A direct approach to cochlear anatomy and pathology in man

The spiral ganglion and Rosenthal's canal in beluga whales

With the increase of human activity and corresponding increase in anthropogenic sounds in marine waters of the Arctic, it is necessary to understand its effect on the hearing of marine wildlife. We have conducted a baseline study on the spiral ganglion and Rosenthal's canal of the cochlea in beluga whales (Delphinapterus leucas) as an initial assessment of auditory anatomy and health. We present morphometric data on the length of the cochlea, number of whorls, neuron densities along its length, Rosenthal's canal length, and cross-sectional area, and show some histological results. In belugas, Rosenthal's canal is not a cylinder of equal cross-sectional area, but its cross-section is greatest near the apex of the basal whorl. We found systematic variation in the numbers of neurons along the length of the spiral ganglion, indicating that neurons are not dispersed evenly in Rosenthal's canal. These results provide data on functionally important structural parameters of the beluga ear. We observed no signs of acoustic trauma in our sample of beluga whales.

Cochlear infrastructure for electrical hearing

Although the cochlear implant is already the world's most successful neural prosthesis, opportunities for further improvement abound. Promising areas of current research include work on improving the biological infrastructure in the implanted cochlea to optimize reception of cochlear implant stimulation and on designing the pattern of electrical stimulation to take maximal advantage of conditions in the implanted cochlea. In this review we summarize what is currently known about conditions in the cochlea of deaf, implanted humans and then review recent work from our animal laboratory investigating the effects of preserving or reinnervating tissues on psychophysical and electrophysiological measures of implant function. Additionally we review work from our human laboratory on optimizing the pattern of electrical stimulation to better utilize strengths in the cochlear infrastructure. Histological studies of human temporal bones from implant users and from people who would have been candidates for implants show a range of pathologic conditions including spiral ganglion cell counts ranging from approximately 2% to 92% of normal and partial hair cell survival in some cases. To duplicate these conditions in a guinea pig model, we use a variety of deafening and implantation procedures as well as post-deafening therapies designed to protect neurons and/or regenerate neurites. Across populations of human patients, relationships between nerve survival and functional measures such as speech have been difficult to demonstrate, possibly due to the numerous subject variables that can affect implant function and the elapsed time between functional measures and postmortem histology. However, psychophysical studies across stimulation sites within individual human subjects suggest that biological conditions near the implanted electrodes contribute significantly to implant function, and this is supported by studies in animal models comparing histological findings to psychophysical and electrophysiological data. Results of these studies support the efforts to improve the biological infrastructure in the implanted ear and guide strategies which optimize stimulation patterns to match patient-specific conditions in the cochlea.

Immunohistochemical and morphological studies on the human fetal cochlea: a comparative view on methods

The preservation of morphology and antigenicity can vary uncontrollably with human fetuses since these rely heavily on immediate fixation of the temporal bone following spontaneous abortion. Once good fixation is established, there is the question of the approach taken for morphologic and immunohistochemical studies. To achieve maximal preservation for the purpose of studying normal and pathologic fetal cochleae, commonly used preparation methods for analyzing the cochlea were reviewed and compared for both immunohistochemical and morphologic studies. Cochleae obtained after spontaneous abortion ranged from the 9th gestational week to birth. Four different methods were compared for morphologic study: the block surface method; a microslicing technique; paraffin; and celloidin sectioning. For immunohistochemical study, three methods were compared: pre-embedding; paraffin; and frozen sectioning. For morphologic preservation, the block surface method gave best overall results, showing good representation of the fetal cochlea for surface preparation, light, and electron microscopy. Celloidin sectioning was also found to show good light microscopic results for both the middle and inner ear. To achieve optimal results, preservation quality, fixation procedures, and antibody all contribute to the efficacy of a methods choice.

Cerebro-oculo-facio-skeletal syndrome as a human example for accelerated cochlear nerve degeneration

BACKGROUND

Cerebro-oculo-facio-skeletal (COFS) syndrome is a rare autosomal-recessive disorder that includes microcephaly, severe mental retardation, and multiple congenital anomalies. Otologic findings are usually limited to descriptions of the auricles.

PATIENT AND METHODS

The authors report inner ear histopathologic findings of a deceased 13-year-old patient with COFS. A histologic study of the inner ear in COFS syndrome has not yet been described. This patient was documented as having a profound bilateral sensorineural hearing loss at the age of 2 years.

