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At least 19 recordsLinked to original sources

CT detection of facial canal dehiscence and semicircular canal fistula: comparison with surgical findings.

OBJECTIVE: The purpose of this study was to determine the accuracy of high resolution CT (HRCT) in the detection of facial canal dehiscence and semicircular canal fistula, the preoperative evaluation of both of which is clinically very important for ear surgery. MATERIALS AND METHODS: We retrospectively reviewed the HRCT findings in 61 patients who underwent mastoidectomy at Yamagata University between 1989 and 1993. The HRCT images were obtained in the axial and semicoronal planes using 1 mm slice thickness and 1 mm intersection gap. RESULTS: In 46 (75%) of the 61 patients, the HRCT image-based assessment of the facial canal dehiscence coincided with the surgical findings. The data for the facial canal revealed sensitivity of 66% and specificity of 84%. For semicircular canal fistula, in 59 (97%) of the 61 patients, the HRCT image-based assessment and the surgical findings coincided. The image-based assessment in the remaining two patients, who both had massive cholesteatoma, was false-positive. CONCLUSION: HRCT is useful in the diagnosis of facial canal dehiscence and labyrinthine fistula, but its limitations should also be recognized.

Adolescent↗

Semicircular canal plane head impulses detect absent function of individual semicircular canals.

We studied the human vestibulo-ocular reflex (VOR) in response to head 'impulses': brief, unpredictable, passive, high-acceleration (up to 4000 degrees/s2), low-amplitude (20-30 degrees) head rotations. We delivered the head impulses approximately in the plane of the semicircular canal (SCC) being tested. To test the anterior and posterior SCCs, the head impulses were delivered in a diagonal plane, midway between the frontal (roll) and sagittal (pitch) planes. We recorded head and eye position in three dimensions with scleral search coils in nine normal subjects, seven patients following unilateral surgical vestibular neurectomy and three patients following unilateral posterior SCC occlusion. In the post-surgical patients we demonstrated a severe, permanent VOR gain deficit (0.2-0.3) for head impulses directed toward any single non-functioning SCC. The sensitivity of the test depends on the physiological properties of primary vestibular afferents, and its specificity depends on the anatomical orientation of the SCCs. The diagonal head impulse is the first test of individual vertical SCC function in humans, and together with the horizontal head impulse, forms a comprehensive battery of SCC-plane tests. These canal-plane impulses could be useful in evaluating patients with vertigo or other vestibular disorders.

Adult↗

Acoustic stimulation of the semicircular canals.

Stimulation of the semicircular canals provides an alternative method of vibratory stimulation of the auditory system. The frequency response characteristics of stimulation of the tympanic membrane, malleus, stapes, round window, and fenestrated semicircular canal are presented in this article.

Animals↗

An electrokinetic model of transduction in the semicircular canal.

Transduction in the semicircular canal was studied by focusing an infrared beam on either side of exposed ampullae from the posterior canals of Rana pipiens. The direction of fluid movement resulting from a stimulus was inferred by observing the polarity of the change in afferent impulse mean rate relative to the spontaneous value. On the basis of the accepted functional polarization of this receptor, the results indicate that fluid moved toward the warmer side of the ampulla. Convection and thermal reception were shown to be unlikely explanations for these results. Morover, cupular displacements toward the warmer side would not be expected. Because thermo-osmosis can cause fluid to move toward the warmer side in a gelatin membrane, the results can be interpreted as evidence that thermo-osmosis occurred in the gelatinous cupula and influenced the transduction mechanism. Thermo-osmosis of liquids appears to be due to an electric field that is set up in a charged membrane; hence, the hair cells might have detected an electric field that occurred in the cupula during thermo-osmosis. Electroreception might be an important link in the transduction of physiological stimuli also. Rotational stimuli could result in weak electric fields in the cupula by the mechanoelectric effect. Cupular displacements could be important for large stimuli, but extrapolations to threshold stimuli suggest displacements of angstrom amplitudes. Therefore, electroreception by the hair cells could be an explanation of the great sensitivity that has been observed in the semicircular canal and other labyrinthine receptors.

Animals↗

Head impulses reveal loss of individual semicircular canal function.

