Histopathologic Evaluation of Vascular Findings in the Cochlea in Patients With Presbycusis

Kurata, Natsuko; Schachern, Patricia A.; Paparella, Michael M.; Cüreoğlu, Sebahattin

doi:10.1001/jamaoto.2015.3163

Cited by 42 publications

(31 citation statements)

References 27 publications

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“…[ 10 11 ] Although it belongs to a somewhat subjective manner, the audiometric patterns can provide valuable information at the first sight of the audiogram reports. In addition, from the pathophysiological point of view, different from the vascular findings[ 23 ] in the cochlea in patients with presbycusis, the cause of Meniere's disease is recognized as the hydrolabyrinth with evidence. [ 24 ] The degree of endolymphatic hydrops in Meniere's disease has its regulated changes during progression.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of the Cochlear Symptoms and Functions in Meniere's Disease

Zhang

Liu

Wang³

et al. 2016

Chinese Medical Journal

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Background:Meniere's disease is a unique, progressive disease of the inner ear. The complex manifestation presents diagnostic challenges. The cochlear symptoms often present before vertigo and tend to be ignored. This study aimed to analyze the characteristics of cochlear symptoms and functions associated with Meniere's disease to investigate the regularity of the development of this disorder.Methods:One-hundred fifteen patients who were diagnosed with definite unilateral Meniere's disease at the Hearing and Vestibular Clinic of the Department of Otorhinolaryngology of Beijing Tongren Hospital from August 2013 to November 2015 were recruited in this retrospective study. Initial symptoms, duration from initial symptoms to the diagnosis, hearing thresholds, audiogram patterns, and caloric test results were collected and analyzed for each patient. Data were analyzed using SPSS 13.0 statistical software by Spearman's correlation, Kruskal–Wallis H test, Chi-square test, and Fisher's exact test.Results:The average hearing threshold of these patients was 45.24 ± 18.40 dB HL. A majority of the patients (55.65%) were in Stage 3. The initial presentation of the disorder in 58 cases (50.43%) comprised only cochlear symptoms without vertigo. A weak, positive correlation was found between the degree of hearing loss and duration of the disease from initial symptoms to the diagnosis (rs = 0.288, P = 0.002). Upward-sloping, inverted “V,” downward-sloping, and flat pattern were the main audiometric patterns observed with a distinctive distribution between stages (P < 0.001). Based on the configurations of audiograms, the audiometric patterns had a weak correlation to the duration (rs = 0.269, P = 0.004), and there was a tendency of duration to rising from upward-sloping, inverted V, downward-sloping to flat pattern. (H = 10.024, P = 0.018). Frequencies of tinnitus in 56 patients (64.4%) were at the lowest points of the audiograms, i.e., the frequencies of the poorest hearing threshold. The patients at an advanced stage (Stage 3 [56] and Stage 4 [73]) exhibited a significantly higher abnormality of canal paresis than those at the earlier stages (Stage 1 [23] and Stage 2 [42]) (χ2 = 5.973, P = 0.015).Conclusions:Patients with definite Meniere's disease always have a moderate to severe sensorineural hearing loss before diagnosis. Cochlear symptoms are the most common initial presentation. With the progression of the duration, the hearing impairment becomes more severe and the distribution of the audiometric pattern is distinctive between stages.

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Section: Discussionmentioning

confidence: 99%

Characteristics of the Cochlear Symptoms and Functions in Meniere's Disease

Zhang

Liu

Wang³

et al. 2016

Chinese Medical Journal

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“…Although the condition of the spiral ligament, the stria vascularis and its vasculature are less frequently evaluated in aged cochleas, degeneration of these structures has been observed and measured in aged human temporal bones and represents a major pathology (Ishiyama, Tokita, Lopez, Tang, & Ishiyama, ; Kurata, Schachern, Paparella, & Cureoglu, ; Schuknecht, ; Schuknecht & Gacek, ; Suzuki et al, ). Quiet‐aged gerbil, rat, and beagle dog cochleas have strial and spiral ligament degeneration at both ends of the cochlear duct related to vascular degeneration in the same locations (Gratton et al, ,; Keithley, Ryan, & Feldman, ; Le & Keithley, ; Spicer & Schulte, ).…”

