Cochlear pathology in human temporal bones with otitis media

Abstract

Conclusion-Middle and inner ear interactions in otitis media can lead to cochlear pathology. More severe pathological changes observed in the basal turn of the cochlea are consistent with prevalence of sensorineural hearing loss at higher frequencies in patients with otitis media.Methods-Of 614 temporal bones with otitis media, 47 with chronic and 35 with purulent otitis media were selected following strict exclusion of subjects with a history of acoustic trauma, head trauma, ototoxic drugs, and other diseases affecting the cochlear labyrinth. Temporal bones with labyrinthine inflammatory changes were further evaluated for loss of hair cells and other histopathologic changes compared to age-matched controls.Results-In all, 19% of temporal bones with chronic and 9% with purulent otitis media showed labyrinthine inflammatory changes. In chronic otitis media, inflammatory changes were: 56% localized purulent, 22% localized serous, 11% generalized seropurulent, and 11% generalized serous. Inflammatory changes in temporal bones with purulent otitis media included 67% localized purulent and 33% were generalized seropurulent. Pathological findings included: serofibrinous precipitates and inflammatory cells in scala tympani of basal turn and cochlear aqueduct, significant loss of outer and inner hair cells, and significant decrease in area of stria vascularis in the basal turn of the cochlea, as compared to controls.

Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

“…A significant loss of outer and inner hair cells, as well as significant atrophy of the stria vascularis in the basal turn of the cochlea, has been observed in CSOM patients. The basal turn of the cochlea also demonstrated severe pathological changes that were consistent with the high-frequency SNHL in CSOM patients (Cureoglu et al, 2004;Joglekar et al, 2010). SNHL in CSOM patients is often demonstrated by higher bone conduction (BC) thresholds in the audiogram.…”

“…The majority of SNHL in CSOM patients is in the high-frequency range and is unilateral (Jensen et al, 2013). A recent study has also shown that bacterial toxins found in the middle ear during CSOM can pass into the cochlea and result in cochlear pathology (Joglekar et al, 2010). These bacterial toxins can be exotoxins (proteins) produced by both Gram-positive and Gramnegative bacteria, or endotoxins (LPSs of the outer membrane of Gram-negative bacteria).…”

Clinical evaluation of inner ear changes as result of chronic otitis media and its surgery

“…This idea was supported by the histological experiments of temporal bones. Joglekar et al [1] showed 19% labyrinthine inflammatory changes in temporal bones with COM. Meyerhoff et al [18] reviewed 123 temporal bones with COM accompanied by labyrinthitis.…”

“…This is supported by histological studies. [1] We evaluated tinnitus symptoms of participants before and after middle ear surgery. Although it was not a primary complaint, 35 patients had a complaint of tinnitus and this symptom completely disappeared in 15 of 35 patients following surgery.…”

“…High frequency sensorineural hearing loss (SNHL) is commonly seen in COM patients in conjunction with the evidence that human temporal bones demonstrated more severe pathological changes in the basal turn of the cochlea. Furthermore Joglekar et al [1] also demonstrated labyrinthine inflammatory changes in temporal bones of COM patients.…”