Morphological and morphometric study of the superior vestibular nerve trunk in guinea pigs.

The guinea pig has been chosen as a research model for otologic or neuropathic studies due to the relative ease of the cochlea, cochlear nerve, and vestibular nerve dissection. Little data have been reported on the normality of these nerves. The vestibular nerve is composed of the superior vestibular, inferior vestibular, and branch nerves. This study aimed to study the microscopic anatomy of the superior vestibular nerve (SVN) of guinea pigs using light microscopy and to search for normality patterns for use in experimental models in basic otologic research. We used eight male albino guinea pigs (Cavia porcellus, English strain), weighing between 400 and 500 g. After anesthetizing, the animals were perfused with a fixative solution of 2.5% glutaraldehyde. Dissection was performed by the access method to the temporal bone, coming to the rock and exposing the cochlea and vestibular nerve. The NVS fragments were removed, postfixed in osmium tetroxide, and embedded in the epoxy plastic resin Poly/Bed 812® (Polysciences Inc., Warrington, PA). Semi-thin transverse serial sections (0.5 µm) were made using a microtome MT6000-XL, RMC, Inc. and stained with toluidine blue. Morphology and morphometry were described and evaluated using the KS 400 application (Kontron 2.0, EchingBei, Munich, Germany) by macro, a computer program specially designed and developed for the study of the VIII nerve. The SVN was found to be devoid of epineurium, with only a thin conjunctive tissue layer. The myelin sheath of guinea pigs is relatively thin compared to the sensory and motor nerves found in mammals. The average fascicular area SVN was 0.19 ± 0.05 mm2 , with the largest area found to be 0.24 mm2 and the lowest was 0.12 mm2 . The average number of fibers was 5,753.00 ± 538 fibers. The density of myelinated fibers reached 32,316.08 ± 11,375.29 fibers/mm2 . Its diameter ranged from 1.0 to 9 µm and its peak was 3 µm. The measured results confirm the results of another study, indicating that the methodology is appropriate and reproducible. These findings are important for the evaluation of injured nerves in experimental models of peripheral neuropathy and basic ear disease.

Retrosigmoid Vestibular Neurectomy for Meniere Disease: A Technical Note.

BACKGROUND: Meniere disease (MD) is an idiopathic peripheral pathology involving the acoustic apparatus. One of the most critical challenges in managing MD is intractable vertigo. In this context, retrosigmoid vestibular neurectomy has been described as a safe and effective technique to manage this symptom when it is resistant to first- and second-line treatments. This article analyzed the alternative treatment options, specific surgical anatomy, and relevant details of vestibular neurectomies performed for intractable MD. METHODS: Relevant neurovascular landmarks, critical surgical steps, adequate indications, and potential pitfalls of retrosigmoid vestibular neurectomy were analyzed based on an illustrative clinical case of intractable MD. RESULTS: The illustrative case demonstrated how early recognition of the facial nerve and the vestibulocochlear plane is fundamental to performing retrosigmoid vestibular neurectomy. This procedure is indicated in cases of resistant MD with preoperative hearing integrity. Potential pitfalls of this technique are incomplete neurotomy, nerve regeneration, comorbidities in the contralateral ear, adverse anatomy, the possibility of nonotologic vertigo, and incomplete vestibular compensation. CONCLUSIONS: Vestibular neurectomy represents a safe and effective technique to manage MD that is resistant to medical treatment, allowing symptom control and hearing preservation. Nevertheless, detailed knowledge of surgical anatomy and possible pitfalls is of paramount importance to achieve a good outcome.

Gangliformis Intumescentia and Beyond: Antonio Scarpa and His Core Contribution to Neuroanatomy, Neurosurgery, and Otoneurosurgery.

