Comparison among ultrasonic, electrical apparatus, and toxic chemicals for vestibular lesion in mice.

BACKGROUND: The vestibular lesion (VL) is required to examine the physiological function of the vestibular system in animals. Toxic chemicals or electrical apparatus have been used for the VL, however, they are not ideal as they have low specificity, and can result in unintended damage, and systemic toxic effect. NEW METHOD: Localized vibration-induced VL, using an ultrasonicator, is expected to overcome the problems associated with chemical and electrical lesions. Thus, we examined the effect of the ultrasonication on the VL from the aspects of both the physiological function and histology in the present study. RESULTS: and Comparison with Existing Method(s) Complete VL, which was evaluated by deterioration of swimming skills, righting reflex, and body stability, was induced using an ultrasonicator or electrical apparatus. Histological evaluation shows that hair cell layers in the saccule and utricle were completely destroyed in both methods Furthermore, significant drop in body mass was observed in VL. However, abscess at the cranial base was observed in VL induced by the electrical apparatus in ICR mice. Complete chemically-induced VL was observed in C57BL/6J but not ICR mice, and systemic leakage of the toxic chemicals (arsenic) was not detectable even 1day after surgery. CONCLUSIONS: Compared to the electrical apparatus, the ultrasonicator is useful for inducing VL in ICR and C57BL/6J mice, as it results in less non-specific damage. Toxic chemicals can be used for inducing VL in C57BL/6J mice; however, this method does not ensure complete disruption of the hair cells in the saccule and utricle.

Maturation of glutamatergic transmission in the vestibulo-olivary pathway impacts on the registration of head rotational signals in the brainstem of rats.

The recognition of head orientation in the adult involves multi-level integration of inputs within the central vestibular circuitry. How the different inputs are recruited during postnatal development remains unclear. We hypothesize that glutamatergic transmission at the vestibular nucleus contributes to developmental registration of head orientations along the vestibulo-olivary pathway. To investigate the maturation profile by which head rotational signals are registered in the brainstem, we used sinusoidal rotations on the orthogonal planes of the three pairs of semicircular canals. Fos expression was used as readout of neurons responsive to the rotational stimulus. Neurons in the vestibular nucleus and prepositus hypoglossal nucleus responded to all rotations as early as P4 and reached adult numbers by P21. In the reticular formation and inferior olive, neurons also responded to horizontal rotations as early as P4 but to vertical rotations not until P21 and P25, respectively. Neuronal subpopulations that distinguish between rotations activating the orthogonally oriented vertical canals were identifiable in the medial and spinal vestibular nuclei by P14 and in the inferior olivary subnuclei IOß and IOK by P25. Neonatal perturbation of glutamate transmission in the vestibular nucleus was sufficient to derange formation of this distribution in the inferior olive. This is the first demonstration that developmental refinement of glutamatergic synapses in the central vestibular circuitry is essential for developmental registration of head rotational signals in the brainstem.

Treatment of traumatic stapediovestibular luxation: case report with the introduction of a new technique and review of literature.

OBJECTIVE: Stapediovestibular luxations are rare lesions that are most commonly caused by direct, penetrating trauma to the external ear canal. In this type of ossicular dislocation, disruption of the annular ligament or footplate fracture may lead to a perilymphatic fistula (PLF) presenting with cochleovestibular symptoms including (progressive) sensorineural hearing loss, tinnitus, and vestibular symptoms. The objective of this article is to define the optimal treatment of stapediovestibular luxations and review the literature on this topic. PATIENT: We present a case of internal stapediovestibular dislocation and pneumolabyrinth after penetrating trauma with predominantly conductive hearing loss and incapacitating vertigo. INTERVENTION: Middle ear inspection with removal of the luxated incus, repositioning of the stapes with a "stapedial strut" and closure of the tympanic membrane. MAIN OUTCOME MEASURES: Hearing outcome and vestibular symptoms of this patient are presented, and all comparable cases in the literature are reviewed. RESULTS: Complete resolution of the vestibular symptoms and stabilization of the bone conduction thresholds. CONCLUSION: In patients with pneumolabyrinth after middle ear trauma with mild symptoms, we recommend initial conservative treatment with close monitoring of hearing. In patients with severe, persisting, or progressive vestibulocochlear symptoms, exploratory tympanotomy should be performed to check for and treat PLF. Oval window fistula repair is reported to have variable hearing outcomes but offers complete resolution of vestibular symptoms in most cases. The stapedial strut is one of the possible surgical techniques in case of an internally luxated stapes.

