Elektrophysiologische Untersuchung zum Einsatz von Streptolysin O und Natrium-Hyaluronat zur Permeabilitätsmodulation der Membran des runden Fensters beim Meerschweinchen

Background: The round window membrane (RWM) acts like a barrier for topically applied substances into the middle ear preventing diffusion into the perilymphatic fluid compartment. Material and Method: In an animal model, modulation of the permeability of the RWM was attempted using Streptolysin-O (SLO) in various concentrations and sodium hyaluronate. Thereafter, the effect of intratympanically applied Lidocain 2% on hearing threshold measured by auditory brainstem response was tested for Lidocain 2 % and Lidocain 2 % in combination with SLO or sodium hyaluronate. Results: The results show that both, SLO and sodium hyaluronate, influence the effect of Lidocain 2 % on hearing thresholds as a…

Intraoperatives Monitoring motorischer Hirnnerven bei Operationen an Hals und Schädelbasis

Intraoperative monitoring of cranial nerves is performed to minimize postoperative cranial nerve dysfunction. We performed electrophysiological monitoring of motor cranial nerves with a NIM 2 unit from Xomed Treace and a patient multiplexer developed in our clinic. This multiplexer allows simultaneous monitoring of 4 cranial nerves and is additionally equipped with a bipolar stimulation mode. This intraoperative monitoring was employed during 102 skull base operations. Of these 102 operations, 44 were acoustic neuroma removals by translabyrinthine approach and 36 by a middle fossa approach. Various operations including removal of tumours of the jugular foramen and the infratemporal fossa we…

Alteration of the Calcium Content in Inner Hair Cells of the Cochlea of the Guinea Pig after Acute Noise Trauma with and without Application of the Organic Calcium Channel Blocker Diltiazem

Calcium ions are known to be important to the process of signal transduction across the apical and basal sides of the inner hair cells. Calcium channel antagonists have been demonstrated by light microscopy to provide protection against acoustic trauma. To evaluate the protective effect of calcium channel blocker on the inner ear cells to noise exposure, the amount of the histochemical reaction products formed in the cytoplasm of the inner hair cells of the guinea pig after application of pyroantimonate was measured by an image processing system connected to an energy-filtering transmission electron microscope (EFTEM). Compared to untreated control specimens (experimental animal group I) th…

Epidural hematoma after cochlear implantation in a 2.5-year-old boy.

OBJECTIVE Report a case of an epidural hematoma after cochlear implantation in a 2.5-year-old boy, the diagnostic and therapeutical emergency management, as well as the postinterventional course and rehabilitation of the child. STUDY DESIGN Retrospective case review. PATIENT Two and a half-year-old boy, suffering from early onset, profound sensorineural hearing loss had been diagnosed at an age of 1.5 years, which had been more severe on the right side initially, but had progressed to bilateral deafness. INTERVENTION AND COMPLICATION: Cochlear implantation on the left side, followed up by an extensive epidural hematoma, causing intracranial compression with a midline shift of 15 mm to the r…

Reliability of cochlear implants.

Background The long-term reliability of cochlear implants over time is an important issue for patients and cochlear implant teams. The calculation of cumulative survival rates including all hard failures of cochlear implants is suitable to report objectively about cochlear implant reliability. Methods This is a report of 192 cochlear implants from different manufacturers in adults (n = 58) and children (n = 134). Results The overall cumulative implant survival rate was 91.7% for a period of 11 years. The main reasons for hard failures were design errors of the products and direct or indirect trauma to the cochlea implant site (especially in children) with consecutive breaks of the implant b…

Possible Ca 2+ -dependent mechanism of apical outer hair cell modulation within the cochlea of the guinea pig

Calcium ions were precipitated with potassium antimonate after injection of the inorganic calcium channel blocker MnCl2 or the inorganic potassium channel blockers BaCl2 or CsCl into the perilymph of the scala vestibuli of the guinea pig. The spatial distribution of the formed histochemical reaction products within the organ of Corti was studied by energy-filtering transmission-electron microscopy. Compared with untreated control ears, the number of the formed precipitates drastically increased at the extracellular side of the lamina reticularis after application of the various inorganic channel blockers. The apical side of the outer hair cells and the intervening Deiter cells were covered …

Immunoelectron microscopic localization of nitric oxide synthase III in the guinea pig organ of Corti