Section: Pathologymentioning

confidence: 99%

Pathology and mechanisms of cochlear aging

Keithley

2019

J of Neuroscience Research

164

106

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Presbycusis, or age‐related hearing loss (ARHL), occurs in most mammals with variations in the age of onset, rate of decline, and magnitude of degeneration in the central nervous system and inner ear. The affected cochlear structures include the stria vascularis and its vasculature, spiral ligament, sensory hair cells and auditory neurons. Dysfunction of the stria vascularis results in a reduced endocochlear potential. Without this potential, the cochlear amplification provided by the electro‐motility of the outer hair cells is insufficient, and a high‐frequency hearing‐loss results. Degeneration of the sensory cells, especially the outer hair cells also leads to hearing loss due to lack of amplification. Neuronal degeneration, another hallmark of ARHL, most likely underlies difficulties with speech discrimination, especially in noisy environments. Noise exposure is a major cause of ARHL. It is well‐known to cause sensory cell degeneration, especially the outer hair cells at the high frequency end of the cochlea. Even loud, but not uncomfortable, sound levels can lead to synaptopathy and ultimately neuronal degeneration. Even in the absence of a noisy environment, aged cells degenerate. This pathology most likely results from damage to mitochondria and contributes to degenerative changes in the stria vascularis, hair cells, and neurons. The genetic underpinnings of ARHL are still unknown and most likely involve various combinations of genes. At present, the only effective strategy for reducing ARHL is prevention of noise exposure. If future strategies can improve mitochondrial activity and reduce oxidative damage in old age, these should also bring relief.

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“… 30 Vasculitis appears to be the major factor involved in cochlear and vestibular damage. 2 , 12 , 13 , 25 , 36 , 37 …”

Section: Pathophysiology Of Inner Ear Involvement In Slementioning

confidence: 99%

Systemic Lupus Erythematosus and hearing disorders: Literature review and meta-analysis of clinical and temporal bone findings

Stadio

Ralli

2017

J Int Med Res

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ObjectiveThis literature review and meta-analysis was performed to evaluate the correlations among hearing and vestibular clinical symptoms, temporal bone findings, and pathological mechanisms in patients with systemic lupus erythematosus (SLE).Study designRelevant papers in the literature were retrospectively reviewed. Clinical hearing aspects in patients with SLE and relevant temporal bone studies in the same field were analyzed.MethodsPubMed and Google Scholar searches were performed using the following keywords: “auto-immune disease,” “systemic lupus erythematosus (SLE),” “hearing loss,” “temporal bone study,” “vertigo,” “dizziness,” “tinnitus,” “ear symptoms,” “treatment,” “diagnosis,” “symptoms,” “etiopathogenesis,” “Wegener granulomatosis,” “Sjogren,” “polyarteritis nodosa,” “Cogan syndrome,” and “granulomatosis.” Also included were reviews in which the following terms were present: “SLE,” “temporal bone,” and “hearing symptoms.”Review and conclusionThis literature review and meta-analysis focused on the pathological mechanisms through which SLE can damage inner ear structures and determinate hearing and vestibular symptoms. The main mechanisms involved in inner ear damage include the autoimmune response, deposition of immune complexes in the vessels and, to a lesser extent, cytotoxic damage.

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Histopathologic Evaluation of Vascular Findings in the Cochlea in Patients With Presbycusis

Cited by 42 publications

References 27 publications

Characteristics of the Cochlear Symptoms and Functions in Meniere's Disease

Characteristics of the Cochlear Symptoms and Functions in Meniere's Disease

Pathology and mechanisms of cochlear aging

Systemic Lupus Erythematosus and hearing disorders: Literature review and meta-analysis of clinical and temporal bone findings

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