Nearly 250 years ago, Antonio Scarpa became a professor of anatomy and surgery only 2 years after he graduated from the University of Padua. The young lecturer soon became one of the most renowned anatomists in Italy and a director of the Faculty of Medicine at the University of Pavia. He worked in the fields of general surgery and ophthalmology. Several anatomic structures have been named after him, mainly Scarpa fascia and Scarpa triangle. His interest in neuroanatomy was ardent, despite being occasionally neglected. Scarpa's contributions to the fields of neurosciences have been significant. He was the first to describe the round window and the secondary tympanic membrane, and he eventually focused on the auditory and olfactory organs. Notably, the vestibular ganglion is now known as Scarpa ganglion. Scarpa's magnum opus was the book Tabulae Neurologicae, in which he described the path of several cranial nerves including the vagus nerve and innervation of the heart. Since his death in 1832, Scarpa's head has been preserved at the University History Museum of the University of Pavia. In this historical vignette, we aim to describe Antonio Scarpa's troubled life and brilliant career, focusing on his core contributions to neuroanatomy, neurosurgery, and otoneurosurgery.

Segmental Analysis of the Vestibular Nerve and the Efferents of the Vestibular Complex.

Use of a segmental approach in the study of vestibular centers in the hindbrain improves morphological and functional understanding of this region controlled by Hox genes, among other molecular determinants. Here, we review accrued data about segmental organization of vestibular afferents and efferents. Inner ear-originated vestibular fibers enter the hindbrain, together with auditory ones, through the alar plate of rhombomere 4, then branch into descending and ascending branches to reach appropriate vestibular nuclei along the vestibular column. Classical vestibular nuclei (superior, lateral, medial, and inferior) originate in eight successive rhombomeric segments, which suggests internal subdivisions correlated with distinct connections and functions. The vestibular projection neurons identified for various targets aggregate in discrete groups, which correlate topographically either with rhombomeric units, or with internal subdivisions within them. Each vestibular projection system (e.g., vestibulo-spinal, vestibulo-ocular, vestibulocerebellar) has a characteristic ipsilateral/contralateral organization. Comparing them as a connective mosaic in different species shows that various aspects of this segmental connective organization are conserved throughout evolution in vertebrates. Furthermore, certain genes that control the development of the rhombomeric units in the hindbrain may determine, among other aspects, the specific properties of the different neuronal subpopulations related to their axonal navigation and synaptogenesis. Anat Rec, 302:472-484, 2019. © 2018 Wiley Periodicals, Inc.

Electrophysiological Properties of Rat Vestibular Labyrinth and Their Effect on Parameters of Transmitted Voltage Pulses.

We propose a new approach to optimization of electrical stimulation of the vestibular nerve and improving the transfer function of vestibular implant. A mathematical model of the vestibular organ is developed based on its anatomy, the model premises, 3D-analysis of MRI and CT images, and mathematical description of physical processes underlying propagation of alternating electric current across the tissues of vestibular labyrinth. This approach was tested in vitro on the rat vestibular apparatus and had been examined anatomically prior to the development of its mathematical model and equivalent electrical circuit. The experimental and theoretical values of changes of the gain-phase characteristics of vestibular tissues in relation to location of the reference electrode obtained in this study can be used to optimize the electrical stimulation of vestibular nerve.

Anatomía, fisiología y rol clínico de la corteza vestibular / Anatomy, physiology and clinical role of the vestibular cortex

El sistema vestibular, mediante sus órganos periféricos, nos permite procesar correctamente los cambios de aceleración angular de la cabeza y lineal del cuerpo y así permitirnos una correcta orientación en el espacio. Esta información sensorial es dirigida hacia los núcleos vestibulares y desde aquí se comunica con los núcleos óculo-motores y estructuras del tálamo a través de tractos ascendentes del tronco encefálico. Posteriormente la información se dirige hacia centros subcorticales y corticales de naturaleza eminentemente multisensorial. La naturaleza y función de estas estructuras es controversial. En esta revisión se abordan los principales conceptos y descubrimientos a nivel de investigación básica y clínica del procesamiento cortical generado por estimulación de tipo vestibular.

The vestibular system, thanks to its peripheral organs, allows us to properly process the angular head movements and linear acceleration in order to give us a proper orientation in space. The information from these sensory inputs is routed to the vestibular nuclei and thence ascending tracts of the brainstem, which communicate with the oculomotor nuclei of the thalamus and structures. Then the information goes to subcortical and cortical centers, which are eminently multisensory nature. The nature and function of these structures are controversial. In this review the main concepts and discoveries at the level of basic and clinical research generated cortical processing of vestibular stimulation are addressed.

