\s=b\ Diagnostic levels of pulsed ultrasound were applied abdominally over the uteri of pregnant rats for five minutes daily during the first 20 days of gestation. The average energy output of the ultrasound machine at the optimum focal length of the transducer (5.4 cm) was 7.2 mW /sq cm. Postnatal auditory evoked potentials demonstrated a significant alteration in the offspring of the treated animals when compared with similarly treated, but nonexposed controls. This alteration only occurred in the high frequency range. Neither light nor electron microscopy revealed significant morphologic alterations in the cochlear elements of the exposed offspring. Although a cochlear deficit occurred in a range known to be important to the rat's hearing, several issues make this data reassuring to clinicians using diagnostic levels of pulsed ultrasound: the total amount of ultrasound exposure was higher than would be expected with human use, the defect was mild, and the absence of clear-cut morphologic abnormalities may indicate the presence of a minimal, or even reversible, defect. (Arch Otolaryngol 1985;111:309-314) Used in extraordinary doses, there is little question that ultrasound has a deleterious effect on cellular structures and/or tissues.1"9 Indeed, this effect has been amply demon¬ strated in destruction of the laby¬ rinth, on growing tissues, on human lymphocytes, and in a host of other models.18 However, there is little question in the majority of these mod¬ els that the energy levels were suffi¬ cient to cause heating and thus destruction. Serious questions remain about the possible effects of lower energy levels through cavitation, reso¬ nance, or other more subtle effects.Thus, the question of whether ultra¬ sound exerts untoward effects at lev¬ els that may be reached during diag¬ nostic application continues to be of concern.10 The purpose of this report is to detail a portion of the work in progress in our laboratory concerning the effects of diagnostic levels of pulsed ultrasound. The hypothesis to be tested is that ultrasonic application to the fetus, even at levels that may be reached by diagnostic application, may have a demonstrable effect on the inner ear.Earlier work in our laboratories using the same methodology and equipment to be described below, demonstrated a statistically significant (P < .05) hearing deficit in ten animals sonicated in utero as compared with ten unsonicated controls at all auditory frequency levels tested (2,4,8,12, 16, and 20 kHz). Because this work indi¬ cated a possible effect of ultrasound on the fetus, the study was repeated using more animals, with the addition of even more stringent guidelines, bet¬ ter mensuration of the applied ultra¬ sound, and light and electron micro¬ scopic evaluation of the cochlear organ of Corti.
MATERIALS AND METHODSTen Sprague Dawley (outbred) mature female rats were randomly divided into two groups of five control and five tobe-treated animals. All ten were placed in a light (14 hours) and dark (ten hours) cycled breeding room, and dai...