Peripheral Vestibular Organ Degeneration After Temporal Bone Fracture: A Human Otopathology Study.
Peripheral Vestibular Organ Degeneration After Temporal Bone Fracture: A Human Otopathology Study.
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颞骨骨折后周围前庭器官退化：人类耳病理学研究。
DOI：
10.1002/lary.28010
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Kozin,ElliottD
中科院分区：
文献类型：
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作者：
Knoll,RenataM;Ishai,Reuven;Lubner,RoryJ;Trakimas,DanielleR;Brodsky,JacobR;Jung,DavidH;Rauch,StevenD;NadolJr.,,JosephB;Remenschneider,AaronK;Kozin,ElliottD
目的/假设前庭症状是颞骨骨折（TBF）的常见后遗症。然而，TBF后外周前庭系统损伤的机制尚未得到很好的描述。在此，我们的目的是调查外周前庭系统的组织病理学的患者谁持续TBBS.Study DesignRetrospective人类标本analysis.MethodsSpecimens从国家颞骨病理学登记（病例）和无（对照）TBF进行了评价。标本进行了分析，通过光学显微镜前庭毛细胞和/或树突状细胞变性，存在内淋巴积水，内淋巴管堵塞，斯卡帕神经节细胞（ScGC）的数量在上级和下vestibular nerves.Results7个颞骨（TB）从5个人与TBF，7 TB从6个年龄匹配的个人没有头部损伤的历史符合纳入和排除标准。所有骨折均涉及耳囊。在所有TBF病例中，半规管内的嵴均严重变性。TBF患者椭圆囊和囊状黄斑变性程度轻至重。TBF病例中还存在前庭积水（n = 2 TB）和内淋巴管阻塞（n = 3 TB）。与年龄匹配的对照组（n = 7 TB，P = 0.015）相比，TBF病例（n = 3 TB）的平均总ScGC计数降低了52.6%。与年龄匹配的对照组相比，上级前庭神经中ScGCs的平均丢失率为53%，前庭下神经中ScGCs的平均丢失率为52.3%（分别为P = 0.033和P = 0.021）。
Objectives/HypothesisVestibular symptoms are a common sequela of temporal bone fractures (TBFs). The mechanisms of injury to the peripheral vestibular system following TBF, however, are not well described. Herein, we aimed to investigate the histopathology of the peripheral vestibular system in patients who sustained TBFs.Study DesignRetrospective human specimen analysis.MethodsSpecimens from the National Temporal Bone Pathology Registry with (cases) and without (controls) TBFs were evaluated. Specimens were analyzed by light microscopy for vestibular hair cell and/or dendritic degeneration, presence of endolymphatic hydrops, blockage of the endolymphatic duct, and number of Scarpa ganglion cells (ScGCs) in the superior and inferior vestibular nerves.ResultsSeven temporal bones (TBs) from five individuals with TBFs, and seven TBs from six age‐matched individuals without a history of head injury met inclusion and exclusion criteria. All fractures involved the otic capsule. Severe degeneration of the cristae was identified in the semicircular canals in all TBF cases. The utricular and saccular maculae showed mild to severe degeneration in the TBF cases. Vestibular hydrops (n = 2 TBs) and blockage of the endolymphatic duct (n = 3 TBs) were also present in the TBF cases. There was a decrease of 52.6% in the mean total ScGC count in the TBF cases (n = 3 TBs) compared to age‐matched controls (n = 7 TBs,P =.015). There was a mean loss of 53% of the ScGCs in the superior vestibular nerve and a mean loss of 52.3% of the ScGCs in the inferior vestibular nerve compared to age‐matched controls (P =.033 andP =.021, respectively).ConclusionsIn a cohort of patients with TBFs, there were distinct peripheral vestibular changes including reduction of ScGCs.Level of EvidenceNALaryngoscope, 130:752–760, 2020