Pelin KOÇDOR, Patricia SCHACHERN, Sebahattin CÜREOĞLU, Eric R SIEGEL, Michael M PAPARELLA

Cochlear lateral wall and vestibular aqueduct in temporal bones with endolymphatic hydrops from patients with and without vestibular symptoms

Objectives: This study aims to compare the stria vascularis and spiral ligament, and evaluate the bony arch around the vestibularaqueduct, in temporal bones with endolymphatic hydrops (EH) from patients with (EH+), and without (EH-) vestibular symptoms,compared to control temporal bones, to better understand the mechanism of vestibular symptoms in Meniere disease.Patients and Methods: A total of 30 temporal bones (twelve EH+, six EH-, and twelve controls from 27 subjects [mean age 72 years;range 61-89 years]) were retrospectively evaluated in this study. Exclusions were ototoxicity, systemic or neurologic diseases. Striavascularis areas were measured in all cochlear turns. The spiral ligament was divided into four sections according to fibrocytes. Thebony area around the vestibular aqueduct was evaluated according to cellular appearance.Results: Stria vascularis area between EH+ and EH- in any turn except upper middle was statistically insignificant. Loss of fibrocyteswas not statistically different between any groups. Denuded osteoblasts, and diminished edges around bony layer of vestibularaquaduct were statistically different in EH+ and EH- (p=.0003).Conclusion: Lack of histopathologic differences in cochlear lateral walls between any group suggest that these changes might notbe responsible for generation of vestibular symptoms. Significant degenerative changes in the vestibular aqueduct in EH+ comparedto EH- bones may suggest a relationship of the vestibular aqueduct and vestibular symptoms.

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1. Paparella MM, Djalilian HR. Etiology, pathophysiology of symptoms, and pathogenesis of Meniere's disease. Otolaryngol Clin North Am 2002;35:529-45.
2. Cureoglu S, Schachern PA, Paul S, Paparella MM, Singh RK. Cellular changes of Reissner's membrane in Meniere's disease: human temporal bone study. Otolaryngol Head Neck Surg 2004;130:113-9.
3. Merchant SN, Adams JC, Nadol JB Jr. Pathophysiology of Meniere's syndrome: are symptoms caused by endolymphatic hydrops? Otol Neurotol 2005;26:74-81.
4. Michaels L, Soucek S, Linthicum F. The intravestibular source of the vestibular aqueduct: Its structure and pathology in Ménière's disease. Acta Otolaryngol 2009;129:592-601.
5. Michaels L, Soucek S. The intravestibular source of the vestibular aqueduct. III: Osseous pathology of Ménière's disease, clarified by a developmental study of the intraskeletal channels of the otic capsule. Acta Otolaryngol 2010;130:793-8.
6. Spicer SS, Schulte BA. Differentiation of inner ear fibrocytes according to their ion transport related activity. Hear Res 1991;56:53-64.
7. Hequembourg S, Liberman MC. Spiral ligament pathology: a major aspect of age-related cochlear degeneration in C57BL/6 mice. J Assoc Res Otolaryngol 2001;2:118-29.
8. Albers FW, de Groot JC, Veldman JE, Huizing EH. Ultrastructure of the stria vascularis and Reissner's membrane in experimental hydrops. Acta Otolaryngol 1987;104:202-10.
9. Nadol JB Jr, Adams JC, Kim JR. Degenerative changes in the organ of Corti and lateral cochlear wall in experimental endolymphatic hydrops and human Menière's disease. Acta Otolaryngol Suppl 1995;519:47-59.
10. Shinomori Y, Kimura RS, Adams JC. Changes in immunostaining for Na+, K+, 2CL-cotransporter 1, taurine and c-Jun N-terminal kinase in experimentally induced endolymphatic hydrops. ARO Abstr 2001;24:134.
11. Yeo SW, Gottschlich S, Harris JP, Keithley EM. Antigen diffusion from the perilymphatic space of the cochlea. Laryngoscope 1995;105:623-8.