Anatomy of the Human Osseous Spiral Lamina and Cochlear Partition Bridge: Relevance for Cochlear Partition Motion.

The classic view of cochlear partition (CP) motion, generalized to be for all mammals, was derived from basal-turn measurements in laboratory animals. Recently, we reported motion of the human CP in the cochlear base that differs substantially from the classic view. We described a human soft tissue "bridge" (non-existent in the classic view) between the osseous spiral lamina (OSL) and basilar membrane (BM), and showed how OSL and bridge move in response to sound. Here, we detail relevant human anatomy to better understand the relationship between form and function. The bridge and BM have similar widths that increase linearly from base to apex, whereas the OSL width decreases from base to apex, leading to an approximately constant total CP width throughout the cochlea. The bony three-dimensional OSL microstructure, reconstructed from unconventionally thin, 2-µm histological sections, revealed thin, radially wide OSL plates with pores that vary in size, extent, and distribution with cochlear location. Polarized light microscopy revealed collagen fibers in the BM that spread out medially through the bridge to connect to the OSL. The long width and porosity of the OSL may explain its considerable bending flexibility. The similarity of BM and bridge widths along the cochlea, both containing continuous collagen fibers, may make them a functional unit and allow maximum CP motion near the bridge-BM boundary, as recently described. These anatomical findings may help us better understand the motion of the structures surrounding the organ of Corti and how they shape the input to the cochlear sensory mechanism.

Morphological Immaturity of the Neonatal Organ of Corti and Associated Structures in Humans.

Although anatomical development of the cochlear duct is thought to be complete by term birth, human newborns continue to show postnatal immaturities in functional measures such as otoacoustic emissions (OAEs). Some of these OAE immaturities are no doubt influenced by incomplete maturation of the external and middle ears in infants; however, the observed prolongation of distortion-product OAE phase-gradient delays in newborns cannot readily be explained by conductive factors. This functional immaturity suggests that the human cochlea at birth may lack fully adult-like traveling-wave motion. In this study, we analyzed temporal-bone sections at the light microscopic level in newborns and adults to quantify dimensions and geometry of cochlear structures thought to influence the mechanical response of the cochlea. Contrary to common belief, results show multiple morphological immaturities along the length of the newborn spiral, suggesting that important refinements in the size and shape of the sensory epithelium and associated structures continue after birth. Specifically, immaturities of the newborn basilar membrane and organ of Corti are consistent with a more compliant and less massive cochlear partition, which could produce longer DPOAE delays and a shifted frequency-place map in the neonatal ear.

Evaluation of the depiction ability of the microanatomy of the temporal bone in quarter-detector CT: Model-based iterative reconstruction vs hybrid iterative reconstruction.

Little is known regarding differences between model-based iterative reconstruction (MBIR) and hybrid iterative reconstruction (HIR) in temporal bone computed tomography (CT). This study compared the ability to depict microstructures in temporal bone in quarter-detector CT (QDCT) between MBIR and HIR.Sixty-two temporal bones in 31 consecutive adult patients who underwent QDCT were included. Reconstruction was performed with Forward projected model-based Iterative Reconstruction SoluTion (FIRST) BONE mild mode and Adaptive Iterative Dose Reduction 3D (AIDR3D) enhanced mild mode. Imaging quality was graded for 3 microstructures (spiral osseous lamina, tympanic membrane, and singular canal).Spiral osseous lamina was significantly well-delineated in the AIDR3D enhanced group, compared with the FIRST group. In nearly all cases with FIRST, spiral osseous lamina was poorly defined. Although there was no significant difference, depiction of the tympanic membrane and singular canal tended to be better with AIDR3D enhanced mode.Routine reconstruction for preoperative temporal bone CT should be performed with HIR, rather than MBIR.

The secondary spiral lamina and its relevance in cochlear implant surgery.

OBJECTIVE: We used synchrotron radiation phase contrast imaging (SR-PCI) to study the 3D microanatomy of the basilar membrane (BM) and its attachment to the spiral ligament (SL) (with a conceivable secondary spiral lamina [SSL] or secondary spiral plate) at the round window membrane (RWM) in the human cochlea. The conception of this complex anatomy may be essential for accomplishing structural preservation at cochlear implant surgery. MATERIAL AND METHODS: Sixteen freshly fixed human temporal bones were used to reproduce the BM, SL, primary and secondary osseous spiral laminae (OSL), and RWM using volume-rendering software. Confocal microscopy immunohistochemistry (IHC) was performed to analyze the molecular constituents. RESULTS: SR-PCI reproduced the soft tissues including the RWM, Reissner's membrane (RM), and the BM attachment to the lateral wall (LW) in three dimensions. A variable SR-PCI contrast enhancement was recognized in the caudal part of the SL facing the scala tympani (ST). It seemed to represent a SSL allied to the basilar crest (BC). The SSL extended along the postero-superior margin of the round window (RW) and immunohistochemically expressed type II collagen. CONCLUSIONS: Unlike in several mammalian species, the human SSL is restricted to the most basal portion of the cochlea around the RW. It anchors the BM and may influence its hydro-mechanical properties. It could also help to shield the BM from the RW. The microanatomy should be considered at cochlear implant surgery.