We studied individual semicircular canal responses in three dimensions to high-acceleration head rotations ("head impulses") in subjects with known surgical lesions of the semicircular canals, and compared their results to those of normal subjects. We found that vestibular-ocular reflex (VOR) gains at close to peak head velocity in response to yaw, pitch and roll impulses were reliable indicators of semicircular canal function. When compared to normals, lateral canal function showed a 70-80% decrease in VOR gain at peak of yaw head velocity during ipsilesional yaw impulses. After the loss of one vertical canal function there was a 30-50% decrease in vertical and torsional VOR gain in response to ipsilesional pitch and roll impulses respectively. Bilateral deficits in anterior or posterior canal function resulted in a 80-90% decrease in vertical VOR gain during ipsilesional pitch impulses, while the loss of ipsilateral anterior and posterior canal functions will result in a 80-90% decrease in torsional VOR gain in response to ipsilesional roll impulses. Three-dimensional vector analysis and animation of the VOR responses in a unilateral vestibular deafferented subject to yaw, pitch and roll impulses further demonstrated the deficits in magnitude and direction of the VOR responses following the loss of unilateral lateral, anterior and posterior canal functions.

Adult↗

Differential processing of semicircular canal signals in the vestibulo-ocular reflex.

Selective semicircular canal inactivation and three-dimensional eye movement recordings have been used to investigate the spatial organization of vestibular signals in the vestibulo-ocular reflex (VOR) of rhesus monkeys. In animals with one pair of semicircular canals inactivated, afferent activity no longer codes all spatial components of head angular velocity. if it were the activation pattern of semicircular canal afferents alone that determines VOR slow phase eye velocity, the head velocity components along the sensitivity vectors of the remaining intact semicircular canals would determine the orientation of slow phase eye velocity. Thus, angular head velocity and slow phase eye velocity would not necessarily always align. Alternatively, if vestibulo-ocular signals coded absolute angular head motion in space based on both semicircular canal and otolith afferent information, one might expect a spatial transformation of the encoded head angular velocity signals such that slow phase eye velocity and angular head velocity continue to spatially align. Examination of the VOR at different frequencies between 0.01 Hz and 1 Hz revealed a frequency-specific spatial organization of vestibulo-ocular signals. Mid and high frequency vestibulo-ocular responses were determined exclusively by the orientation of the sensitivity vectors of the remaining intact semicircular canals. In contrasts, low frequency vestibulo-ocular responses were largely determined by the orientation of the head relative to gravity. These low frequency responses after selective semicircular canal inactivation could be predicted and simulated by a simple model where semicircular canal signals are spatially transformed from a head-fixed to a space-fixed (inertial) representation of angular head velocity. These findings suggest that low frequency vestibulo-ocular responses are dominated by inertial vestibular signals that detect absolute head motion in space based on both semicircular canal and otolith afferent information. Inertial vestibular signals are likely to contribute to head control and motor coordination of gaze, head and body posture.

Animals↗

[Position of semicircular canals in humans and cryptogenetic cupulolithiasis].

Semicircular canals in humans are three membranous tubes each forming two-thirds of a circle, arranged in a coordinate system. The horizontal semicircular canal makes a 30 degree angle with the horizontal plane, a phenomenon neither easily understood nor explained in Literature. This paper reports a personal opinion based on the theory of evolution. Before man assumed erect posture (Australopithecus Afarensis), more than 3 million years ago, the head was bent forward (as in other primates) so that the temporal bone (structures inside included) laid on the horizontal plane. In the Author's opinion the present alignment might have come about after the gradual change in posture in human evolution. The ampulla of the posterior canal and the non ampullary branch of the horizontal semicircular canal became the lowest part of the utricule thereby allowing otoconial debris to settle. On the basis of this hypothesis the Authors attempt to explain the high prevalence of idiopathic cupulolithiasis.

Humans↗

A quantitative analysis of the spatial organization of the vestibulo-ocular reflexes in lateral- and frontal-eyed animals--I. Orientation of semicircular canals and extraocular muscles.