RESULTS

Histologic evaluation revealed accelerated neural and neuronal degeneration at the cochlear and retrocochlear levels. Remaining myelinated nerve fibers, counted in the spiral lamina, had degenerated by up to 97% when compared with normal innervation densities. Afferent nerve fibers innervating inner hair cells were completely absent, whereas medial efferent fibers to outer hair cells were found. Vestibular nerve fibers were less affected.

CONCLUSION

The authors report inner ear findings that differ from animal models of primary cochlear neural degeneration and that resemble the pattern of hereditary cochlear nerve degeneration reported in Friedreich's ataxia.

Quantitative evaluation of myelinated nerve fibres and hair cells in cochleae of humans with age-related high-tone hearing loss

In this study 9 human temporal bones from 8 individuals were fixed with Karnovsky solution by perilymphatic perfusion within 1-3 h after death and examined using the "block-surface method' (Spoendlin and Brun, 1974; Spoendlin and Schrott, 1987) and the "micro-dissection method' (Johnsson and Hawkins, 1967). The audiogram of 7 individuals showed high-tone hearing loss, typical for sensory-neural presbycusis. The inner (IHC) and outer hair cells (OHC) and the myelinated nerve fibers in the osseous spiral lamina were counted to correlate audiometric curves with hair-cell and nerve-fibre densities. The "block-surface' method allows accurate hair-cell and myelinated nerve-fibre enumeration with maximal preservation of cochlear structures. The most significant change in the cochlea was not the expected loss of hair cells but an evident loss of nerve fibres in the spiral lamina along the entire length of the cochlea. This loss of nerve fibres was found to be age-related. Reductions up to 30-40% in comparison to normal-hearing middle-aged persons were found in cochleae from persons older than 60 years. In 2 cases only 13% of the fibres remained in some regions of the cochlea. The hair-cell counts showed a reduction of approximately 80% of the OHCs, mainly in the apical parts of the cochlea, and only little differences in the number of IHCs as compared with a group of normal-hearing middle-aged persons. We conclude that neither loss of hair cells nor primary degeneration of nerve fibres alone can fully explain the high-tone loss. Probably injuries of hair cells or neuronal elements at the cellular level can cause threshold elevation.

Distortion product otoacoustic emissions in Macaca mulatta and humans

Distortion product otoacoustic emissions (DPOAEs) were compared in eight rhesus monkeys (Macaca mulatta) and eight normal hearing humans. DPOAEs were recorded in three conditions. In the first condition, DPOAEgrams were generated for monkeys and humans from approximately f2 = 0.5-20 kHz. Monkeys had larger amplitude DPOAEs at all frequencies except around f2 = 1 kHz. In the second condition, DPOAE amplitudes increased and then decreased as the separation between the primaries increased. These functions were similar in the two species except at the lowest frequencies assessed. In the third condition, the levels of the primaries were varied independently. Monkeys had steeper input/output (I/O) functions than humans. The slopes of DPOAE I/O functions increased with frequency in both species. When the levels of both primaries were increased simultaneously, DPOAE I/O functions were well described by power functions throughout the intensity range assessed (from threshold to 65 dB SPL). Monkey I/O functions tended to be expansive power functions at all but the lowest frequencies, while human I/O functions tended to be compressive power functions except at the highest frequencies assessed. Other differences in I/O functions f2 = 8 kHz may indicate species specific differences at high (for human) frequencies.