Anatomy and surgical approach of rat's vestibular sensors and nerves.

BACKGROUND: The rat is one of the most used species in the neurosciences, but how to selectively reach each of its 5 vestibular sensors has never been described. Besides, new functions of the vestibular system have been recently discovered in the rat involving vegetative, circadian and cognitive functions. But the central pathways sustaining these functions and the role of each of the vestibular sensors are not clear. NEW METHODS: Here we want to describe the anatomy and look for a direct surgical approach to the 5 vestibular sensors in rats, as an indispensable technique to further study the central vestibular pathways. To do so we studied 10 rats either by microtomography with osmium tetroxide staining, histology with hematoxilyn-eosine staining or microsurgical dissection. RESULTS: The microtomography allows a 3D representation of the 5 vestibular sensors and their nerves, with precise landmarks confirmed by the histological analysis. Each of the landmarks are illustrated and a selective surgical approach to each sensor and their nerves, is described step by step. COMPARISON WITH EXISTING METHOD: Selective approaches to the vestibular sensors have been used in other species such as cats, monkeys and recently humans but the current study is the first allowing this technique in rats. CONCLUSION: Each vestibular sensor of the rat can be reached by a selective surgical approach. This allows further techniques such as electrophysiology or neurotracing of the central vestibular pathways. This also indicates the rat as a potential model for vestibular prostheses.

A biophysical model examining the role of low-voltage-activated potassium currents in shaping the responses of vestibular ganglion neurons.

The vestibular nerve is characterized by two broad groups of neurons that differ in the timing of their interspike intervals; some fire at highly regular intervals, whereas others fire at highly irregular intervals. Heterogeneity in ion channel properties has been proposed as shaping these firing patterns (Highstein SM, Politoff AL. Brain Res 150: 182-187, 1978; Smith CE, Goldberg JM. Biol Cybern 54: 41-51, 1986). Kalluri et al. (J Neurophysiol 104: 2034-2051, 2010) proposed that regularity is controlled by the density of low-voltage-activated potassium currents (IKL). To examine the impact of IKL on spike timing regularity, we implemented a single-compartment model with three conductances known to be present in the vestibular ganglion: transient sodium (gNa), low-voltage-activated potassium (gKL), and high-voltage-activated potassium (gKH). Consistent with in vitro observations, removing gKL depolarized resting potential, increased input resistance and membrane time constant, and converted current step-evoked firing patterns from transient (1 spike at current onset) to sustained (many spikes). Modeled neurons were driven with a time-varying synaptic conductance that captured the random arrival times and amplitudes of glutamate-driven synaptic events. In the presence of gKL, spiking occurred only in response to large events with fast onsets. Models without gKL exhibited greater integration by responding to the superposition of rapidly arriving events. Three synaptic conductance were modeled, each with different kinetics to represent a variety of different synaptic processes. In response to all three types of synaptic conductance, models containing gKL produced spike trains with irregular interspike intervals. Only models lacking gKL when driven by rapidly arriving small excitatory postsynaptic currents were capable of generating regular spiking.

Macroscopic description of the external and middle ear of paca (Cuniculus paca Linnaeus, 1766) / Descrição macroscópica da orelha externa e media da paca (Cuniculus paca Linnaeus, 1766)

Paca (Cuniculus paca), one of the largest rodents of the Brazilian fauna, has inherent characteristics of its species which can conribute as a new option for animal experimantation. As there is a growing demand for suitable experimental models in audiologic and otologic surgical research, the gross anatomy and ultrastructural ear of this rodent have been analyzed and described in detail. Fifteen adult pacas from the Wild Animals Sector herd of Faculdade de Ciências Agrárias e Veterinárias, Unesp-Jaboticabal, were used in this study. After anesthesia and euthanasia, we evaluated the entire composition of the external ear, registering and ddescribing the details; the temporal region was often dissected for a better view and detailing of the tympanic bulla which was removed and opened to expose the ear structures analyzed mascroscopically and ultrastructurally. The ear pinna has a triangular and concave shape with irregular ridges and sharp apex. The external auditory canal is winding in its path to the tympanic mebrane. The tympanic bulla is is on the back-bottom of the skull. The middle ear is formed by a cavity region filled with bone and membranous structures bounded by the tympanic membrane and the oval and round windows. The tympanic membrane is flat and seals the ear canal. The anatomy of the paca ear is similar to the guinea pig and from the viewpoint of experimental model has major advantages compared with the mouse ear.