The spatial relationship between extraocular muscles and semicircular canals was evaluated in cat (frontal-eyed animal) and rabbit (lateral-eyed animal). Semicircular canal orientations in the rabbit were determined by a principal components analysis of data points obtained from the exposed osseous canals using a three-axis micromanipulator. Canal orientations were presented in terms of unit sensitivity vectors. Orientation of extraocular muscles in rabbits and cats was derived from measurements of the insertion and origin of each muscle with respect to a reference point on the skull and a calculated estimate of the center of the eye. Muscle orientations were presented in terms of unit action vectors. Semicircular canal planes of the rabbit labyrinth were not orthogonal, having deviations up to 14 degrees. Pairs of antagonistically acting vertical semicircular canals, left (right) anterior-right (left) posterior deviated from coplanarity by 16 degrees, while the deviation for the horizontal canals was 9 degrees. In both animals, muscles of an antagonistic pair were coplanar to within 8 degrees, with the exception of the oblique muscles in the rabbit for which the deviation was 19 degrees. The three pairs of antagonistic muscles were almost orthogonal to each other, the maximum deviation between any of the pairs being 8 degrees in the cat and 18 degrees in the rabbit. Comparing extraocular muscle planes and semicircular canal planes reveals that they are roughly aligned. However, there were slight but consistent differences between a given semicircular canal plane and the planes of the muscles to which this canal is connected by the classical three-neuron-arc (principal vestibulo-ocular reflex circuits).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

In vitro electrogenic K secretion in the frog semicircular canal: absence of effect of streptomycin.

In vitro, the frog semicircular canal secretes an endolymph-like fluid, i.e. a K-rich, positively polarized fluid. This electrogenic K secretion involved basolateral Na+, K(+)-ATPase and Na-K-Cl co-transporter and a luminal protein possessing sulfhydryl groups blocked by N-ethylmaleimide. Streptomycin, an ototoxic antibiotic, is known to block the non-specific mechano-dependent channels in the sensory cells of the ampulla of the semicircular canal. The aim of the present study was to investigate the possible effect of streptomycin on the K fluxes in the ampulla of the semicircular canal. The posterior frog semicircular canal was isolated and the lumen was filled with perilymph-like solution containing or not containing 0.5 mM streptomycin. The luminal K concentration and the transepithelial potential were measured and the unidirectional K fluxes calculated. The K influxes (into the lumen, pmoles/min/mm2) were 114 +/- 25.9 and 111 +/- 3.2 (mean +/- SE, n = 3) in the absence and presence of streptomycin, respectively. The transepithelial potential was not altered (4.0 +/- 1.08 mV versus 3.4 +/- 1.03 mV, n = 3). When ouabain (10(-3)M) was added to the basolateral solution together with luminal streptomycin, no further alteration occurred as compared with the effect of ouabain alone. These results suggest that in these conditions, the sensory organ does not have a major role in the endolymphatic K secretion in the ampulla of the frog semicircular canal.

Animals↗

Spatial orientation of semicircular canals and afferent sensitivity vectors in pigeons.

Rotational head motion in vertebrates is detected by the semicircular canal system, whose innervating primary afferent fibers carry information about movement in specific head planes. The semicircular canals have been qualitatively examined over a number of years, and the canal planes have been quantitatively characterized in several animal species. The present study first determined the geometric relationship between individual semicircular canals and between the canals and the stereotactic head planes in pigeons. Stereotactic measurements of multiple points along the circumference of the bony canals were taken, and the measured points fitted with a three-dimensional planar surface. Direction normals to the plane's surface were calculated and used to define angles between semicircular canal pairs. Because of the unusual shape of the anterior semicircular canals in pigeons, two planes, a major and a minor, were fitted to the canal's course. Calculated angle values for all canals indicated that the horizontal and posterior semicircular canals are nearly orthogonal, but the anterior canals have substantial deviations from orthogonality with other canal planes. Next, the responses of the afferent fibers that innervate each of the semicircular canals to 0.5 Hz sinusoidal rotation about an earth-vertical axis were obtained. The head orientation relative to the rotation axis was systematically varied so that directions of maximum sensitivity for each canal afferent could be determined. These sensitivity vectors were then compared with the canal plane direction normals. The afferents that innervated specific semicircular canals formed homogeneous clusters of sensitivity vectors in different head planes. The horizontal and posterior afferents had average sensitivity vectors that were largely co-incident with the innervated canal plane direction normals. Anterior canal afferents, however, appeared to synthesize contributions from the major and minor plane components of the bony canal structure to produce a resultant sensitivity vector that was positioned between the canal planes. Calculated angles between the average canal afferent sensitivity vectors revealed that direction orthogonality is preserved at the afferent signal level, even though deviations from canal plane orthogonality exist.

Afferent Pathways↗

Functional model of benign paroxysmal positional vertigo using an isolated frog semicircular canal.