Nitric oxide synthase III (NOS III) was identified in the guinea pig cochlea on an ultrastructural level using a post-embedding immunolabeling procedure. Ultrathin sections of London Resin (LR) White-embedded specimens were incubated with various concentrations of a commercially available antibody to NOS III and the immunoreactivity visualized by a gold-labeled secondary antibody. Analysis of ultrathin sections of the organ of Corti in the second turn of the cochlea showed that NOS III could be localized in the endothelial cells of the blood vessels under the basilar membrane, which was comparable to its location in similar cells types in various biological systems. Besides this, NOS III wa…

Morphologic Damage and Changes of Intracellular Calcium-Binding Sites after Acute Noise Trauma in the Organ of Corti of the Guinea Pig

In guinea pigs, an acute acoustic trauma was created by 6 consecutive gunshots. The sound pressure at the ear drum was 156 +/- 4 dB, the frequency maximum was between 4 and 6 kHz. Sixty hours after the noise trauma, the animals were decapitated, and the cochleae were prepared for microscopic analysis of the resulting trauma to the organ of Corti. During the process of fixation, the potassium-pyroantimonate precipitation reaction was performed to localize calcium-binding sites. The pattern of cell morphology and the distribution of calcium-binding sites was compared to that of normal control animals. Morphologic changes of the cells in the organ of Corti correlated with changes of the cellul…

Steroid and vasoactive treatment for acute deafness after attempted hearing preservation acoustic neuroma surgery.

<i>Objective:</i> To investigate whether intravenous steroid and vasoactive therapy in the acute postoperative period improves hearing outcome in patients who develop acute deafness after attempted hearing preservation surgery for acoustic neuroma (AN) through a retrosigmoid or a middle cranial fossa approach. <i>Study Design and Setting:</i> Retrospective controlled study in a tertiary care center. Thirty-six patients who had developed acute deafness after hearing preservation surgery for treatment of an AN were reviewed. Preoperative AAOHNS hearing class was A in 2, B in 2 and D in 32 patients. Twenty-seven patients were treated with prednisolone, hydroxyethyl star…

Intratympanale Intervalltherapie des Morbus Meni�re mit Gentamicin unter Erhalt der Kochleafunktion

Patienten und Methode Zwischen 1997 und 2000 haben wir 57 Patienten intratympanal einseitig mit Gentamicininjektionen (jeweils 0,3 ml = 12 mg) therapiert. Eine Therapieserie bestand maximal aus je einer Injektion an Tag 1, 8 und 15. Intratympanal injiziertes Gentamicin akkumuliert langsam (Durchschnitt unseres Krankenguts: 4,6 Tage) im Innenohr. Die Intervalltherapie vermeidet uberhohte Gentamicinkonzentrationen. Sobald Zeichen einer Innenohrreaktion auftreten (Nystagmus, Unsicherheit, Schwindel), hat die Therapie gewirkt und darf keinesfalls weitergefuhrt werden.

DPOAE‐Grams in Patients with Acute Tonal Tinnitus

To investigate cochlear outer hair cell function in patients with acute tonal tinnitus and normal or near-normal hearing threshold.Prospective controlled study in an academic tertiary health center. Distortion products of otoacoustic emissions (DPOAE)-grams of 32 ears with acute tonal tinnitus and normal hearing or minimal hearing loss were compared with those of 17 healthy nontinnitus ears.Tinnitus ears exhibited relatively increased amplitudes of DPOAE at high frequencies (4-6.3 kHz) when compared with the group of healthy ears and relatively decreased DPOAE amplitudes at middle frequencies (1650-2400 Hz). Statistically significant ( P0.01) increased mean values of DPOAE amplitudes were o…

Ultrasonography for evaluation of the carotid artery in head and neck cancer.

The dynamic relationship of lymph node metastases to surrounding vascular structures in the neck is important for preoperative patient assessment. When carotid artery involvement is suspected, this relationship often determines whether or not to operate. In the case of adhesive neck metastases along the internal jugular vein, it becomes possible to predict preoperatively if the integrity of this vein may be preserved. Ultrasonography has the ability to differentiate subtle from gross adherence, or simple compression from vascular invasion. This is done by manually palpating the tumor mass and asking the patient to perform various maneuvers while observing on a monitor the relationship of th…

Localization of the two constitutively expressed nitric oxide synthase isoforms (nNOS and eNOS) in the same cell types in the saccule maculae of the frog Rana pipiens by immunoelectron microscopy: evidence for a back-up system?