Spiral Form of the Human Cochlea Results from Spatial Constraints.

The human inner ear has an intricate spiral shape often compared to shells of mollusks, particularly to the nautilus shell. It has inspired many functional hearing theories. The reasons for this complex geometry remain unresolved. We digitized 138 human cochleae at microscopic resolution and observed an astonishing interindividual variability in the shape. A 3D analytical cochlear model was developed that fits the analyzed data with high precision. The cochlear geometry neither matched a proposed function, namely sound focusing similar to a whispering gallery, nor did it have the form of a nautilus. Instead, the innate cochlear blueprint and its actual ontogenetic variants were determined by spatial constraints and resulted from an efficient packing of the cochlear duct within the petrous bone. The analytical model predicts well the individual 3D cochlear geometry from few clinical measures and represents a clinical tool for an individualized approach to neurosensory restoration with cochlear implants.

Surgical planning and evaluation of implanting a penetrating cochlear nerve implant in human temporal bones using microcomputed tomography.

OBJECTIVE: To develop a transmastoid-posterior tympanotomy approach for the implantation of a penetrating auditory prosthesis in the most distal portion of the cochlear nerve. BACKGROUND: Animal studies suggest that penetrating cochlear nerve implants may overcome limitations of current cochlear implant systems. One step toward human implantation is the development of a suitable surgical approach. METHODS: In computer-rendered 3-dimensional (3-D) models (based on micro-CT scans of 10 human temporal bones), we simulated trajectories through the most basal part of the cochlea that gave access to the most distal portion of the cochlear nerve with minimal damage to intracochlear structures. We determined their vectors with respect to the mid-modiolar axis and posterior round window edge and assessed if they intersected the chorda tympani nerve. RESULTS: The typical vector obtained with these 3-D models ran in an anterosuperior direction, through the inferior part of the facial recess and anterior round window edge. In 7 of 10 temporal bones, this trajectory intersected the chorda tympani nerve. Based on the vectors, dummy probes were implanted in 3 of 10 temporal bones, and the need for chorda tympani removal was confirmed in accordance with the 3-D models. Postoperative micro-CT scans revealed that all probes were successfully implanted in the cochlear nerve, whereas the osseous spiral lamina and basilar membrane were preserved. CONCLUSION: The vector for drilling and implantation found in this study can be used as a guideline for real-life surgery and, therefore, is another step toward the clinical implementation of cochlear nerve implants.

Rotation of the osseous spiral lamina from the hook region along the basal turn of the cochlea: results of a magnetic resonance image anatomical study using high-resolution DRIVE sequences.

PURPOSE: To define the rotational anatomy of the osseous spiral lamina (OSL) at the hook region and along the basal turn of the cochlea and to illustrate the potential utility of high-resolution MRI images to study inner ear ultrastructure. METHODS: Retrospective review of high-resolution temporal bone MRI images in 20 consecutive adult patients referred for imaging unrelated to hearing loss. The main outcome measure utilised images in an oblique sagittal plane to measure the rotation of the OSL relative to the vertical axis in the hook region and along the basal turn of the cochlea. RESULTS: The right OSL is noted to rotate in a clockwise direction as one proceeds anteriorly; over the same distance, the left OSL rotates in an anti-clockwise direction. The average overall rotation for all subjects as measured over a distance of 1-7 mm from the posterior margin of the round window was 25.95°. Inter-subject variability was noted. CONCLUSIONS: Prominent rotation of the OSL was noted in the hook region, this being most pronounced in the proximity to the round window. This concept may have implications for cochleostomy site selection with implant surgery. The study highlights the feasibility of high-resolution MRI to be used to systematically study variations in intra-cochlear anatomy.

The topographical anatomy of the round window and related structures for the purpose of cochlear implant surgery.