Vestibular loss promotes procedural response during a spatial task in rats.

Declarative memory refers to a spatial strategy using numerous sources of sensory input information in which visual and vestibular inputs are assimilated in the hippocampus. In contrast, procedural memory refers to a response strategy based on motor skills and familiar gestures and involves the striatum. Even if vestibular loss impairs hippocampal activity and spatial memory, vestibular-lesioned rats remain able to find food rewards during complex spatial memory task. Since hippocampal lesions induce a switch from declarative memory to procedural memory, we hypothesize that vestibular-lesioned rats use a strategy other than that of hippocampal spatial response to complete the task and to counterbalance the loss of vestibular information. We test, in a reverse T-maze paradigm, the types of strategy vestibular-lesioned rats preferentially uses in a spatial task. We clearly demonstrate that all vestibular-lesioned rats shift to a response strategy to solve the spatial task, while control rats use spatial and response strategies equally. We conclude that the loss of vestibular informations leading to spatial learning impairments is not offset at the hippocampus level by integration process of other sense mainly visual informations; but favors a response strategy through procedural memory most likely involving the striatum, cerebellum, and motor learning.

Effective sensory modality activating an escape triggering neuron switches during early development in zebrafish.

Developing nervous systems grow to integrate sensory signals from different modalities and to respond through various behaviors. Here, we examined the development of escape behavior in zebrafish [45-170 h postfertilization (hpf)] to study how developing sensory inputs are integrated into sensorimotor circuits. Mature fish exhibit fast escape upon both auditory/vestibular (AV) and head-tactile stimuli. Newly hatched larvae, however, do not respond to AV stimuli before 75 hpf. Because AV-induced fast escape in mature fish is triggered by a pair of hindbrain neurons known as Mauthner (M) cells, we studied functional development of the M-cell circuit accounting for late acquisition of AV-induced escape. In fast escape elicited by head-directed water jet, minimum onset latency decreased throughout development (5 ms at 45-59 hpf, 3 ms after 75 hpf). After 75 hpf, lesioning the otic vesicle (OV) to eliminate AV input resulted in loss of short-latency (<5 ms) fast escape, whereas ablation of the sensory trigeminal ganglion (gV) to block head-tactile input did not. Before 75 hpf, however, fast escape persisted after OV lesion but disappeared after gV ablation. Laser ablation of the M-cell and Ca²âº imaging of the M-cell during escape demonstrated that M-cell firing is required to initiate short-latency fast escapes at every developmental stage and further suggest that head-tactile input activates the M-cell before 75 hpf, but that after this point AV input activates the M-cell instead. Thus, a switch in the effective sensory input to the M-cells mediates the acquisition of a novel modality for initiating fast escape.

Evidence that spatial memory deficits following bilateral vestibular deafferentation in rats are probably permanent.

Previous studies of rats with bilateral vestibular deafferentation (BVD) have demonstrated spatial memory deficits, suggesting adverse effects on the hippocampus. However, the longest post-operative time interval that has been studied was approx. 5-7 months post-surgery. In this study, we investigated whether rats exhibited spatial memory deficits at 14 months following BVD and whether these deficits could be exacerbated by administration of cannabinoid (CB) drugs. Twenty-eight adult rats were divided into four groups: (1) sham surgery+vehicle; (2) sham surgery+the CB1/CB(2) receptor agonist WIN55,212-2 ('WIN'); (3) BVD+vehicle; and (4) BVD+WIN. WIN (1.0 or 2.0 mg/kg/day) or vehicle, was administered (s.c.) on days 1-10 and 11-20 (respectively), 30 min before the rats performed in a foraging task. On day 21, the CB receptor inverse agonist, AM251 (3.0 mg/kg, s.c.), was administered before WIN or vehicle. To our surprise, BVD animals were impaired in using the visual cues during the probe test in light. In the dark trials, when visual cues were unavailable, BVD animals were unable to use self-movement cues in homing. However, WIN at 2 mg/kg, significantly improved BVD animals' homing time and number of errors in the dark through strategies other than the improvement in using self-movement cues. Furthermore, AM251 significantly improved heading angle in vehicle-treated animals and the first home choice in WIN-treated animals. These results suggest that at 14 months post-BVD, the animals are not only impaired in path integration, but also piloting and that the spatial memory deficits may be permanent. The involvement of the cannabinoid system is more complicated than expected.