A paca (Cuniculus paca), um dos maiores roedores da fauna brasileira, possui características inerentes à sua espécie que podem contribuir como uma nova opção de animal experimental; assim, considerando-se que há crescente busca por modelos experimentais apropriados para pesquisas audiológicas e otológica cirúrgicas foram analisados e descritos em detalhes a anatomia macroscópica e ultraestrutural da orelha desse roedor. Para o estudo, utilizaram-se 15 animais adultos provenientes do plantel do Setor de Animais Silvestres da Faculdade de Ciências Agrárias e Veterinárias, Unesp-Jaboticabal, Jaboticabal/SP. Após anestesia e eutanásia, avaliou-se toda a composição da orelha externa, registrando-se e descrevendo-se os detalhes, também se dissecou a região temporal para melhor visibilização e detalhamento da bula timpânica e estas foram removidas e abertas a fim de expor as estruturas da orelha, as quais foram analisadas, macroscopicamente e ultraestruturalmente. O pavilhão auricular apresenta forma triangular e côncava com cristas irregulares e ápice pontiagudo; o conduto auditivo externo é sinuoso em seu trajeto até a membrana timpânica; a bula timpânica encontra-se na parte posterior-inferior do crânio; a orelha média é formada por uma região cavitária preenchida por estruturas ósseas e membranosas. É delimitada pela membrana timpânica e as janelas redonda e oval, sendo a membrana timpânica de forma plana e que veda todo o conduto auditivo. A anatomia da orelha da paca é semelhante à da cobaia e do ponto de vista de modelo experimental apresenta grandes vantagens em comparação com a orelha do rato.

The distribution of vestibular efferent neurons receiving innervation of secondary vestibular afferent nerves in rats.

OBJECTIVES/HYPOTHESIS: To explore the innervation areas of the medial vestibular nucleus (MVN) afferent neurons onto vestibular efferent neurons in the brain stem of rats. STUDY DESIGN: A morphology study in the central vestibular system. METHODS: Two neuronal tracers were used. Lectin PHA-L Conjugates (PHA-L, Invitrogen L - 11270,) was injected into the MVN as an anterograde tracer, and 5% FluoSpheres carboxylate-modified microspheres (MFS, Molecular Probe F-8793) was injected into the contralateral peripheral vestibule using as a retrograde tracer. All animals were allowed to recover for 12 days to facilitate sufficient transportation of the tracers. Then brain stems were sliced coronally on a freezing microtome and observed under a fluorescence microscope and laser confocal microscopy. RESULTS: Neurons in the MVN labeled with PHA-L exhibited green fluorescence, and their axons were distributed near the genu of the facial nerve (g7) and in the reticulation structure, as well as in the cerebellum or oculomotor-related nuclei. Neurons labeled with red fluorescence of MFS were mainly located dorsomedial and dorsolateral to g7 and in the caudal pontine reticular nucleus (PnC) bilaterally and presented different morphologies at different locations. The synaptic junctions would display color overlap (fluoresced yellow). Under three-dimensional reconstruction of the confocal laser microscopy, the synaptic junctions were visualized dorsomedial and dorsolateral to g7 bilaterally, predominantly ipsilateral to the MVN injection site. CONCLUSIONS: Morphologic evidence of the distribution of vestibular efferent neurons synapsed by afferent nerves from MVN was demonstrated. These efferent neurons constitute short closed-loop circuits with neurons in the MVN.

Morphological and morphometric study on human Scarpa ganglion development.