The treatment of total deafness using a cochlear implant has now become a routine medical procedure. The tendency to expand the audiological indications for cochlear stimulation and to preserve the remnants of hearing has brought new problems. The authors have studied the topographical anatomy of the internal structures of the ear in the area where cochleostomy is usually performed and an implant electrode inserted. Ten human temporal bones were obtained from cadavers and prepared in a formalin stain. After dissection of the bone in the area of round and oval windows, the following diameters were measured using a microscope with a scale: the transverse diameters of the cochlear and vestibular scalae at the level of the centre of the round window and 0.5 mm anteriorly to the round window, the distance between the windows and the distances from the end of the spiral lamina to the centre of the round window and to its anterior margin. The width of the cochlear scala at the level of the round window was 1.23 mm, and 0.5 mm anteriorly to the round window membrane it was 1.24 mm. The corresponding diameters for the vestibular scala are 1.34 and 1.27 mm. The distances from the end of the spiral lamina to the centre of the round window and to its anterior margin are 1.26 and 2.06 respectively. The authors noted that the two methods of electrode insertion show a difference of 2 mm in the length of the stimulated spiral lamina. The average total length of the unstimulated lamina is 2.06 and 4.06 in the two situations respectively.

[In vivo cochleoscopy through the round window]. / In-vivo-Cochleoskopie durch das runde Fenster.

The overall aim of the present investigation was to develop a technique for endoscopic investigation of the cochlea. In the experiments reported here, the possible effect of the endoscope-called the "cochleoscope"-on the electrophysiology of the cochlea was investigated by recording the cochlear action potential (CAP) threshold tuning curve from (0.1-34 kHz). The dorsolateral bulla of anesthesized guinea pigs (with ketamine 60 mg/kg and Rompun 12 mg/kg) was opened, after which the cochleoscope was introduced under micromanipulator control through the round window membrane. Three cochleoscopes were used and had diameters of 0.29 mm, 0.7 mm and 0.89 mm, respectively, containing 2000, 3000 and 3000 fibers each. Experiments in 7 animals showed that the cochleoscope did not influence CAP thresholds. Although the present resolution of the endoscopes is limited, the basilar membrane can be clearly distinguished from the osseous spiral lamina. It is anticipated that improved resolution will allow the cochleoscope to be used for diagnostic purposes in cases of sensorineural hearing loss.

Microtubule-associated proteins in adult human sensory organs.

The distribution of microtubule-associated proteins MAP-1 and MAP-2 was analysed with immunomorphological techniques in the serially sectioned adult human membranous labyrinth. In the organ of Corti, monoclonal antibodies to MAP-1 did not stain. Positivity for MAP-2 occurred in the entire outer hair cell cytoplasm, in the inner hair cells (?), in the nerve fibres and in the cytoplasm of epithelial cells of the spiral prominence. In addition, staining for MAP-2 was identified in many (but not all) cells or Reissner's membrane. Immunofluorescence for MAP-1 occurred in the supporting cells of the cristae and maculae interpreted to be localized in the apical region adjacent to the sensory cells. Thus, the distribution of MAP-1 and MAP-2 in the adult human membranous labyrinth was the same as described for several animal species with regard to the cochlea. In contrast to such a pattern, both MAP-1 and MAP-2 were identified in the human vestibular organs, thus identifying a subpopulation of centrally located nerve calyces and possibly also the apical portion of vestibular hair cells.

A study of cochlear innervation in the young cat with the Golgi method.

Individual afferent and efferent nerve fibers were identified and traced in Golgi-impregnated cochleas of cats from newborn to one month old. Afferent radial fibers project radially without varicosities to terminate at the base of one or two inner hair cells. Outer spiral fibers have both radial and spiral orientations within the organ of Corti, do not form varicosities while crossing the base of the tunnel, and spiral for long distances in the outer spiral bundles. They contact many outer hair cells of more than one row both en passant and by small terminal branchlets. Two separate groups of efferent fibers are identifiable. Thin efferent fibers with many large varicosities spiral for long distances in the inner and tunnel spiral bundles; varicosities in the inner spiral bundle may contact radial afferent fibers or hair cells, depending on age. Thick radial efferent fibers course radially through the tunnel spiral bundle and across the upper part of the tunnel, often in fascicles. They contact a few outer hair cell bases by large terminals. The spiral expanse of the terminals is limited. These fibers are most common in the more basal turns of the organ. The present results confirm the anatomical separation of radial and spiral afferent fiber systems and identify two separate efferent populations beyond the neonatal period in the cat. The major features of afferent innervation discernible in Golgi-impregnated cochleas are present at birth, although some simplification of afferent fibers probably occurs during the first postnatal week. In contrast, the efferent fiber pattern undergoes important changes during the first few weeks after birth. In mature animals, the fine spiral efferents probably contact only afferent fibers, whereas the thick radial efferents may contact both outer hair cells and spiral afferent fibers. The possibility that some individual efferents branch to both inner and outer hair cell regions in the older cats cannot be ruled out.