Bull frogs posterior semicircular canals (psc) wee used to simulate the condition of benign paroxysmal positional vertigo (BPPV). The psc was isolated in frog Ringer's solution, and the saccular otoconia were used as a responsible material to stimulate the cupula. When the otoconia were placed on the cupular surface to mimic the condition of cupulolithiasis, the psc ampullary nerve action potentials instantaneously changed according to the direction of the gravity produced by otoconia. When the otoconia were dropped into the canal to mimic the condition of moving otoconia in the canal, the action potentials changed together with the otoconial flow after a latent period. Both cupulolithiasis and moving otoconia are possibly valid mechanisms of BPPV, since they effectively stimulate the cupula. However, moving otoconia with a latent period would better explain clinical features of BPPV.

Action Potentials↗

Sensorineural and conductive hearing loss associated with lateral semicircular canal malformation.

OBJECTIVE: Lateral semicircular canal (LSCC) malformation is one of the most common radiological inner ear malformations. Traditionally, inner ear malformations are thought to be associated with sensorineural hearing loss (SNHL). Recent experience with patients with LSCC malformation suggested that LSCC malformation may be associated with both SNHL and conductive hearing loss (CHL). The auditory phenotype associated with LSCC malformation is not well delineated. The objective of this study is to define the nature of the hearing loss associated with LSCC malformation. STUDY DESIGN: Retrospective review METHODS: Retrospective review of clinical records, audiological evaluation, and imaging studies. RESULTS: Two patients with unilateral and 13 patients with bilateral LSCC malformation were identified. LSCC malformation was associated with CHL in 14% (4 ears), SNHL in 71% (20 ears), normal hearing in 11% (3 ears) and CHL due to atresia in one ear. Hearing loss varied from mild to profound but did not correlate with the severity of LSCC malformation. In bilateral malformation, the hearing loss was asymmetric in half of the cases. Malformation of the posterior limb of the LSCC was always associated with a large vestibular aqueduct. An absent or rudimentary LSCC was invariably associated with a cochlear abnormality. CONCLUSIONS: LSCC malformation, like other inner ear malformations such as large vestibular aqueduct and X-linked mixed deafness with perilymph gusher, can be associated with CHL, SNHL, or normal hearing. Children with unexplained conductive hearing loss often undergo exploratory surgery to improve hearing. Given that inner ear malformations may be associated with a pure CHL, it is critical that children undergo computed tomography scan of the temporal bone prior to undergoing exploratory surgery.

Adolescent↗

Contributions of single semicircular canals to caloric nystagmus as revealed by canal plugging in rhesus monkeys.

We demonstrated specific responses from the anterior and the posterior semicircular canal to irrigation of the outer ear canal with cold water in the Rhesus monkey. This required i) three-dimensional analysis of the evoked eye movements in the planes of the semicircular canals (canal plane vectors, CPV); ii) assessing these CPV responses in eight different head positions relative to gravity; iii) comparing the responses in 6 normal animals (12 ears) with responses after selective plugging of pairs of semicircular canals (all, both lateral, and right anterior + left posterior). The results showed: i) Irrigation of the outer ear canal with cold water induces thermoconvection also in the posterior and anterior semicircular canals. This can be inferred from the sinusoidal modulation of eye movement components with changes in position of the corresponding semicircular canal plane relative to gravity; ii) Specific vertical canal responses occur exclusively in the direction of the corresponding semicircular canal, though they are superimposed with response components of other origin, one probably related to endolymph shift in the lateral semicircular canal; iii) before possible clinical application, these different response components of vertical canals will need to be determined in humans.

Animals↗

Plane-specific brainstem commissural inhibition in frog second-order semicircular canal neurons.