Alterações no sistema vestibulococlear decorrentes da exposição ao agrotóxico: revisão de literatura / Vestibulocochlear system alterations caused by exposure to pesticides: a literature review

Os agrotóxicos são amplamente utilizados no meio rural e sua larga utilização, desprovida de medidas de biossegurança apropriadas, vem provocando impactos potenciais tanto para a degradação ambiental quanto para o organismo humano, aumentando a incidência de intoxicações ocupacionais. O objetivo do presente estudo foi revisar e discutir a respeito da exposição aos agrotóxicos e sua influência na função e estrutura do sistema auditivo. Foram revisados periódicos nacionais e internacionais relevantes indexados no PubMed, Medline, Bireme e LILACS, assim como capítulos de livros e dissertações publicados no período entre 1987 e 2009. As pesquisas sugerem que a exposição, principalmente crônica, aos agrotóxicos induz a alterações funcionais no sistema vestibulococlear, manifestando ainda uma série de sinais e sintomas. Apesar da escassez de dados sobre a influência do organofosforado nas características morfológicas do aparelho auditivo, os estudos indicam que a exposição de caráter agudo aos agrotóxicos pode também ser responsável por alterações no sistema auditivo, caracterizadas por lesões estruturais na cóclea, principalmente nas células ciliadas externas.

Pesticides are widely used in agriculture, and the widespread application of these agents, without the appropriate use of bio-security measures, has been causing potential impacts for environmental degradation, as well as for the human organism, increasing the incidence of occupational poisoning. The aim of the present study was to review the available literature and to carry out a discussion regarding pesticides exposure and its harmful effects on the auditory system's function and structure. Relevant national and international journals indexed in PubMed, Medline, Bireme and LILACS were reviewed, as well as book chapters and dissertations published between 1987 and 2009. The available data suggest that chronic exposure to pesticides lead to functional alterations in the vestibulocochlear system, as well as a series of signs and symptoms. In spite of the scarce data describing organophosphorus influence on morphological characteristics of the auditory system, the literature suggest that acute exposure to pesticides can also be responsible for auditory system alterations, characterized by structural lesions in the cochlea, mainly in outer hair cells.

Effect of cochlear implantation on horizontal semicircular canal function.

The objective of this study was to assess the influence of a cochlear implant (CI) on horizontal semicircular canal (hSCC) function, to test the correlation with symptomatic vertigo and to identify possible risk factors for a postoperative vestibular impairment. In a prospective observational study design, forty-seven adult patients who had undergone cochlear implantation at Cochlear Implant Center at a tertiary referral university hospital, Munich, between 2003 and 2007, were studied. Postoperative vertigo symptoms were assessed using a questionnaire followed by a structured interview. Patients were subjected to caloric and rotational chair vestibular function tests pre- and postoperatively. The CI operation was performed with a retroauricular transmastoidal approach by three different surgeons. Thirty-six implants were Cochlear Nucleus 24 devices and 11 implants were MedEl devices. Twenty-one (45%) patients reported vertigo symptoms after CI. Functional testing of the hSCC yielded valid results in 45 of the 47 patients. Thirty-two percent of patients had a substantially reduced hSCC function after CI. Responses of caloric irrigation showed a significant worsening postoperatively in the CI ears. No direct correlation between a decrease in caloric response and risk of postoperative vertigo symptoms could be established. For the criteria age, sex, implant type, surgeon, cause of deafness, petrous bone CT findings and preoperative vertigo, there were no significant differences between the patients with and the patients without postoperative vertigo. Besides morphological changes, a cochlear implantation also causes functional damage of vestibular parts of the labyrinth. Our study showed a significant worsening of the caloric response. However, this alteration did not lead to vertigo complaints in all patients. It is therefore presumed that additional damage to sensory or visual afferents and central vestibular compensatory mechanisms play a role.

Loss of stapes prosthesis into vestibule during stapedectomy: a case report.

We present a unique case of intraoperative loss of a piston prosthesis into the right vestibule of a 47-year-old man during stapedectomy. Despite the fact that the prosthesis remains unfixed in the scala vestibuli at the basal turn of the cochlea, the patient has remained nearly asymptomatic in his right ear for approximately 2 years. We discuss the patient's presenting condition, operative course, and our diagnostic and management strategy in this case.

