Succinic dehydrogenase histochemistry as an early marker for hair cell pathology.

Density measurements of succinic dehydrogenase (SDH) activity were obtained from the inner and outer hair cells on surface preparations obtained from the guinea pig cochlea. Guinea pigs were exposed to noise (3.85 kHz, 120 dB SPL, 22.5 min) and sacrificed 0, 4 or 24 h after the exposure. By 4 h after exposure, the first- and second-row outer hair cells already demonstrated an altered SDH activity. By 24 h after exposure, a significant decrease in SDH staining in both the inner and outer hair cells at a distance of 10-12 mm from the cochlear apex was demonstrated. After a 1-month recovery period, scanning electron microscopy confirmed the main lesion site to be at a distance of 10-12 mm. In addition, Hensen's cells (supporting cells) at a distance of 10-12 mm from the apex were intensely stained by SDH after noise exposure, indicating an increase in oxidative metabolism. SDH staining in the Hensen's cells from the unexposed cochleae was not found. In conclusion, our findings suggest that the early use of SDH histochemistry can predict later permanent damage to the organ of Corti.

[Pediatric tonsillectomy can be performed as day surgery]. / Tonsillektomi på barn kan utföras i dagkirurgi.

In the spring of 1996, tonsillectomy, traditionally regarded as a procedure requiring hospitalization, began to be performed at the recently started day surgery unit at Danderyd Hospital. The article consists in a report of results obtained with a series comprising just over 200 children who were the first to undergo adenotonsillectomy in day surgery, and followed up, for instance, by questionnaire. There were no cases of complications requiring hospitalization during the first postoperative day. The parents were fairly satisfied with the care provided, though 25 per cent of them said that in the event of a new operation being necessary they would prefer that it be performed as an in-patient procedure.

Auditory impairment in guinea pigs treated with isepamicin.

Groups of adult guinea pigs were treated intramuscularly with isepamicin at doses of 100, 150 and 225 mg/kg/day for 21 days. For comparison, two other groups were administered either saline or amikacin 225 mg/kg/day. Auditory function, as measured by the Preyer pinna reflex and the brain stem evoked response, was impaired in both the isepamicin and amikacin groups treated with 225 mg/kg/day, and to a lesser extent in the group receiving isepamicin 150 mg/kg/day. Morphological evaluation of the organ in Corti, performed either by scanning electron microscopy or by light microscopy, showed the typical pattern of damage associated with the aminoglycosides. The greatest damage was observed at 225 mg/kg/day, with no difference between isepamicin and amikacin. Isepamicin 100 mg/kg/day produced no impairment in auditory function and very little change in the morphology of the organ of Corti.

Hair cell damage after continuous and interrupted pure tone overstimulation: a scanning electron microscopic study in the guinea pig.

In our earlier investigations [Fredelius et al., Hear. Res. 30, 157-167 (1987)] acoustic trauma was studied after continuous 3.85-kHz pure tone exposures of different intensities and durations. In the present investigation, the importance of the introduction of a break during longer 3.85-kHz pure tone exposures was studied. Female pigmented guinea pigs were exposed to 108, 114, or 120 dB SPL for 6 h with or without a 1-h break after the first 3 h. Four weeks after exposure the cochleas were prepared for scanning electron microscopy and the resulting hair cell damage was evaluated according to a 4-grade damage scale. Significant differences could be demonstrated in the hair cell damage in the animals exposed to continuous acoustic overstimulation and those exposed to intermittent overstimulation. The importance of rest periods to decrease hair cell damage during long periods of acoustic overstimulation was clearly demonstrated.

Time-related changes in the guinea pig cochlea after acoustic overstimulation.

Forty-eight female pigmented guinea pigs were used to study the development of the morphologic and electrophysiologic changes occurring during a 4-week period after exposure to a 3.85-kHz pure tone at an intensity of 120 dB sound pressure level for 22.5 minutes. The morphologic results suggest an alteration in the permeability of ions between the inner ear fluids through gradual development of holes in the reticular lamina.

The role of macrophages in the disposal of degeneration products within the organ of corti after acoustic overstimulation.

We analysed the ultrastructure of scavenger cells in the organ of Corti of 10 guinea pigs at five different intervals (5 min, 4 h, 24 h, 5 days and 28 days) after acoustic overstimulation. There was evidence of phagocytic cells only at 5 days after noise exposure. Dendritic macrophages were seen phagocytosing degenerating cells and debris in the tunnel of Corti and in the region of the outer hair cells. Transforming monocytes in this area and leukocytic accumulation within the spiral lamina vessel suggest that these cells may be derived from blood-borne monocytes. These cells may contribute to local disposal of intracochlear cell degeneration products and thus to healing of organ of hearing after induction of noise-induced damage.

Effect of acoustic overstimulation on the glycocalyx and the ciliary interconnections in the organ of Corti: high resolution scanning electron microscopic investigation.

