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Vestibulo-ocular reflexes after selective plugging of the semicircular canals in the monkey--response plane determinations.

The contribution from different pairs of semicircular canals to the generation of horizontal vestibular nystagmus was examined in monkeys. Animals with different pairs of semicircular canals surgically plugged were accelerated sinusoidally at 1 Hz (a predictive stimulus) or with steps of angular velocity (a non-predictive stimulus) about an earth vertical axis while the head was placed in various static pitch positions. In normal animals, and in animals with only the lateral canals intact, horizontal nystagmus elicited with angular velocity steps is maximal at a static pitch angle of 15 degrees nose-down (relative to the horizontal stereotaxic plane). The response follows a cosine function of the pitch angle, approaches zero at an angle of 90 degrees to the optimal orientation, and finally reverses. In animals with only the vertical canals operating, direction specific horizontal nystagmus can still be elicited. Using velocity steps, a null plane at which nystagmus reverses can be determined. It is found at about 32 degrees nose-down and thus is different from the optimal plane of the lateral canals. Consequently, it is not possible to stimulate the lateral canals maximally without stimulating the vertical canals simultaneously. Using sinusoidal rotation, nystagmus is attenuated at the static pitch position of 32 degrees nose-down, but does not reverse direction with further pitching.

Animals↗

Input patterns and pathways from the six semicircular canals to motoneurons of neck muscles. II. The longissimus and semispinalis muscle groups.

To reveal patterns of input from the six semicircular canals to motoneurons of various neck muscles and their relationship to the mechanical actions of individual neck muscles, patterns of input to neck motoneurons of the longissimus and the semispinalis muscle groups were investigated in the upper cervical spinal cord of anesthetized cats. Intracellular potentials were recorded from motoneurons of the longissimus muscle group (obliquus capitis superior muscle, OCS; splenius muscle, SPL; longissimus muscle, LONG) and the semispinalis muscle group (biventer cervicis muscle, BIV; complexus muscle, COMP), and effects of separate electrical stimulation of the six ampullary nerves on them were analyzed in each preparation. Neck motoneurons usually received convergent inputs from all of the six ampullary nerves, and motoneurons that supplied a particular muscle had a homogeneous pattern of input from the six ampullary nerves. Two different patterns of input were identified for motoneurons of these two muscle groups; one pattern for motoneurons of the longissimus muscle group and the other pattern for motoneurons of the semispinalis muscle group. Motoneurons of the OCS, the SPL, and the LONG muscles received excitation from the three contralateral ampullary nerves and inhibition from the three ipsilateral ampullary nerves. BIV and COMP motoneurons received excitation from the bilateral anterior canal nerves (ACNs) and the contralateral canal nerve (LCN) and inhibition from the bilateral posterior canal nerves (PCNs) and the ipsilateral LCN. Latencies of postsynaptic potentials (PSPs) evoked by stimulation of each of the six ampullary nerves indicated that the earliest component of excitatory PSPs (EPSPs) and inhibitory PSPs (IPSPs) was disynaptic in these motoneurons. However, trisynaptic IPSPs were evoked by stimulation of the contralateral PCN in a considerable number of BIV and COMP motoneurons. In OCS, SPL, and LONG motoneurons, all of the excitation from the contralateral and all of the inhibition from the ipsilateral ampullary nerves were mediated through the ipsilateral medial longitudinal fascicle (MLF). In BIV and COMP motoneurons, disynaptic excitation from the contralateral ACN and LCN and disynaptic inhibition from the ipsilateral LCN and bilateral PCNs were mediated through the ipsilateral MLF, whereas disynaptic excitation from the ipsilateral ACN was mediated through the ipsilateral lateral vestibulospinal tract. The patterns of semicircular canal input to neck motoneurons of these two muscle groups are related closely to the mechanical actions of the individual neck muscles and the optimal stimulus to the semicircular canals such that the connections will tend to stabilize head positions in response to head perturbations.

Animals↗

Characteristics of regenerating horizontal semicircular canal afferent and efferent fibers in the toadfish, Opsanus tau.

