracanalicular (2 cases), Stage 2; less than 5 mm (2 cases), Stage 3; > or = 5 and <15 mm (8 cases), Stage 4; > or = 15 and <25 mm (9 cases) and Stage 5; > or = 25 mm (5 cases). Rearrangement of the arachnoid on the tumour was conceptualised throughout all stages. RESULTS: All tumours of Stage 1 and 2 were entirely located in the subarachnoid space of the cerebello-pontine cistern without arachnoidal rearrangement, while all tumours of Stages 3 to 5 were enveloped, in the CP angle, with invaginated arachnoid membrane consisting of cerebello-pontine cistern except two surfaces; the medial pole and the tumour surface under the facial and cochlear nerves near the porus. CONCLUSION: The tumour originates subarachnoidally within the internal auditory meatus (IAM) and grows epiarachnoidally in the CP angle. Rearrangement of the arachnoid begins with its adhesion on the medial pole of the tumour along the porus, resulting in the arachnoidal invagination into the cerebello-pontine cistern with further growing of the tumour.

Adult↗

PubMed2002

[A case of partial hearing recovery after ablation of cerebello-pontine angle neurinoma].

A case of a 44 year-old woman farmer with a total deafness and lack of vestibular function on the left side operated upon the cerebello-pontine cystic neuroma 2.5 x 2.0 x 1.5 cm large via the retromastoidal craniectomy is presented. Despite of the negative audiological tests' results the cochlear nerve flatten on the tumor was cautiously separated. Some time after surgery, she observed "a partial recovery of hearing" in the operated ear confirmed by the tonal (mean 0.5-2 kHz 36 dBHL) vocal SRT 70 dB), BERA and EOAEs tests. The paralysis of the left vestibular function did not recover. In consecutive audiogram a notch at 6 kHz 15 dB deep appeared in the operated ear and one can presume an increased vulnerability of this ear to the noise of the agricultural machines used by then by the patient.

Adult↗

PubMed2001

[Relationship between three inner ear antigens and autoimmune inner ear disease].

OBJECTIVE: To investigate the relationship between three purified inner ear antigens and autoimmune inner ear disease (AIED), and to determine their expressions in normal guinea pig cochleas. METHODS: Guinea pigs were divided into group B, group C and group D and immunized respectively with three subcomponents of crude inner ear antigens (31,000, 42,000-45,000 and 60,000 proteins). Hearing thresholds, serum IgG levels and morphological changes of inner ear were observed. The protein expressions of these antigens were examined by immunohistochemistry. In the control group, antigens were replaced by gel homogenate of polyacrylamide. RESULTS: There were no significant differences of hearing threshold among groups before immunization with inner ear antigens (F = 0.07, P > 0.05). There were no significant changes of hearing thresholds and inner ear morphology in group C and control group. Hearing thresholds dropped in part of animals immunized with 31,000 or 60,000 protein. Hearing threshold of group B and D changed significantly after immunization, as compared with the control group(F = 9.12, P < 0.01). Serum IgG levels increased significantly in all experimental groups compared with the control group(F = 7.46, P < 0.01). The 31,000 protein distributed strictly in cochlear nerve, and 42,000-45,000 or 60,000 protein distributed widely, including the spiral ganglion, Corti's organ, stria vascularis and spiral ligament. CONCLUSIONS: Two subcomponents of 31,000 and 60,000 in crude inner ear antigen could induce autoimmune inner ear disease. The distribution of 31,000 protein was more tissue specific and might be used as a marker protein for clinical diagnosis of autoimmune inner ear disease.

Animals↗