There is growing evidence for a nitric oxide/cyclic GMP pathway of signal transduction in the vestibular system. Recently, two isoforms of nitric oxide (NO) synthase (nNOS and eNOS) and NO itself have been identified at the light microscopic level in the vestibulocochlear system of mice using specific antibodies and a new fluorescence indicator. In order to acquire more information about signal transduction and tissue modulation in this neuroepithelium at the cellular and subcellular levels, ultrathin sections of London Resin White-embedded saccule maculae of the frog Rana pipiens were incubated with various concentrations of commercially available antibodies to nNOS and eNOS. The immunorea…

Localization of Ca(2+)-stores and tissue compartments with a Ca(2+)-binding capacity in the organ of Corti of the guinea-pig by electron energy-loss spectroscopy.

SUMMARY The addition of 10 mM CaCl2 to glutaraldehyde fixative leads to the formation of small electron-dense deposits in the organ of Corti of the guinea-pig. These precipitates are mainly attached to cell membranes in contact with different extracellular lymphatic fluids. A higher number of precipitates is localized in the acellular parts of tectorial and basilar membrane. Electron energy-loss spectroscopy (EELS) was used to determine the elemental composition of the deposits formed. The spectra showed a prominent signal at the Ca2+ L2,3 ionization edge. Oxygen could also be detected in all the precipitates analysed. EELS analysis of mitochondria of the inner and outer hair cells after co…

Fehlerquellen der Navigation in der lateralen Sch�delbasischirurgie

Die Identifikation moglicher Storfaktoren navigationsunterstutzter Eingriffe an der lateralen Schadelbasis ermoglichen dem Anwender die Vermeidung und Behebung dieser Fehler. Anhand unserer Erfahrungen von 85 navigationsunterstutzten Eingriffen im Bereich der lateralen Schadelbasis werden Fehler der Hard- und Software, der Bildgebung und des -transfers, der Patientenregistrierung, durch den Anwender und solche strategischer Art analysiert. Bei optischen CAS-Systemen fuhrt eine Blockade des Sichtfelds der Kameras zu Funktionsbeschrankungen, wahrend elektromagnetische Systeme durch ferromagnetisch aktive Materialien beeinflusst werden konnen. Die bisherigen Verfahren der Patientenregistrierun…

Vestibular Function after Acoustic Neuroma Removal with Preservation of One Branch of the Vestibular Nerve

Background Vestibular compensation after acoustic neuroma surgery is affected by many parameters. Apart from surgical approach, age of the patient, and comorbidity, the use of rehabilitative vestibular training and the degree of preoperative vestibular compensation play their respective roles. Objective To examine whether and how surgical preservation of one branch of the vestibular nerve affects the compensation process in patients after acoustic neuroma removal. Study design Prospective study involving 29 patients with acoustic neuromas. In 15 patients operated on by the middle fossa or retrosigmoid approach, one branch of the vestibular nerve could be preserved intraoperatively, and the …

Respiratory epithelium exposed to sulfur dioxide--functional and ultrastructural alterations.

The value of morphological investigations of airway mucosa should be compared to a functional method when estimating the toxicity of airborne pollutants. In 34 guinea pig tracheas, mucociliary activity was measured using a modified light beam reflex method before and following exposure to sulfur dioxide for 30 minutes in concentrations ranging between 7.5 and 37.5 mg/m3. Exposure to air served as a control. Simultaneously, specimens were taken for light and electron microscopy. Mucociliary activity decreased from 8.4 +/- 2.9 Hz (control exposure) to 4.0 +/- 2.9 Hz following exposure to 7.5 mg/m3, to 3.4 +/- 2.7 Hz at 15 mg/m3 sulfur dioxide, to 1.8 +/- 2.2 Hz at 22.5 mg/m3 sulfur dioxide, t…

Long-Term Results after Interval Therapy with Intratympanic Gentamicin for Meni??re???s Disease

Objectives The new single-shot and interval treatment for Meniere's disease with gentamicin was designed to avoid cochlear damage during treatment with gentamicin. Methods To date, 90 patients were treated with the single-shot or interval gentamicin therapy. Fifty-seven cases of Meniere's disease were followed up prospectively between 2 and 4 years. During one treatment series, a maximum of three intratympanic gentamicin injections within 15 days were applied, each consisting of 0.3 mL (12 mg) of gentamicin (days 1, 8, and 15). Thirty of these 57 patients (53%) needed only one injection to be controlled (single-shot treatment). Results Vertigo attacks were completely controlled in 95% and p…

Possible roles of nitric oxide in the physiology and pathophysiology of the guinea pig cochlea.