Evaluating cochlear implant trauma to the scala vestibuli.

OBJECTIVES: Placement of cochlear implant electrodes into the scala vestibuli may be intentional, e.g. in case of blocked scala tympani or unintentional as a result of trauma to the basilar membrane or erroneous location of the cochieostomy. The aim of this study was to evaluate the morphological consequences and cochlear trauma after implantation of different cochlear implant electrode arrays in the scala vestibuli. DESIGN: Human temporal bone study with histological and radiological evaluation. SETTING: Twelve human cadaver temporal bones were implanted with different cochlear implant electrodes. Implanted bones were processed using a special method to section undecalcified bone. MAIN OUTCOME MEASURES: Cochlear trauma and intracochlear positions. RESULTS: All implanted electrodes were implanted into the scala vestibuli using a special approach that allows direct scala vestibuli insertions. Fractures of the osseous spiral lamina were evaluated in some bones in the basal cochlear regions. In most electrodes, delicate structures of the organ of Corti were left intact, however, Reissner's membrane was destroyed in all specimens and the electrode lay upon the tectorial membrane. In some bones the organ of Corti was destroyed. CONCLUSIONS: Scala vestibuli insertions did not cause severe trauma to osseous or neural structures, thus preserving the basis for electrostimulation of the cochlea. However, destruction of Reissner's membrane and impact on the Organ of Corti can be assumed to destroy residual hearing.

Long-term changes in hippocampal n-methyl-D-aspartate receptor subunits following unilateral vestibular damage in rat.

Previous studies have indicated that damage to the peripheral vestibular system results in dysfunction of hippocampal place cells and an impairment of spatial learning and memory. The aim of this study was to determine whether lesions of one vestibular labyrinth (unilateral vestibular deafferentation, UVD) result in changes in the expression of the NR1 and NR2A subunits of the N-methyl-D-aspartate (NMDA) receptor, and the GluR2 subunit of the alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate receptor, in subregions of the rat hippocampus (CA1, CA2/3 and the dentate gyrus) at 10 h or 2 weeks following UVD. Compared with sham surgery controls and anaesthetic controls, the expression of the NR1 subunit was significantly reduced in the ipsilateral CA2/3 region at 2 weeks post-UVD. The expression of the NR2A subunit was also significantly reduced in the ipsilateral CA2/3 and, to a smaller extent, in the contralateral CA2/3 region, at 2 weeks post-UVD. The only other change in NR2A expression was an increase in the ipsilateral CA1 at 10 h post-UVD. No other changes in NR1, NR2A or GluR2 expression were observed in any hippocampal subregion, at any time point, or in cortical tissue at any time point. These results suggest that UVD may result in long-term changes in NMDA receptor subunit expression in the rat hippocampus.

Role of cholinergic mossy fibers in medial vestibular and prepositus hypoglossal nuclei in vestibular compensation.

Several lines of evidence have suggested that acetylcholine is a possible neurotransmitter/neuromodulator involved in vestibular compensation. Further, the central vestibular system, oculo- and spino-motor neurons and peripheral vestibular efferents contain abundant cholinergic neurons. However, details of cholinergic effective sites during vestibular compensation remain to be clarified. In the present study, we selectively damaged rat vestibulo-floccular and vestibulo-uvulonodular cholinergic mossy fibers using ethylcholine mustard aziridinium ions. In these treated animals, unilateral labyrinthectomy caused more severe vestibulo-ocular deficits especially during the initial stage. From these findings we suggest that vestibulo-floccular and vestibulo-uvulonodular cholinergic mossy fibers contribute to the restoration of a balance between intervestibular nuclear activities for the induction of vestibular compensation during the initial stage.

Apoptotic death of hair cells in mammalian vestibular sensory epithelia.