Spontaneous otoacoustic emissions in a nonhuman primate. II. Cochlear anatomy

Both cochleas of a rhesus monkey exhibiting stable spontaneous and stimulus-frequency emissions were evaluated histologically using surface-preparation methods to determine if certain features of these emissions could be related to structural properties of the organ of Corti (OC). The comprehensive assessment included preparation of routine cytocochleograms and a detailed study of the arrangement of cochlear sensory cells, best revealed by the precise positional relationships between stereocilia bundles, in selected areas representing low-, medium-, and high-frequencies. Several additional measurements were made in an area extending from about 25-60% distance from the apex, which was estimated to encompass the cochlear region where emissions were generated. These quantifications included measures, in both micrometers and Hertz, of the distances between irregularities in the lateral border of the OC due to a sporadically occurring fourth row of outer hair cells (OHCs). Measures, in micrometers, of the changes in the radial extent of the corresponding OC in the presence or absence of this extra fourth row of OHCs were also made. A final measure within low-, medium-, and high-frequency OC regions consisted of describing the angles that the tips of the stereocilia bundles were displaced from an axis parallel to the tunnel of Corti. For comparative purposes, similar plots were made in comparable regions of the OC in the normal and experimental cochleas of three additional rhesus monkeys in which one ear had been systematically exposed to noise. In the emitting-monkey cochlea, there was a mild loss of sensory cells scattered throughout the OC which was generally greater for the OHCs. No evidence of small circumscribed lesions, defined as a loss of more than four adjacent hair cells, was found. The most striking observation which varied in degree across the three other monkeys was a generalized irregularity in the cellular organization of the OHC region which was most pronounced in the low- and midfrequency regions of the OC. The notable cellular disorganization specific to the apical half of the cochlea was reflected by an increased variance in the distribution of deviation angles measured for corresponding stereocilia bundles. Outer hair cells in the remaining basal region of the OC were arranged in three regular rows with the usual stereocilia orientation.(ABSTRACT TRUNCATED AT 400 WORDS)

Spontaneous otoacoustic emissions in a nonhuman primate. I. Basic features and relations to other emissions

Otoacoustic emissions in both ears of a rhesus monkey exhibiting stable spontaneous emissions (SOEs) were monitored over a 1-year period. The amplitudes and frequencies of both SOEs and stimulus-frequency emissions (SFEs) were routinely recorded, while transiently evoked (EOE) and distortion-product emissions (DPEs), at the frequency 2f1-f2, were occasionally examined. Between evaluation sessions, both the frequencies and amplitudes of SFEs remained relatively stable in both ears, while the frequencies and amplitudes of SOEs were less constant. Isosuppression contours for SOEs, plotted as a function of frequency and level of tonal maskers, revealed sharp tuning consistent with normal frequency selectivity. Detailed analyses of long-term measurements showed that SOEs occurred most frequently at the peaks of the SFE response. A regular frequency spacing between neighboring amplitude maxima and minima of the SFEs was consistent with the notion that this particular emitted response may result from a periodic disruption of the orderly pattern of sensory cells along the organ of Corti. Intramuscular administration of aspirin abolished SOE and SFE responses, while DPEs remained relatively unchanged suggesting the involvement of separate mechanisms in the generation of different emissions.

Microdissection, cytocochleogram and transmission electron microscopy: a technique for a comprehensive evaluation of human cochlear pathology

A technique combining microdissection with cytocochleogram and TEM is described as a tool for studying human cochlear pathology. It is recommended in cases well studied from a clinical point of view and with a short time interval between death and fixation.

Fibre population of the vestibulocochlear anastomosis in humans

The vestibulocochlear anastomosis in the adult human was studied by light and electron microscopy. It was found to contain both myelinated and unmyelinated axons. The number of myelinated axons ranged from 223 to 695, with a mean of 360, while the unmyelinated axons varied from 638 to 1453, with a mean of 1005. The ratio of unmyelinated to myelinated axons varied from 2.1 to 4.4, with a mean of 3.0.

What can specific behavioural testing procedures contribute to the assessment of neurotoxicity in laboratory animals?

Subchronic testing of laboratory animals in accordance with present regulatory guidelines involves maximum exposure with the chemical under investigation and serves for the evaluation of systemic toxicity as well as of lesions in organs and organ systems, including neurotoxicity. The primary assessment of neurotoxicity is essentially based on the overall observation of animal behaviour in the course of the customary toxicity studies and on the subsequent neuropathological evaluation with contemporary techniques. Under this maximum exposure the absence of symptoms and signs of neural abnormalities indicates that the material tested would be devoid of neurotoxicity. Any overt or suspicious symptoms for neurotoxicity appearing in the course of subchronic testing may be further characterized with additional functional tests such as neurological examination, electrodiagnostics and possibly with specific behavioural tests. The subsequent neuropathological investigation would have to be expanded to include a detailed evaluation of all neural structures possibly related with the above functional derangements. In case of relevant neurotoxicity subsequent specific behavioural tests might include the evaluation of complex neural functions such as integrated psycho-neuro-motor activity and memory. These behavioural tests might help to explain neurotoxicity and to assess behaviour at low levels of exposure. The implementation of such specific behavioural testing procedures beyond the scope of routine toxicity studies would require a group of investigators capable to carry out appropriate tests.(ABSTRACT TRUNCATED AT 250 WORDS)