Two nitric oxide synthase isoforms (NOS-I and NOS-III) are present in the mammalian cochlea, and many regulatory functions of the inner ear could be mediated by NO. In this study, cochlear potentials and immunohistochemical measures were analyzed by changing the concentration of NO in the guinea pig during intracochlear and intravenous application of an NOS inhibitor and an NO donor. In anesthetized guinea pigs the NOS inhibitor NG-nitro-L-arginine-methylester (L-NAME) was applied by intracochlear perfusion or intravenously. The cochlear potentials and blood pressure were measured during and after the application. Cochleae were removed and prepared for morphological and immunohistochemical …

Progress in electron microscopic diagnostics: semi-quantitative determination of precipitable calcium in different cell types of the organ of Corti in the guinea-pig

Potassium antimonate was used to precipitate calcium in the cochlea of the guinea-pig. The distribution of the calcium antimonate precipitates was analysed by electron microscopy. The precipitate density was determined in different cell types in the organ of Corti by counting the number of calcium binding sites in a 10-micron 2 area. The size of the precipitates varied considerably, and thus the relative amount of the precipitable calcium was estimated only semi-quantitatively. As the prominent carbon signal is superimposed over the nearby small Ca(2+)-edge signals, the combined signal of the antimony M4,5-edge and the oxygen K-edge of the calcium antimonate salt formed was chosen for the s…

Immunoelectron-microscopic localization of synaptophysin in the organ of Corti of the guinea pig.

Synaptophysin has been localized previously in the mammalian cochlea at the light-microscopic level and in few reports by electron microscopy using either a preincubation procedure or the avidin-biotin reaction. Here we present results of the electron-microscopic analysis for postembedding immunoreactivity of synaptophysin in the cochlea of the guinea pig of LR-White-embedded samples. Strong synaptophysin immunoreactivity is located in the cytoplasm of the efferent nerve endings at the base of inner and outer hair cells. Besides this, some antibodies to synaptophysin were also identified in the cytoplasm of outer hair cells. To get more information about the cellular content of synaptophysi…

Immuno-electron microscopic localization of the alpha(1) and beta(1)-subunits of soluble guanylyl cyclase in the guinea pig organ of corti.

Guanylyl cyclases (GC) catalyze the formation of the intracellular signal molecule cyclic GMP from GTP. For some years it has been known that the heme-containing soluble guanylyl cyclase (sGC) is stimulated by NO and NO-containing compounds. The sGC enzyme consists of two subunits (alpha(1) and beta(1)). In the present study, the alpha(1) and beta(1)-subunits were identified in the guinea pig cochlea at the electron microscopic level using a post-embedding immuno-labeling procedure. Ultrathin sections of LR White embedded specimens were incubated with various concentrations of two rabbit polyclonal antibodies to the alpha(1)- and beta(1)-subunit, respectively. The immunoreactivity was visua…

The influence of Ca2+ antagonists on the ciliary activity of the guinea pig trachea.

The ciliary activity of the guinea pig tracheal respiratory epithelium was measured using a photoelectric device. Fourteen animals were administered 75 mg diltiazem/kg body weight 2 days, 1 day and 4 h prior to the investigation. Thirteen animals served as controls. In the pretreated group, the mean ciliary stroke frequency (13.4 +/- 3.0 Hz) was significantly lower (P = 0.02) than in the control group (16.6 +/- 3.7 Hz). The application of aerosolized 0.3 mmol/l nifedipine solution on the tracheal preparations of the control animals also significantly reduced the stroke frequency (P = 0.02). The ciliary activity never dropped beyond a frequency of about 8 Hz. The most probable interpretation…

Histochemical localization of calcium ATPase in the cochlea of the guinea pig

The activity of Ca(2+)-ATPase in the inner ear of the guinea pig was studied ultracytochemically by the lead citrate reaction. The electron-dense reaction products as an expression of Ca(2+)-ATPase activity were localized in endolymphatic cells of Reissner's membrane, in outer and inner hair cells and in some supporting cells. The main finding was the difference in the localization of Ca(2+)-ATPase in outer and inner hair cells. In the latter cells the activity sites were mainly intracellular and in apical membrane specializations, whereas in the outer hair cells the enzyme was localized in the apical membrane specializations and the basolateral plasma membrane.