The horizontal semicircular canal nerve of the toadfish, Opsanus tau, was transected and allowed to regenerate. The time course, morphometrics, and projection patterns of regenerating afferent and efferent vestibular fibers were determined. Nerve transections were performed both pre- and postganglionically, and regeneration was assessed in afferent and efferent fibers by bulk labeling the peripheral axons of the horizontal semicircular canal nerve with biocytin after nerve regrowth. Afferent fibers regrew through the transection site within 14 days and projected to all vestibular nuclei within 3 weeks. Bouton and branch number, axon length, surface area, volume, fiber diameter, and internodal distance were quantified for afferent fibers from eight sites within the vestibular nuclei, and axon number and soma size was quantified for the efferent fibers. Extensive regeneration was seen within 5 weeks of transection in all nuclei, and most morphometric parameters approached or exceeded control levels within 10 weeks. Regeneration appeared to recapitulate morphogenesis with an initial overproduction of boutons and branch points followed by elimination of presumably superfluous structures. Internodal distance remained significantly shorter in regenerating afferent axons than in control fish throughout the 15-week observation period. Efferent fibers also were observed to regenerate. Efferent axon number, diameter, and soma size were indistinguishable from those in controls from 3 weeks posttransection through week 15. Electrophysiological recordings from the horizontal canal nerve during mechanical stimuli of the canal confirmed that the regenerated axons transmitted normal signals. The return of normal equilibrium and behavior coincided with the projection of afferent fibers into the central vestibular nuclei, indicating that functional connections had been reestablished.

Afferent Pathways↗

[Benign paroxysmal positional vertigo of the horizontal and superior semicircular canals].

The incidence of benign paroxysmal positional vertigo (BPPV) of the horizontal and superior semicircular canals is much less than that of BPPV due to affection of the posterior semicircular canal. Their diagnosis is however much more difficult and still prone to controversies. The provocative manoeuvre of the BPPV of the horizontal canal (BPPV-HSC) is the manoeuvre of rotation of the head in dorsal position. A horizontal positional nystagmus is obtained. There are two forms of BPPV-HSC: the geotropic form and the ageotropic form. In the geotropic form, the liberatory manoeuvre is a "barbecue" rotation of 180 with 360 degrees towards the healthy side. In the ageotropic form, there is no universal liberatory manoeuvre. Moreover as some cases of neurological aetiology have been recognized, it is not appropriate to apply ineffective manoeuvres. The BPPV of the superior canal (BPV-SSC) is very rare. The provocative manoeuvre is the Dix and Hallpike's manoeuvre. It causes positional torsional and vertical nystagmus with an opposite direction to that obtained for a BPPV of the contra-lateral posterior canal. The liberatory manoeuvre is a Semont manoeuvre, which is identical to that we would make for a contra-lateral BPPV of the posterior canal.

Caloric Tests↗

[Functional relationships between the horizontal and vertical anterior semicircular canals in the labyrinth of the frog (Rana esculenta L.)].

We have studied the vestibular postrotatory reactions (reactions elicited by the stimulation of the horizontal semicircular canals) in the frog blinded by section of optic nerves, before and after section of the ampullary nerves of the vertical anterior semicircular canals (VAC). 90 frogs have been studied. In 30 frogs the ampullary nerves of the two VAC have been cut; in 60 animals either the ampullary nerve of the right VAC or of the left VAC has been cut. Both after section of the ampullary nerves of the two VAC and after section of the ampullary nerve of one VAC, the postrotatory reactions were decreased in about the half of the animals. The decrease of the postrotatory reactions is not due to a lesion of the ampullary nerves of the horizontal semicircular canals and it may be explained by the existence of functional connections between the VAC and the horizontal canal.

Animals↗

Hearing results following posterior semicircular canal injury during antesigmoid retrolabyrinthine selective vestibular nerve section.

The disastrous hearing results in six patients whose posterior semicircular canal was entered during antesigmoid mastoid craniotomy for retrolabyrinthine selective vestibular nerve section were reviewed. The injury occurred during skeletonization of the posterior semicircular canal to maximize intracranial exposure of the eighth nerve. All patients had Meniere's disease. Four patients were deafened, and in two, there was either no serviceable hearing or severe hearing impairment in the operated ear. Caution is urged in posterior semicircular canal labyrinthotomy for vertigo and attempted hearing preservation if a patient has symptoms of endolymphatic hydrops.

Craniotomy↗

Synaptic responses to mechanical stimulation in calyceal and bouton type vestibular afferents studied in an isolated preparation of semicircular canal ampullae of chicken.