CONCLUSION: In Scarpa neurons the cell and nuclear area increases and nuclear/cytoplasm ratio decreases with fetal age (p < 0.0001). There are statistically significant differences in cell area between all fetal groups, except for the interval 45-74 mm crown-rump-length (CRL). Displacement of a neuron within the internal auditory meatus (IAM) occurs from 9 weeks in the fetus until the neonate. METHODS: A light microscopic histomorphometric study of the Scarpa ganglion in human fetuses from spontaneous abortions measuring 45, 74, 90, 134, 145 and 270 mm CRL and a from a 1-day-old neonate (360 mm) was carried out. Cell and nuclear area, ganglion area and distances from the Scarpa ganglion neurons to the endocranial porus of the IAM were measured. RESULTS: In the 45, 74, 90 and 134 mm CRL human fetuses the cartilaginous labyrinthine capsule appears divided by the facial nerve and the Scarpa ganglion into two compartments: rostral and dorsal. Ovoidal Scarpa ganglion in the 45 mm CRL lies within the IAM near its endocranial porus (15 µm). In the otic capsule of the 145 mm CRL fetus an endochondral ossification appears in the IAM base, where Scarpa ganglion neurons are displayed in two groups: superior and inferior divided by a vascular-connective septum. This anatomy remains from this specimen until the neonate specimen.

Anastomoses of the vestibular, cochlear, and facial nerves.

The internal auditory canal (IAC) is 10 to 17 mm in length, and the facial nerve and vestibulocochlear nerve, which consist of the cochlear nerve, the superior vestibular nerve, and the inferior vestibular nerve, run together in the IAC packaged in dura mater. Oort first described the vestibulocochlear anastomoses in 1918, which is important for the understanding of the pathogenesis and pathophysiology of otologic disorders. The current study documents the existence of vestibulofacial and vestibulocochlear neural connections and topographical relationship of the nerves as part of a radiologic evaluation of 73 human temporal bones from brainstem to the lateral portion of IAC.

[Functional anatomy of the vestibular nerve]. / Anatomie fonctionnelle du nerf vestibulaire.

The vestibular system detects head movements such as angular rotation, translation, and head position relative to gravity. It acts to stabilize the eyes and posture through subcortical reflexes. Its signals are also integrated at the cortical level to participate in the elaboration of a body scheme, used for different functions such as spatial orientation and motor control. The vestibular nerve shows a resting discharge rate that is modulated up or down according to head motion or position. Central functioning depends on the detection of an asymmetry between signals coming from a pair of peripheral sensors, one on either side. In pathological cases, unilateral peripheral dysfunction is interpreted by the central system as an asymmetry resulting from a change in head position leading to nystagmus, postural disturbances, and vertigo. The dysfunction can be either a deficit, such as observed in vestibular neuronitis, or hyperactivity such as observed in neurovascular compression syndrome of the VIIIth nerve. Anatomically, the VIIIth nerve has a long Root Entry Zone (REZ) that extends over 10mm before entering the brainstem. The VIIIth nerve is also physiologically close to numerous vessels at the pontocerebellar angle and internal auditory meatus. Therefore, vestibular syndrome resulting from neurovascular compression syndrome of the VIIIth nerve may exist, but it is very difficult to prove using radiological imagery.

[Morphological anatomy of the cranial nerves in their cisternal segment (III-XII)]. / Anatomie morphologique des nerfs crâniens dans leur portion cisternale (du III au XII).

One hundred brains (first injected in cerebral arteries and veins with latex neoprene or India ink and studied under optic magnification) illustrate this anatomic chapter concerning the microsurgical anatomy of the cisternal segment, the neurovascular relationships, and the blood supply of the IIIrd to the XIIth cranial nerves.

The topographical relationships and anastomosis of the nerves in the human internal auditory canal.

INTRODUCTION: The anatomy of the nerves in the human internal auditory canal (IAC) has been reported by a number of authors, and there are some differences among the viewpoints of the literatures. With the development of the microsurgery and endoscopic surgery in the IAC, the study of the topographical relationship of the nerves in the human IAC becomes more and more important. The purpose of this study was to investigate the anastomosis and topographical relationship of the nerves in the human IAC. METHODS: In this study, we dissected 30 human temporal bones from 15 heads, and examined the topographical relationship and the anastomosis of the nerves in human IAC. RESULTS: (1) In 11 out of 30 cases (37%), the facial nerve is anterosuperior to the vestibulocochlear nerve through the whole IAC; and for the remaining 19 cases (63%), the facial nerve rotates anteroinferiorly at an angle ranging from 30 degrees to 90 degrees , which is in the same direction as that of the cochlear. (2) Vestibulofacial nerve anastomosis occurs in 25 cases (83%), of which 67% appears near the porus acusticus, and of which 33% appears between the lateral and intermedial portion of IAC. The diameter was about 0.5-1 mm. (3) Vestibulocochlear anastomosis occurs in 24 cases (80%) among which, some brush-like nerve fiber bundles of the cochlear nerve were seen to enter the acculus proprius directly in 13 cases. Transverse vestibulocochlear anastomosis in the fundus of internal acoustic meatus occurred in 15 cases, including two cases with more anastomosis. No vestibulocochlear nerve anastomosis was found in six cases in this study. CONCLUSIONS: Our study shows that the Vestibulofacial nerve anastomosis and the vestibulocochlear nerve anastomosis do exist, and some variations appear due to individual differences. The appearance of the facial and vestibulocochlearnerves is variable but follows certain consistent patterns.