Expression of Matrix-Degrading Cysteine Proteinase Cathepsin K in Cholesteatoma

Cholesteatoma is a nonneoplastic lesion of the middle ear space or mastoid that is histologically characterized by a progressive bone erosion of the ossicles and surrounding bone. Several matrix-degrading enzymes have been implicated as mediators of this bone erosion. Because the novel cysteine proteinase cathepsin K has been shown to play a central role in bone resorption, we examined the expression of this enzyme in tissue specimens of cholesteatoma. Tissue specimens of 9 patients with cholesteatoma were obtained during middle-ear surgery. Expression of cathepsin K mRNA was determined by RT-PCR using specific primers. Immunohistochemical analysis of cathepsin K protein expression in tissu…

Electron microscopic localization of nitric oxide I synthase in the organ of Corti of the guinea pig

Nitric oxide synthase (NOS) activity has been detected previously in the mammalian cochlea at a light microscopic level. Here we present results of electron microscopic analysis for post-embedding immunoreactivity of neural-type NOS I in the cochlea of the guinea pig. Strong enzyme immunoreactivity was identified in the cytoplasm of inner and outer hair cells. Gold-labeled NOS I antibodies were mainly located in electron-dense areas of the cytoplasm, whereas electron-lucent regions of the receptor cells were nearly free from any immunoreactivity. In both types of hair cells anti-NOS I antibodies were also visible in the cuticular plates, hair bundles and nuclei. Further ultrastructural anal…

Modifications of a nerve integrity monitor useful in skull base surgery.

Auditory Late Cortical Response and Speech Recognition in Digisonic Cochlear Implant Users

Objective The purpose of the study was to test for differences in late electrically evoked auditory potentials between subjects exhibiting “good” versus “poor” speech recognition performances with their cochlear implants. Methods Late auditory evoked responses were measured in 30 subjects equipped with the Digisonic (MXM, Antibes, France) cochlear implant, 15 of whom had “good” speech recognition scores (i.e., more than 89% correct phoneme identification without lip reading). The 15 other subjects had poorer speech recognition scores (i.e., less than 85%). Results Differences in N1P2 amplitude, as well as P1, N1, and P2 latencies, and N1-P1 and N1-P2 latency intervals were tested. Wave P2 l…

Intraoperative Navigation in der Chirurgie der Nasennebenhöhlen und der vorderen Schädelbasis

Hintergrund und Fragestellung. Beim Einsatz der computerassistierten Chirurgie im Bereich der Nasennebenhohlen und vorderen Schadelbasis sind einige Fehlerquellen zu beachten, die durch physikalische Gesetze, den technischen Entwicklungs- und individuellen Kenntnisstand des Anwenders bedingt sind. Patienten/Methodik. Anhand unserer Erfahrungen von 436 navigationsunterstutzten Eingriffen werden Hard- und Softwarefehler, Fehler der Bildgebung und des -transfers, Fehler der Patientenregistrierung, Anwenderfehler und strategische Fehler analysiert. Ergebnisse. Bei optischen CAS-Systemen fuhrt die Blockade des Sichtfeldes der Kamera zu Funktionseinschrankungen, wahrend elektromagnetische Systeme…

Effekt der kontralateralen Stimulation auf evozierte otoakustische Emissionen bei akutem Hörverlust*

23 patients with unilateral hearing loss and presence of TEOAE on both ears were examined with regard to the association between contralateral acoustic stimulation and evoked otoacoustic emissions. Contralateral white noise of 40 dB HL, 50 dB HL and 60 dB HL decreases the amplitude of TEOAE both at the ear with and without hearing loss. In comparison with a group of subjects with normal hearing, the decrease in the amplitude of TEOAE was less in the group of patients with hearing loss. Two paradoxical cases were found with an increase in the TEOAE amplitude in the ear with hearing loss during contralateral stimulation. It is assumed that impairment of the efferent synapses on the outer hair…