A new technique for the study of temporal bone pathology

A new technique for the study of the temporal bone at autopsy is presented in which thin slices of the fixed bone are prepared on a special cutting machine which preserves the configuration of the delicate anatomical structures. Selected areas are then processed for light microscopy. There is thus opportunity for gross examination, only a short period for immersion in acid for decalcification if required, and special histological procedures may also be carried out. The method is quick and technically easier than serial sectioning and storage of the smaller numbers of sections from each case is less of a problem. Temporal bones which have been perfused through the perilymph within 3 h of death may also be cut in the same way in order to allow removal of samples of membranous labyrinth for surface preparation or electron microscopy, avoiding the need for drilling to reach the membranous labyrinth, and being quicker and less damaging.

The organization of the horizontal semicircular duct, ampulla and utricle in the rat and guinea pig

Microdissections of the labyrinth of the guinea pig and rat were carried out with the labyrinth in place in the skull. This enabled photographs to be taken from a standardized identified orientation so as to show the relation of the horizontal semicircular duct and utricle to the planes of the head, and changes in the horizontal duct and utricle during development. It was also possible to show, for the first time, the relation of the horizontal duct and utricle to major brainstem structures. Photographic evidence is presented of the distribution of dark cells around the horizontal duct and ampulla in the guinea pig and of postnatal developmental changes in dark cells in the rat.

Scanning electron microscopy of the normal human cochlea

Preservation of the fine structures of the human cochlea has been achieved by perfusing the cochlea with fixative shortly after death. Following the dissection of the temporal bone the surface of the organ of Corti and stria vascularis has been examined in the scanning electron microscope. The surfaces of the inner and outer hair cells can be seen and the stereocilia projecting from their surfaces closely examined. The number and length of the stereocilia of the outer hair cells changes linearly with distance along the cochlear duct. The surface of the stria vascularis is similar to that seen in other animals.

Scanning electron microscopy of the human cochlea--the organ of Corti

The surface of the organ of Corti from normally hearing adult humans has been examined with the scanning electron microscope. It is possible to construct cytocochleograms and to derive a regression line with confidence limits to represent the distribution of the sensory hair cells. Examining individual hair cells more closely, the number of cilia on each hair cell, decreased linearly with distance, from the base of the cochlea. However, the length of the longest cilia on each outer hair cell increased linearly with distance.

Hearing loss and inner ear changes in a patient suffering from severe gentamicin ototoxicity

The long-term histological effects of gentamicin ototoxicity could be studied in a human being in relation to the audiometric impairment. The possible sequence of degeneration of hair cells, supporting cells, nerve fibers, stria vascularis, spiral ganglion cells, and vascular supply is discussed.

Cochlear and vestibular lesions in capsular otosclerosis as seen in microdissection

In 24 temporal bones from patients with otosclerosis prepared by the method of microdissection and surface preparations, otosclerotic foci could be clearly seen during removal of the otic capsule. The state of activity of each focus was estimated on the basis of its consistency and vascularity. Small anterior foci constituted the most common form of involvement of the otic capsule. All were judged to be inactive, and none of them appeared to have caused obvious sensorineural degeneration. No cases of "pure cochlear otosclerosis" were seen. Sensorineural degeneration was associated with large anterior foci which reached the upper basal turn. One specimen displayed a circumscribed sensorineural degeneration in the upper basal turn, with an almost exact correspondence between the location and extent of the cochlear lesion and the site of invasion by the otosclerotic process in the bone and endosteum bordering on scala media and scala tympani. It is postulated that a toxic factor had diffused from the focus and acted directly on the organ of Corti. When multiple foci were present they were usually poorly defined. The otosclerotic process involved the round window, with new lamellar bone formation in the scala tympant of the lower half of the basal turn. The most extensive sensorineural degeneration in the entire material was seen in this group. One specimen also had severe cochlear hydrops. In three specimens large shunts were observed to connect the otosclerotic foci with the cochlear vasculature, which was severely dilated. Where otosclerosis involved the endosteum of the scala tympani, loss of vessels was observed. One specimum with extensive active capsular otosclerosis had severe sensorineural degeneration of the vestibular system. Vestibular pathology in fenestrated ears is also described. In a specimen from a patient with no caloric reaction, numerous hair cells were present in the macular organs.