Relationships between the response patterns of semicircular canal afferents to mechanical stimulation and the morphologies of their peripheral endings were investigated in an isolated preparation of the anterior semicircular canal ampulla of chicken, using a combination of electrical recording with intracellular injections of Lucifer Yellow CH. The hair bundle mechanical stimulus was applied in a diffuse manner by a glass rod vibrating in the nearby bathing medium. Two types of spike discharge patterns and postsynaptic potentials were recorded. One type was found exclusively in the bouton type afferent and demonstrated a phasic increase of firing frequency and transient depolarizing postsynaptic potentials at the beginning of mechanical stimulation. These synaptic potentials were also observed spontaneously and their amplitudes were increased by membrane hyperpolarization. The other type was found exclusively in afferents with calyceal endings and showed a tonic increase of spiking frequency and depolarizing DC postsynaptic potentials with superimposing AC responses at the frequency of the mechanical stimulation. Amplitudes of postsynaptic potentials were increased by hyperpolarization. Hair cells generated depolarizing DC transduction potentials superimposed with AC potentials at frequency of the mechanical stimulation. The spontaneous spike discharging patterns of afferent nerve fibres were classified either as a regular type (CV less than 0.10) or as an irregular type (CV greater than 0.25) on the basis of coefficient of variation (CV) of interspike intervals. The spontaneous firing rate of regular units was higher than that of irregular units. Several membrane characteristics are different between these two types of afferent fibers; irregular units had short membrane time constants and fast spikes associated with clear spike-afterhyperpolarization. These features fit with the fact that irregular units tend to have phasic responses to mechanical stimulation while regular units typically have tonic responses. Irregular units had bouton endings with an average axonal diameter thicker than the regular units which had calix endings.

Action Potentials↗

Physiology of the semicircular canals after surgical plugging.

Inactivation of individual semicircular canals by surgical occlusion (plugging) of the slender duct has been used in basic studies to elucidate the role of individual canal inputs to vestibular-mediated control systems and in clinical applications to treat certain vestibular disorders. The procedure has been shown to be highly effective in blocking sensitivity of individual canals, at least for moderate angular motion stimuli. Effectiveness does not extend to stimuli involving high accelerations where a residual response persists even after complete occlusion of the duct. The residual can be quite large at high-stimulus frequencies where sensitivity to angular motion approaches that of patent canals. The overall physiological effect of canal plugging is reported here in terms of the frequency-dependent attenuation in gain and phase shift of primary afferents. Plug-canal responses are quantitatively described in terms of biomechanics of the deformable labyrinth.

Animals↗

Posterior semicircular canal occlusion for intractable benign paroxysmal positional vertigo.

Benign paroxysmal positional vertigo (BPPV) is most often a self-limited disorder arising from the posterior semicircular canal of the undermost ear in the Hallpike position. Some individuals with this disorder have severe and protracted symptoms requiring more than expectant therapy. We describe two patients with intractable BPPV and profound sensorineural hearing loss in the affected ear treated by transmastoid posterior semicircular canal occlusion. Postoperatively, both were relieved of their BPPV and demonstrated preserved lateral semicircular canal function as measured by electronystagmography. We feel this new procedure provides a simpler and possibly safer alternative to singular neurectomy and should be given future consideration in the treatment of intractable BPPV in a normal-hearing ear.

Adult↗

Coronal computed tomography prevalence of superior semicircular canal dehiscence.

OBJECTIVES: The relatively new clinical entity superior canal dehiscence syndrome (SCDS) is diagnosed by clinical symptoms and signs. Coronal computed tomography (CT) has been used to confirm the diagnosis. A consecutive series of temporal bone CT scans was reviewed to define the prevalence of a dehiscent-appearing superior semicircular canal. STUDY DESIGN AND SETTING: Temporal bone CT scans performed over a 2-year period at a university-based tertiary referral center were reviewed independently by 3 individuals. Scans were excluded if coronal images were not obtained or reconstructed from axial images. Prevalence figures for dehiscent-appearing superior semicircular canal were determined by consensus. Medical records of selected individuals with a dehiscent-appearing canal were reviewed for study indications and otologic symptoms. RESULTS: A dehiscent-appearing superior semicircular canal was seen in 9% of studies. Correlation among examiners was greater than 94%. Medical records indicated symptoms suggestive of or compatible with the diagnosis of SCDS in rare cases. CONCLUSION: The prevalence of a dehiscent-appearing superior semicircular canal on coronal CT of the temporal bones performed with 1.0-mm collimation is substantially greater than that predicted by temporal bone histologic study. Clinical symptoms compatible with the diagnosis were seldom recorded, suggesting low specificity. The high sensitivity and low specificity of CT scan create a risk for overdiagnosis of SCDS if the coronal CT scans are not correlated with clinical symptoms.