Optic nerve decompression in trauma and tumor patients

Optic nerve decompression is a procedure that is now receiving increasing clinical attention. However, there are currently no standardized treatment protocols in the therapy of traumatic or pressure insults to the nerve. The present retrospective study was designed to report our experience with microscopic endonasal transethmoid-sphenoid optic nerve decompression in 24 unilateral trauma cases and 11 unilateral skull base tumor patients. In general preoperative visual acuities in the trauma patients were worse than in the tumor patients. Following surgery, 9 of 11 tumor patients (82%) had at least some improvement of their vision, including 5 complete recoveries. In the group with traumatic …

Verbesserte Orts- und Kontrastauflösung in der Ultraschalldiagnostik durch Nutzung Harmonischer Frequenzen

Background: The aim of new techniques in head and neck sonography is to increase the sensitivity and the specificity of the examination, With tissue harmonic imaging (THI) and contrast harmonic imaging (CHI) new techniques are available which allow increased contrast and resolution in head and neck sonography as well as a better detection of small blood vessels. Methods: We studied whether these techniques improve sonographic detection of head and neck lymph nodes and primary tumours of the upper aerodigestive tract. Results: The results indicate that THI allows a better detection of cervical lymph nodes. Furthermore, intranodal structures and the borders of the lymph node can be better det…

Diltiazem for Prevention of Acoustical Trauma during Otologic Surgery

100 patients were tested in a prospective, randomized, double-blinded study to assess the perioperative efficacy of a calcium channel blocker (diltiazem) in preventing acoustical trauma during otologic surgery. The patients were randomly divided into a therapy group (diltiazem) and a control group (placebo). Bone conduction hearing thresholds were examined preoperatively and again 1 day and 3 months postoperatively. Frequency-dependent changes in postoperative bone conduction and the number of patients with various degrees of postoperative hearing loss in both groups were statistically analyzed. The results indicated only a small postoperative hearing loss after ear surgery in both groups. …

Calcium-binding sites in the inner ear after pure-tone stimulation

Five guinea pigs were exposed to an interrupted 90 dB SPL pure tone of 3.2 kHz for a total application time of 5 min. Following sound application all animals were decapitated and the cochleae were removed. After that, calcium-binding sites were located by the potassium pyroantimonate precipitation method. Another three animals served as control animals and did not receive the sound treatment. Findings confirmed previous studies showing the spatial arrangements of precipitate rich regions in the inner ear's two acellular structures (the basilar membrane and tectorial membrane) and the two cellular structures (the inner hair cells and Huschke's teeth). By using semiquantitative evaluation we …

Alteration of loosely bound calcium in the guinea pig organ of Corti after treatment with diltiazem as calcium channel blocker

After oral administration of the organic calcium channel blocker diltiazem to guinea pigs for 7 days, calcium ions were precipitated with potassium antimonate in the cochleae. The spatial distribution of the precipitates was studied by energy-filtering transmission electron microscopy and the amount of the ultrastructural reaction products formed was determined semiquantitatively by an image processing system. Compared with untreated control ears, the number of the formed precipitates was reduced drastically in the inner hair cells after diltiazem treatment. In addition, electron microscopic analysis revealed that the number of calcium precipitates attached at the basolateral membrane of th…

Orbital complications of pediatric sinusitis: treatment of periorbital abscess.

Twenty-six children requiring surgical intervention for orbital complications of acute sinusitis were treated at our institutions between 1985 and 1995. Twenty patients were successfully treated surgically utilizing endoscopic/microscopic endonasal surgery, or traditional external ethmoidectomy. However, six patients failed to respond to initial surgical attempts and ultimately required a revision. In one of these six patients the development of an intracranial abscess also necessitated a craniotomy for surgical drainage. Analysis of these six failures was performed with special attention given to the reasons for initial surgical failure and possible means for preventing revision surgeries…

Use of electron spectroscopic imaging to determine element composition of the melanin granules in the stria vascularis of the guinea pig.

Electron spectroscopic imaging (ESI) was used to analyze the element content of melanin granules in the stria vascularis seen in ultrathin sections of Spurr-embedded cochleae of the guinea pig. To determine element composition, ESI images were taken at different ionization edges, and non-specific background signals were subtracted digitally by an image processing system. The presence of calcium and nitrogen in the melanin granules could be demonstrated clearly. The calcium identified in the melanin granules was then compared with the spatial distributions of calcium binding sites after the application of an antimonate precipitation method, which was used to localize loosely bound calcium. D…

Effects of contralateral white noise stimulation on transitory evoked otoacoustic emissions in patients with acoustic neuroma.