Commissural inputs of identified second-order semicircular canal neurons were studied by separate stimulation of each of the three canal nerves on either side in the vitro frog brains. The spatial pattern of these inputs was further investigated in those second-order canal neurons that received a monosynaptic input from only one ipsilateral canal nerve (91%). Since similar results were obtained in the presence as in the absence of the cerebellum, commissural inputs must have been relayed via fibers crossing in the brainstem. Following stimulation of individual semicircular canal nerves, commissural inputs were either inhibitory or excitatory. A commissural inhibition was evoked in the majority of the recorded neurons (79%) by stimulation of the coplanar semicircular canal nerve on the contralateral side. In the remaining neurons, a commissural excitatory input was evoked. A commissural excitation, originating from the two noncoplanar semicircular canals, predominated in most (68%) of the recorded neurons and was independent of the type of second-order canal neuron. The onset latency of the canal plane-specific commissural inhibitory potentials was di- or trisynaptic. Stimulation of the contralateral VIIIth nerve evoked excitatory commissural responses. The canal plane-specific commissural inhibition therefore might have been masked by commissural excitatory responses as in earlier studies. The similar organization of the canal plane-specific commissural inhibition in frog and cat corroborates the notion of a phylogenetically conservative, basic vestibular organization. The presence of a canal plane-unspecific commissural excitation, however, appears to be a feature that is specific to frogs. The functional implications of these similarities and differences are discussed.

Animals↗

A comparative study of the isolated anterior and posterior semicircular canals of the bull frog.

The anterior semicircular canals of bull frogs were isolated and the cupula was removed from the crista and the sensory cilia on the crista were depressed toward the canal side by a glass micropipette. Seven points on the crista were selected for stimulation. Decremental time constants of the anterior ampullary nerve action potentials were measured. The longer time constants were measured at the lateral points of stimulation which progressively shortened toward the central point. The overall values of the time constant were significantly shorter than those of the posterior semicircular canal. This indicates that the anterior semicircular canal has a larger number of phasic receptors than the posterior canal.

Action Potentials↗

Particulate matter in the posterior semicircular canal.

The pathoetiology of benign paroxysmal positional vertigo (BPPV) is controversial. Particulate matter within the posterior semicircular canal has been identified intraoperatively in patients with BPPV but has also been reported in non-BPPV patients at the time of translabyrinthine surgery (Parnes LS, McClure JA. Free-floating endolymphatic particles: a new operative finding during posterior semicircular canal occlusion. Laryngoscope 1992;102:988-92; Schuknecht HF, Ruby RRF. Cupulolithiasis. Adv Otorhinolaryngol 1973;20: 434-43; Kveton JF, Kashgarian M. Particulate matter within the membranous labyrinth: pathologic or normal? Am J Otol 1994;15:173-6). The nature of the particulate matter remains unknown. The purpose of this study was to prospectively examine the posterior semicircular canal of patients with and without a clinical history of BPPV for the presence of particulate matter. Seventy-three patients without BPPV symptoms undergoing labyrinthine surgery (vestibular schwannoma excision or labyrinthectomy) and 26 patients with BPPV undergoing the posterior semicircular canal occlusion procedure were compared. Additionally, 70 archived temporal bones without a history of BPPV were examined microscopically for the presence of particulate matter within the lumen of the membranous labyrinth. No particles were observed intraoperatively in any of the 73 patients without a history of BPPV. Particulate matter was observed in 8 of 26 patients at the time of the posterior semicircular canal occlusion procedure for intractable BPPV. Of the 70 temporal bones examined, 31 did not show significant postmortem changes and also did not demonstrate cupulolithiasis or canalithiasis. Particulate matter from within the membranous posterior semicircular canal was removed from one patient at the time of posterior semicircular canal occlusion for intractable BPPV symptoms and was examined by scanning electron microscopy. The particulate matter appeared morphologically consistent with degenerating otoconia. These data show a statistically significant association between the presence of particles within the posterior semicircular canal in this study and the symptom complex of BPPV.

Ear, Inner↗

Free-floating endolymph particles: a new operative finding during posterior semicircular canal occlusion.

Most clinicians accept cupulolithiasis as the pathophysiological mechanism underlying benign paroxysmal positional vertigo (BPPV.) According to this theory, a cupular deposit induces a gravitational effect on the posterior canal crista. Posterior semicircular canal occlusion is a new operative procedure for treating incapacitating BPPV. It is postulated that canal occlusion abolishes endolymph movement within the canal, effectively fixing the cupula and rendering it unresponsive to both angular and linear acceleration (gravity). During two recent canal occlusions, abundant "free-floating particles" were identified within the posterior canal endolymph. When changing the position of the canal in the earth vertical plane, these free-floating particles would move under the influence of gravity. The hydrodynamic drag of the particles would induce endolymph movement with cupular displacement leading to the typical response. This finding supports an alternate explanation to cupulolithiasis as the pathophysiological mechanism underlying BPPV.

Aged↗