Assessment of the anatomical relationship between the arcuate eminence and superior semicircular canal by computed tomography.

The anatomical relationship between the arcuate eminence (AE) and the superior semicircular canal (SSC) was examined by computed tomography (CT) in 52 petrous bones of 26 patients. After acquiring volume data by multidetector CT, 1-mm thick oblique bone window images perpendicular to the SSC were obtained from the axial images. The distances between the AE and the SSC, and the SSC and the superior surface of the petrous bone were measured. The AE corresponded exactly with the SSC in only 2/52 petrous bones, and corresponded well in 7/52. The AE was lateral to the SSC in 25/52 cases, medial to the SSC in 6/52 cases, intersected in 3/52 cases, and was indiscernible in 9/52 cases. The distance between the SSC and the petrous surface was 0 mm in 45/52 petrous bones, 1 mm in 5/52, 2 mm in 1/52, and 3 mm in 1/52. The SSC typically does not correspond exactly with the AE, and is generally located just under the surface of the petrous bone. Planning of the middle cranial fossa approach requires location of the SSC by CT.

Axonal pathways and projection levels of anterior semicircular canal nerve-activated vestibulospinal neurons in cats.

Using collision tests of orthodromically and antidromically generated spikes, we studied the axonal pathways, axonal projection levels, and soma location of anterior semicircular canal (AC) nerve-activated vestibulospinal neurons in decerebrate cats. AC nerve-activated vestibulospinal neurons (n=74) were mainly located in the ventral portion of the lateral vestibular nuclei and the rostral portion of the descending vestibular nucleus, which is consistent with previous studies. Of these neurons, 15% projected through the ipsilateral (i-) lateral vestibulospinal tract (LVST), 74% projected through the medial vestibulospinal tract (MVST), and 11% projected through the contralateral (c-) LVST. The vast majority (78%) of AC nerve-activated vestibulospinal neurons were activated antidromically only from the cervical segment of the spinal cord; 15% of neurons were activated from the T1 segment and only one neuron was activated from the L3 segment. AC nerve-activated vestibulospinal neurons may primarily target the neck muscles and thus contribute to the vestibulocollic reflex. Most of the c-LVST neurons were also activated antidromically from the oculomotor nucleus, suggesting that they are closely related to the control of combined eye-head movements.

The anatomy of the vestibular nuclei.

The vestibular portion of the eighth cranial nerve informs the brain about the linear and angular movements of the head in space and the position of the head with respect to gravity. The termination sites of these eighth nerve afferents define the territory of the vestibular nuclei in the brainstem. (There is also a subset of afferents that project directly to the cerebellum.) This chapter reviews the anatomical organization of the vestibular nuclei, and the anatomy of the pathways from the nuclei to various target areas in the brain. The cytoarchitectonics of the vestibular brainstem are discussed, since these features have been used to distinguish the individual nuclei. The neurochemical phenotype of vestibular neurons and pathways are also summarized because the chemical anatomy of the system contributes to its signal-processing capabilities. Similarly, the morphologic features of short-axon local circuit neurons and long-axon cells with extrinsic projections are described in detail, since these structural attributes of the neurons are critical to their functional potential. Finally, the composition and hodology of the afferent and efferent pathways of the vestibular nuclei are discussed. In sum, this chapter reviews the morphology, chemoanatomy, connectivity, and synaptology of the vestibular nuclei.