The vestibular epithelia in experimental hydrops.

Morpho-pathological features, observed by scanning electron microscopy, in guinea pigs with endolymphatic hydrops of 4-14 months included shortening of the hair cell tufts, loss of tufts, retraction of sensory hair cells away from the surrounding tissue and hair cell loss. After 22 months of hydrops, there was complete loss of hair cells with indifferentiation of the epithelium. The loss of ciliary tufts involved loss of both stereocilia and kinocilia identified as short stubs and holes respectively. Control macular epithelia showed no hair tuft loss although ampullae in control ears could show some loss.

Atrophy of outer hair cell stereocilia and hearing loss in hydropic cochleae.

We have earlier described selective atrophy of short and middle stereocilia on outer hair cells of the three upper cochlear turns in hydropic cochleae of guinea pigs. The present study describes sequential early stages of stereocilia degeneration leading to this specific atrophy. Comparison of the morpho-pathology with the ultimate CAP audiograms taken before sacrifice indicated a close association between the low frequency hearing loss and this atrophy of stereocilia. The atrophy appeared to be associated first with the short and then the middle stereocilia of the 2nd and 3rd rows of outer hair cells between 0.5 kHz and 2 kHz and with time included the 1st row of all outer hair cells of the upper cochlear turns down to the 8 kHz region.

Morphological changes of hair cell stereocilia and tectorial membrane in guinea pigs with experimentally induced hydrops.

Endolymphatic hydrops was surgically induced in guinea pigs. Atrophy of middle and short stereocilia on the outer hair cells in the upper 13 mm of the cochlea was systematically observed by scanning electron microscopy in guinea pigs with hydrops between 5-22 months. Light microscope and scanning electron microscope observations indicated that the tectorial membrane in the apical three turns was often abnormally elevated, and could be vertically positioned in longstanding hydrops. The atrophy of outer hair cell middle and short stereocilia and the elevation of the tectorial membrane certainly contribute to the pathophysiology of experimental hydrops and might be implicated in Menière's disease.

Quantitative evaluation of scanning electron microscopy-examined ciliary morphological changes in control and noise exposed guinea pig cochleas.

Many investigations of noise-induced hearing loss have demonstrated a poor correlation between hearing threshold and hair cell loss. One reason for this is that more subtle changes in the hair cell, such as detailed morphological changes of stereocilia, have not been evaluated. However, examining such changes increases the problem of distinguishing experimental pathological changes from artefacts. Preparation of the specimen for scanning electron microscopy (SEM) may result in too many artefacts for an adequate quantification of defects due to noise exposure. One problem with some earlier studies seems to be lack of controls and/or statistical analysis for the purpose of eliminating the influence of artefacts and spontaneous degeneration. The aim of this study was to compare unexposed and noise-exposed cochleas examined with SEM in order to determine if subtle changes due to noise could be distinguished from preparation artefacts and from spontaneous deterioration. Ten different types of hair cell changes were found in exposed and control animals. By means of using controls for statistical comparison with noise-exposed animals two cell damage categories--hair cell loss and missing stereocilia--were found to be produced by exposure to noise.

Effects on the inner and outer hair cells.

Scanning electron microscopy has improved the quality of the information obtained on morphological changes in the organ of Corti caused by noise exposure and the development of non-standard statistical methods has made accurate quantitative evaluation of these morphological changes possible. Many different types of hair cell damage were observed in noise-exposed cochleas, and the changes found in the inner and outer hair cells were found to differ considerably. Both analysis of impulse noise and continuous noise gave different results when applied to the inner hair cells as compared to when applied to the outer hair cells. However, of the outer hair cell rows the outermost was most frequently damaged by both impulse noise and continuous noise. The results of this investigation support previous suggestions that the inner and outer hair cell rows should be evaluated separately in experimental research.

Impulse noise of different durations.

This paper describes a comparison between auditory threshold elevations and morphological cochlear changes evaluated with scanning electron microscopy in order to identify cochlear defects in guinea pigs exposed to impulse noise of varying durations. There was a significant difference in the auditory threshold shifts between animals exposed for 3 and 12 hours. Hair cell loss is generally used as a morphological correlate to noise-induced hearing loss. Minor stereocilia changes, quantified with non-standard statistical methods have been used as a complement. Morphologically, it was not possible to separate cochleas exposed to impulse noise for 3 and 12 hours when only lost hair cells were evaluated. Quantitative evaluation of subtle morphological changes are valuable in the correlation of noise-induced hearing loss with morphologic changes.

Impulse noise and continuous noise of equivalent frequency spectrum and total sound energy.

It has been proposed that impulse noise and continuous noise affect the inner ear differently and investigations have found impulse noise to be harmful to both the inner hair cells and the outer hair cells. Scanning electron microscopy and non-standard methods for statistical analysis have facilitated the evaluation of different types of morphological changes after exposure to various kinds of noise. Morphological differences were compared in groups of guinea pigs exposed to either impulse noise or continuous noise of equivalent duration, spectral content and energy. Functionally, the groups also showed similar threshold elevations. In order to separate the two groups, subtle hair cell changes were recorded and evaluated either alone, in combination with each other or with hair cell loss. It was found that both the inner hair cells and the outer hair cells were affected differently by impulse noise than by continuous noise even though the auditory thresholds were similar.

Dissection technique for cochleas prepared for scanning electron microscopy.

Scanning electron microscopy (SEM) permits a three-dimensional study of the surface morphology of the organ of Corti that is very useful in evaluating the condition of the apical end of the hair cells and the stereocilia. However, some laboratories have experienced problems with curling of the basilar membrane during critical point drying of cochlear specimens prepared for SEM evaluation using the Murakami or osmium thiocarbohydrazide-procedures. This curling of the basilar membrane can obstruct the view of the reticular lamina and the ciliary ends of the hair cells. We have used a dissection method, referred to as the anchor technique, to overcome basilar membrane curling. This technique removes all the structures above the reticular lamina but leaves the basilar membrane attached to the spiral ligament and the lateral bone to which the spiral ligament is anchored. Individual cochlear turns are dissected in this manner and mounted on the same examination stub for SEM evaluation. Maintenance of the lateral attachment of the basilar membrane requires additional dissection time but eliminates the problem of curling during critical point drying. An additional benefit is that mounting the individual turns on the same examination stub facilitates evaluation and photomicroscopy of the surface morphology. The anchor technique has been used successfully on the guinea pig and should be appropriate for most mammalian cochleas.

Clinical evaluation of bone-densitometry in patients with final renal insufficiency operated for hyperparathyroidism.

Because of difficulties in evaluating bone mineral mass with conventional methods in patients with final renal insufficiency before and after parathyroidectomy, bone densitometry has been tried. During a three year period ten patients have been selected for surgery. The parathyroidectomy performed was total in nine patients and subtotal in one. Bone mineral mass was significantly lower preoperatively in the operated patients than in other patients on regular hemodialysis and also lower than in a normal material. In four of ten patients there was a transient decrease in bone mineral mass after parathyroidectomy. Thereafter there was a significant increase in five of ten patients and in the whole group of patients. Thus bone densitometry was found to be of value in following patients with renal insufficiency selected for parathyroidectomy.