Hair cell death was examined in cultured explants of vestibular organs from mature guinea pigs and gerbils. The effects of gentamicin were compared with those of staurosporine, a membrane-permeable kinase inhibitor that induces programmed cell death in almost all cell types. Under the conditions used staurosporine killed hair cells but supporting cells appeared unaffected, and a topographic pattern of differential sensitivity to staurosporine amongst hair cells, similar to that described for aminoglycoside antibiotics, was revealed. This suggests such differential sensitivity is an inherent property of the hair cell population. Thin sectioning, and examination of whole mount preparations after application of the TUNEL procedure or after double fluorescent labelling with phalloidin and with propidium iodide, which labels nuclei, revealed that hair cells after exposure to gentamicin show features identical to those of apoptotic cells after exposure to staurosporine. Furthermore, cells showing features of apoptosis constitute a major proportion of the hair cells that are ultimately lost following exposure to gentamicin. Incubation of cultures with gentamicin in the presence of broad-spectrum inhibitors of caspases, proteases involved specifically in the cell death pathway, prevented almost all of the hair cell deaths normally triggered by gentamicin. This confirms that apoptosis is the predominant mode of hair cell death after gentamicin exposure. Hair cells exposed to gentamicin in the presence of caspase inhibitors appeared to be preserved intact. This, and the thin section observations, suggests that apoptotic death is the fate of the majority of hair cells affected by that drug and that any sub-lethal damage to hair cells exposed to gentamicin does not result in significant morphological alterations. Hair cell death was also prevented by deferoxamine which has been shown to protect cochlear hair cells in vivo from the effects of gentamicin. Explant cultures of mature vestibular organs may be, therefore, a useful model system for examining putative hair cell protecting agents.

Decision tree induction in the diagnosis of otoneurological diseases.

Expert systems have been applied in medicine as diagnostic aids and education tools. The construction of a knowledge base for an expert system may be a difficult task; to automate this task several machine learning methods have been developed. These methods can be also used in the refinement of knowledge bases for removing inconsistencies and redundancies, and for simplifying decision rules. In this study, decision tree induction was employed to acquire diagnostic knowledge for otoneurological diseases and to extract relevant parameters from the database of an otoneurological expert system ONE. The records of patients with benign positional vertigo, Meniere's disease, sudden deafness, traumatic vertigo, vestibular neuritis and vestibular schwannoma were retrieved from the database of ONE, and for each disease, decision trees were constructed. The study shows that decision tree induction is a useful technique for acquiring diagnostic knowledge for otoneurological diseases and for extracting relevant parameters from a large set of parameters.

Manifestacoes auditivas e vestibulares decorrentes da exposicao ao mercurio / Auditive and vestibular manifestations in the mercury exposure

Os autores descrevem tres casos clinicos de trabalhadores da area quimica expostos ao mercurio, com historia pregressa de intoxicacao. Analisam a escassa literatura pertinente as manifestacoes auditivas e vestibulares, observando a importancia do controle com base na propedeutica do VIII Par craniano. Concluem que, mesmo que os niveis biologicos do metal nao tenham atingido valores significativos de intoxicacao, a lesao auditiva e vestibular ja se encontrem instalada, podendo preceder os quadros classicos graves ou mesmo manter-se como indicio de exposicao...

Thermic effects in the "vestibule" during laser stapedotomy with pulsed laser systems.

BACKGROUND AND OBJECTIVE: Apart from the ablation properties at the stapes footplate, the degree of thermic loading in the inner ear is important in determining the suitability of pulsed lasers for stapedotomy. The aim of the study is to compare the thermic effects in the vestibule with different pulsed laser systems. STUDY DESIGN/MATERIALS AND METHODS: Temperature increases and heat exchange processes in the fluid (physiological saline) were examined in a calorically and physiologically approximated cochlea model for applying the laser parameters effective in creating footplate perforations. RESULTS: With all systems, increases in the energy density, number of pulses, and thus resultant total energy lead to higher temperatures. In the effective energy density range, the highest temperature increases achieved with the requisite number of pulses at a distance of 2 mm behind the perforation are 26 degrees C with the Ho:YAG laser. The lowest temperature maxima are 5.5 degrees C with the Er:YAG and <5 degrees C with the Er:YSGG laser. The excimer laser, investigated at only one energy density, showed maximal temperatures of 10 degrees C. CONCLUSION: The Er:YSGG and Er:YAG laser can be applied in laser stapedotomy in a relatively broad energy density range without a risk of inner ear damage by thermic loading. On the other hand, the Ho:YAG laser is not recommended for stapedotomy because of the higher energy density and pulse rate required for sufficient perforation and the resultant higher temperature increases in the perilymph. Though likewise achieving perforations with only slight temperature increases in the fluid of the cochlea model, the excimer laser does not seem appropriate for stapedotomy because of the long period of heat exposure (ca. 60 s) due to the lower ablation rate at the stapes necessitating a longer application time.