Degeneration patterns in human ears exposed to noise

Various forms of sensorineural degeneration patterns related to noise exposure are illustrated in six pairs of temporal bones selected from a group of 33 male patients with histories of noise exposure. For the entire group the commonest form of lesion, associated with a 4-kHz dip in the audiogram, was a relatively diffuse degeneration in the second quadrant of the basal turn, in the 9-13 mm area. An advanced form of this lesion had a wide gap of more or less complete sensorineural degeneration affecting the entire second quadrant and displaying various degrees of extension toward the apex and base. The pattern associated with an "abrupt high-tone loss," with more or less complete hair cell and nerve degeneration in both the second and first quadrants and extending to the basal end of the cochlea, was rare. In one case this pattern appeared to have evolved from the first type of lesion as the remaining nerve fibers in the first quadrant had degenerated. The protective effect of the acoustic shadow of the head for the right ear, in shooting from the right shoulder, is demonstrated for the higher frequencies. Two almost identical cases of sharply-circumscribed single areas of degeneration in the first quadrant and one case with two such areas represent the third type of lesion. In one of these cases there was a history of firearm usage. It is postulated that this type of lesion is caused by impulse noise. In most of the material the degeneration pattern differed markedly from the diffuse degeneration seen with presbycusis. Degeneration patterns with knife-sharp transitions between completely degenerated and apparently undamaged areas appear to be characteristic of noise-induced injuries.

Hearing loss and cochlear pathology in monkeys after noise exposure

Old World monkeys were exposed to octaveband noise from 0.5 to 8 kHz at 120 dB SPL, 8 hours daily for 20 days. Restricted permanent threshold shifts and localized loss of outer hair cells were produced, which were reasonably well correlated with the exposure frequencies. There was also a loss of both inner and outer hair cells at the extreme basal end of Corti's organ, regardless of the exposure frequency. Implications for human inner ear pathology are discussed.

Fluorocitrate ototoxicity. A morphologic and cytochemical model for primary neural degeneration in the guinea pig cochlea

Fluorocitrate, an inhibitor of the tricarboxylic acid cycle at the aconitase reaction, produces a time and dose related neural dystrophy in the guinea pig cochlea. There is direct inhibition of succinic dehydrogenase activity but not nicotinamide adenine dinucleotide dehydrogenase and cytochrome oxidase via cytochrome c activities. The dystrophic neural changes morphologically are similar to those noted in primary neural degeneration and neural presbycusis in man. Neural degeneration in aging appears to be the result of a dissociation of biochemical reactions preventing the proper utilization of organic fuel molecules for generation of energy and direct or indirect inhibition of respiration.

A modified "soft surface specimen technique" for examination of the inner ear

A new surface preparation method was devised for assessing intracochlear vessels and sensorineurepithelium. The method is a combination of the conventional osmic acid stained surface preparation method and a surface preparation technique with injection of Prussian blue and decalcification of the cochlea. Such a combination preserves most advantages of each and eliminates many of the disadvantages. To preserve the delicate sensory and nervous structures we examined variations of the preparation, paying particular attention to fixation, staining, and decalcification procedures and solutions. Varying the preparation had a less marked effect on external wall structures than on the basilar membrane; the primary changes consisted of variation in staining contrast. The method proved useful for demonstrating the normal anatomy and pathological changes in cochlear vasculature and in sensorineural and supporting structures of the labyrinth in light and phase contrast microscopy at moderate magnifications.

Studies of cochlear vasculature and sensory structures: a modified method

A new “soft surface preparation technique” for detailed studies of all intracochlear structures is presented. The method is a combination of the “hard surface preparation technique” with osmic staining of undecalcified temporal bones and the Prussian blue technique with contrast injection of the cochlear vasculature and subsequent decalcification. Most of the disadvantages of both methods are eliminated by this combination. Large or small pieces of the cochlea can be studied including vascular pattern, vessel details, sensory and supporting structures, and membranes.

Otolithic membranes of the saccule and utricle in man

The otolithic membranes of the human saccule and utricle can be prepared as whole mounts or surface specimens for microscopic examination. They are not simple, homogeneous, gelatinous structures as heretofore described. Instead, each shows a definite and characteristic fibrillar design, which appears to be correlated with the known cytoarchitectural pattern of the underlying neuroepithelium.