Adolescent↗

Floccular influence on excitatory relay neurones of vestibular reflexes of anterior semicircular canal origin in the cat.

Floccular influence on excitatory vestibular reflex arcs of anterior semicircular canal origin was examined in the anaesthetized cat. Stimulation of the anterior semicircular canal nerve (ACN) evoked disynaptic excitatory postsynaptic potentials (EPSPs) in all sampled inferior oblique (IO), superior rectus (SR), and biventor cervicis (BIV) muscle motoneurones of the contralateral side. Conditioning stimulus to the flocculus depressed the amplitude of the EPSPs in both IO and SR motoneurones by 50% on the average but not in any BIV motoneurones. The excitatory vestibulo-ocular neurones identified by orthodromic and antidromic responses to stimulation of the ACN and the contralateral IO motoneurone pool, respectively, were classified as VOC (vestibulo-ocular neurones with axons descending to the cervical segment) or VO (vestibulo-ocular proper) neurones on the basis of whether or not they responded antidromically to stimulation of the spinal cord in the C1 segment. All of the VO neurones in the superior vestibular nucleus (n = 19) were inhibited from the flocculus while the activities of three-fourths of the VO neurones (36/48) in the other vestibular nuclei were not suppressed by floccular stimulation. In contrast, none of VOC neurones (n = 49) received floccular inhibition. Besides inhibition, floccular stimulation induced the antidromic or orthodromic responses in some VO and VOC neurones.

Animals↗

[The responses of frog vestibular neurons to the combined temperature microstimulation of the semicircular canals].

Controlled temperature microstimulation of the frog semicircular canal (heating of 2 sec duration, peak amplitude from 0.5 to 5.0 degrees C above the temperature level of the labyrinth, 17-19 degrees C) may be considered as an analogue of angular acceleration in the plane of the canal. Combined temperature microstimulation of some canals may be considered as a physical model of complicated space rotations. Responses of the frog vestibular nuclei's neurons (n = 278) to temperature microstimulation showed that 80% of them had inputs from 1-2 canals and only 20% of neurons--from 3-6 canals. 201 neurons (72.3%) had ipsilateral inputs only; 14 neurons (5%)--contralateral ones only; 63 neurons (22.7%) had both inputs. The most effective excitatory inputs were ipsilateral horizontal, ipsilateral posterior and contralateral posterior canals; the least effective were contralateral horizontal and contralateral anterior canals. Latent canal inputs (excitatory as well as inhibitory) seem to exist as revealed in combination with the effective inputs.

Animals↗

The orientation of the semicircular canals in the guinea pig.

In 10 adult guinea pigs the stereotaxic coordinates of a series of points along each osseous semicircular canal were analysed to yield an equation of that canal plane in stereotaxic space. Angular relationships among the canal planes and between the canal planes and the major stereotaxic planes are presented together with the optimal positions of the head for physiological stimulation of each canal or pair of synergistic canals. The planes of the semicircular canals in each labyrinth are not perpendicular to one another and the planes of contralateral synergistic canals depart from parallelism by about 30 degrees.

Acceleration↗

Symptoms, findings and treatment in patients with dehiscence of the superior semicircular canal.

Recently Minor and co-workers described patients with sound- and pressure-induced vertigo due to dehiscence of the superior semicircular canal. Identifying patients with this 'new' vestibular entity is important, not only because the symptoms are sometimes very incapacitating, but also because they can be treated. We present symptoms and findings in eight such patients, all of whom reported pressure-induced vertigo that increased during periods of upper respiratory infections. Pulse-synchronous tinnitus and gaze instability during head movements were also common complaints. All patients lateralized Weber's test to the symptomatic ear. In some of the patients the audiogram also revealed a small conductive hearing loss. However, the stapedius reflexes were always normal. A vertical/torsional eye movement related to the superior semicircular canal was seen in most of the patients in response to pressure changes and/or sound stimulation. One patient also had superior canal-related positioning nystagmus. Testing vestibular evoked myogenic potentials revealed in all patients a vestibular hypersensitivity to sounds. In the coronal high-resolution 1-mm section CT scans the dehiscence was visible on 1 to 4 sections. Moreover, the skull base was rather thin in this area and cortical bone separating the middle ear and the antrum from the middle cranial fossa was absent in many of the patients. Two of the patients have undergone plugging of the superior semicircular canal using a transmastoid approach and both patients were relieved of the pressure-induced symptoms.