Changes in ciliary interconnections in the organ of Corti are described after acoustic overstimulation using a special high resolution scanning electron microscope and tannic acid-osmium staining technique, giving an almost three dimensional view. Guinea pigs were exposed to a 3.85 kHz pure tone at an intensity of 120 dB for 22.5 minutes. The first detectable change was a disarrangement of the cilia with a loosening of the interconnections. The ciliary plasma membrane presented with an abnormally smooth appearance. The tip links connecting the tips of the stereocilia to their taller neighbours were also affected showing elongation or even disappearance. The fine granules which cover the tips of the tallest stereocilia of the outer hair cells were decreased. These findings suggest that acoustic overstimulation may affect the carbohydrate metabolism exceeding to degeneration of ciliary interconnections resulting in a disarrangement and detachment of cilia. The tip links, which may participate in sensory cell transduction, seem also to be affected by acoustic overstimulation.

Time sequence of degeneration pattern of the organ of Corti after acoustic overstimulation. A transmission electron microscopy study.

Female pigmented guinea pigs were exposed to a 3.85 kHz pure tone of 120 dB SPL for 22.5 min. The exposed animals were sacrificed after varying post-exposure intervals (5 min, 4 and 24 h, 5 and 28 days). Transmission electron microscopical examination was performed after serial-sectioning in areas of maximum damage and both basal to and apical to this region. By serial-sectioning, the degradation pattern of the individual cell structures in the organ of Corti could be studied in relation to post-exposure time and proximity to the well-demarcated area of maximum damage in the organ of Corti. The results provide further information on the non-reversible changes leading to degeneration and loss of sensory and supportive structures in the organ of Corti.

Time sequence of degeneration pattern of the organ of Corti after acoustic overstimulation. A light microscopical and electrophysiological investigation in the guinea pig.

In order to obtain information about the sequence of events leading to degenerative changes in the cochlea after acoustic trauma, a systematic LM study was performed in the guinea pig organ of Corti. The results were correlated with measurements of CAP N1 thresholds from the same animals. Twenty pigmented guinea pigs were used in the study. Ten of these animals were exposed to a 3.85 kHz pure tone with an intensity varying between 108 and 120 dB SPL for 22.5 to 360 min and were sacrificed after 4 weeks. Eight animals were exposed to 120 dB SPL for 22.5 min and sacrificed at regular intervals after exposure, viz. 5 min, 4, 24 h and 5 days. Prior to sound exposure the animals in the 4-week group were implanted with a permanent round window electrode for measurements of CAP N1 thresholds. The study indicates that the degeneration and reparative processes are not entirely completed after 4 weeks. The development of holes in the reticular lamina may result in further degeneration of cells bilateral to the initial maximum damage. Darkly stained cells seem to be activated in the reparative process in the organ of Corti. Local appearance of dendritic macrophages in the organ of Corti indicate the existence of a local mechanism for disposal of degeneration products from the organ of Corti. The retrograde degeneration of radial nerve fibres seems to be closely associated with that of the pillar cells. A close correlation between structural hair cell damage and CAP N1 threshold shift was found in the region of the organ of Corti corresponding to the exposure frequency. The TS 5 min, 4 h and 24 h after exposure showed a close correlation with swellings in the afferent nerve endings below the IHC in the area of maximum damage and basalwards.

Effects of high intensity pure tone stimulation on the endolymphatic sac. Correlations between cochlear morphology and endolymphatic sac response.

A systematic study of the effects of acoustic overstimulation on the endolymphatic sac (ES) in the guinea pig was performed. The ES was studied with light and transmission electron microscopy after exposure of the animals to a 3.85 kHz pure tone of 108 dB SPL or 120 dB SPL for 22.5 min (sound energy 9.4 and 150 Pa2 X h, respectively). The damage pattern in the organ of Corti was studied after various post-exposure times with SEM and correlated with the morphological characteristics of the ES in the same ear. This was made possible by using a modified technique for histological processing. In ears with induced structural abnormalities to the organ of Corti, the ES displayed few morphological changes without obvious signs of accumulation of cell debris within the lumen. Initially an increase in the amount of freely floating cells was found which persisted for at least 24 h. The role of the ES for disposal and digestion of locally produced degeneration products within the cochlea after acoustically generated structural damage is discussed.

Qualitative and quantitative changes in the guinea pig organ of Corti after pure tone acoustic overstimulation.

A direct relationship between delivered sound energy and morphological overstimulation has been formulated in the so-called equal energy principle. The validity of this principle was systematically tested by studying the effects of acoustic overstimulation on the guinea pig cochlea by means of scanning electron microscopy (SEM) and light microscopy (LM) techniques. The animals in the present study were exposed to 3.85 kHz pure tones of various durations and intensities and allowed a recovery period of 4 weeks before the morphological changes in the cochlea were assessed. A 4-grade scale was devised in order to achieve a qualitative as well as a quantitative SEM evaluation of the cochlear damage. The results of the examinations by LM and SEM were compared and analysed statistically. No significant difference was observed between groups of animals exposed to a sound energy of 9.4 and 37.5 Pa2.h, irrespective of sound intensity (114 or 120 dB SPL). Groups of animals exposed to a higher energy level (150 Pa2.h) differed significantly from those exposed to higher and also lower sound energy levels. Groups exposed to different intensities (108, 114 and 120 dB SPL) did not differ significantly within this energy level.