Abstract Transitory evoked otoacoustic emissions are normal phenomena observed in most persons with hearing levels greater than 35 dB. Further, masking of the contralateral ear produces amplitude reductions in the transitory evoked otoacoustic emissions. We have undertaken a study of transitory evoked otoacoustic emissions in 20 patients with acoustic neuroma. All patients were assessed for transitory evoked otoacoustic emissions bilaterally, with and without contralateral masking with white band noise at 40, 50, and 60 dB. We found that transitory evoked otoacoustic emissions were present in 30% of ears with tumor and that the presence of transitory evoked otoacoustic emissions is associat…

Evidence for a possible NOS back-up system in the organ of Corti of the guinea pig

Recently, the two Ca(2+)/calmodulin-regulated nitric oxide synthase isoforms, nNOS and eNOS, and NO itself have been identified in the cochlea of vertebrates using specific antibodies and a new fluorescence indicator. In order to acquire more information about the quantitative and spatial distribution of these two constitutively expressed NOS isoforms (cNOS) in the organ of Corti at the cellular and subcelluar levels, ultrathin sections of London resin (LR) White-embedded cochleae of the guinea pig were incubated with various concentrations of commercially available antibodies to nNOS and eNOS. The immunoreactivity was visualized by a gold-labeled secondary antibody and the amount of the im…

Ultrastructural evidence for protection of the outer hair cells of the inner ear during intense noise exposure by application of the organic calcium channel blocker diltiazem.

Outer hair cells could be protected during intense noise exposure by the application of the calcium channel blocker diltiazem given before and after noise treatment. After various experimental approaches, the ultrastructural morphology was analysed for the different animal populations in the basal part of the second turn of the cochlea, which was the most destroyed area after an acute noise trauma caused by a gun shot (sound pressure at the ear drum 156 dB, frequency maximum between 4 and 6 kHz). Compared to untreated control specimens (experimental animal group I), the outer hair cells in the basal part of the second turn of the cochlea were mostly destroyed without any diltiazem applicati…

Neural conservation in skull base surgery

Surgical treatment of lesions of the skull base carries significant risk to the functioning of the cerebral hemispheres, brainstem, and cranial nerves. This risk is due to both (1) problems associated with maintaining an adequate blood flow while exposing and removing the tumor and (2) direct or indirect trauma to the brain, perineural tissues, and cranial nerves. These risks may be reduced if information about possible implications of surgical maneuvers on the cerebral blood flow and on the function of the patient’s CNS and cranial nerves is available and can be monitored during surgery of the skull base. The use of EMG neuromonitoring for the facial nerve and of brainstem evoked response …

Sonographische Charakteristika laterozervikaler Raumforderungen

UNLABELLED Sonography of the head and neck mainly focuses on tumours of the lateral neck. Even though most of these masses are enlarged lymph nodes, other tumors have to be considered. AIM To determine whether different pathological cervical masses display a characteristic sonographic morphology. METHOD On the basis of 530 sonographical findings in the neck, typical ultrasound characteristics either in B-scan or in colour coded sonography were demonstrated. RESULTS Apart from enlarged lymph nodes, it was possible to differentiate other occurrences such as branchial cysts, abscesses, laryngoceles, lipomas, neurinomas, glomus tumours, paragangliomas and also fibromas by their specific ultraso…

Characterization of nitric oxide synthase isoforms expressed in different structures of the guinea pig cochlea.

Nitric oxide synthase (NOS) activity and NADPH diaphorase staining has previously been reported in mammalian cochlea. Here we demonstrate immunoreactivity for neuronal-type NOS I and endothelial-type NOS III in the cochlea of the guinea pig. NOS I immunoreactivity was seen in inner and outer hair cells, and spiral ganglion cells. Staining for NOS I was also shown in basal and intermediate cells of the stria vascularis, spiral ligament cells, and the media of vessels near the modiolus. An antibody to NOS III stained primarily vascular endothelial cells. Some NOS III immunoreactivity was also detected in spiral ganglion cells. An antibody to the inducible-type NOS II did not stain any structu…