Adult↗

Influence of surgical plugging on horizontal semicircular canal mechanics and afferent response dynamics.

Mechanical occlusion of one or more of the semicircular canals is a surgical procedure performed clinically to treat certain vestibular disorders and used experimentally to assess individual contributions of separate canals and/or otoliths to vestibular neural pathways. The present experiments were designed to determine if semicircular canal afferent nerve modulation to angular head acceleration is blocked by occlusion of the endolymphatic duct, and if not, what mechanism(s) might account for a persistent afferent response. The perilymphatic space was opened to gain acute access to the horizontal canal (HC) in the oyster toadfish, Opsanus tau. Firing rate responses of HC afferents to sinusoidal whole-body rotation were recorded in the unoccluded control condition, during the process of duct occlusion, and in the plugged condition. The results show that complete occlusion of the duct did not block horizontal canal sensitivity; individual afferents often exhibited a robust firing rate modulation in response to whole-body rotation in the plugged condition. At high stimulus frequencies (about >8 Hz) the average sensitivity (afferent gain; spikes/s per degrees /s of head velocity) in the plugged condition was nearly equal to that observed for unoccluded controls in the same animals. At low stimulus frequencies (about <0.1 Hz), the average sensitivity in the plugged condition was attenuated by more than two orders of magnitude relative to unoccluded controls. The peak afferent firing rate for sinusoidal stimuli was phase advanced approximately 90 degrees in plugged canals relative to their control counterparts for stimulus frequencies approximately 0.1-2 Hz. Data indicate that afferents normally sensitive to angular velocity in the control condition became sensitive to angular acceleration in the plugged condition, whereas afferents sensitive to angular acceleration in the control condition became sensitive to the derivative of acceleration or angular jerk in the plugged condition. At higher frequencies (>8 Hz), the phase of afferents in the plugged condition became nearly equal, on average, to that observed in controls. A three-dimensional biomechanical model of the HC was developed to interpret the residual response in the plugged condition. Labyrinthine fluids were modeled as incompressible and Newtonian; the membranous duct, osseous canal and temporal bone were modeled as visco-elastic materials. The predicted attenuation and phase shift in cupular responses were in close agreement with the observed changes in afferent response dynamics after canal plugging. The model attributes the response of plugged canals to labyrinthine fluid pressure gradients that lead to membranous duct deformation, a spatial redistribution of labyrinthine fluids and cupular displacement. Validity of the model was established through its ability to predict: the relationship between plugged canal responses and unoccluded controls (present study), the relationship between afferent responses recorded during mechanical indentation of the membranous duct and physiological head rotation, the magnitude and phase of endolymphatic pressure generated during HC duct indentation, and previous model results for cupular gain and phase in the rigid-duct case. The same model was adjusted to conform to the morphology of the squirrel monkey and of the human to investigate the possible influence of canal plugging in primates. Membranous duct stiffness and perilymphatic cavity stiffness were identified as the most salient model parameters. Simulations indicate that canal plugging may be the most effective in relatively small species having small labyrinths, stiff round windows, and stiff bony perilymphatic enclosures.

Afferent Pathways↗

A simple technique for thermal stimulation of single semicircular canals.

Two simple thermodes for stimulating single semicircular canals have been designed in order to elicit eye nystagmus. The first, for warm stimulation, is based on the Joule effect: a silver needle is warmed up by means of a coiled nickrome wire. The temperature at the thermode tip is function of current intensity. The thermode for cold stimulation is a device in which a circulating freezing mixture cools a silver needle. The temperature at the thermode tip is proportional to the temperature of the freezing mixture.

Animals↗

Physiological localization of the semicircular canal receptors in the crista.

Isolated posterior semicircular canals from the bull frog model were used. The cupula was removed from the crista and the sensory cilia on the crista were depressed toward the canal side by using a glass micropipette. Seven different points were selected for stimulation on the ampullary wall. Ampullary nerve action potentials induced by depression were recorded and were converted into spike-density histograms. Response decremental time constants were measured on these histograms. The longest time constant was measured at the two lateral points of stimulation and progressively shortened toward the central point of stimulation. These results indicate that the origin of the adaptation is possibly sensorineural.

Action Potentials↗