Dysfunction of the cochlea contributing to hearing loss in acoustic neuromas: an underappreciated entity.
Dysfunction of the cochlea contributing to hearing loss in acoustic neuromas: an underappreciated entity.
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DOI：
10.1097/mao.0b013e318248ee02
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发表时间：
2012-04
期刊：
影响因子：
--
通讯作者：
Merchant SN
中科院分区：
文献类型：
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作者：
Roosli C;Linthicum FH Jr;Cureoglu S;Merchant SN
听力损失是耳蜗前庭神经鞘瘤(VS)患者的常见症状。临床和组织学观察表明，听力损失可能是由耳蜗后机制和耳蜗术后机制共同引起的。我们的目标是对VS患者进行详细的耳蜗病理学评估。颞骨组织病理学的回顾性分析。多中心研究。32例单侧、散发性内耳道VS患者的颞骨。对VS侧和对侧(对照)耳蜗行内、外毛细胞丢失、血管纹萎缩、耳蜗神经元丢失以及内淋巴液或外淋巴液内淋巴积液和沉淀物的检查。观察到的病理与VS的起始神经、VS体积和VS与耳蜗间的距离有关。听力阈值也进行了评估。与对侧耳相比，VS引起更多的内、外毛细胞丢失，耳蜗神经元丢失，内淋巴和外淋巴中的沉淀，纯音平均降低。肿瘤的大小、距耳蜗骨的距离和起源神经与耳蜗骨的结构变化或听力阈值没有相关性。VS患者耳蜗结构明显退变。耳蜗功能障碍可能是VS所致听力损失的一个重要因素，并可解释VS患者某些临床观察到的现象。
Hearing loss is a common symptom in patients with cochleovestibular schwannoma (VS). Clinical and histological observations have suggested that the hearing loss may be caused by both retrocochlear and cochlear mechanisms. Our goal was to perform a detailed assessment of cochlear pathology in patients with VS. Retrospective analysis of temporal bone histopathology. Multi-center study. Temporal bones from 32 patients with unilateral, sporadic VS within the internal auditory canal. Sections through the cochleae on the VS side and opposite (control) ear were evaluated for loss of inner and outer hair cells, atrophy of the stria vascularis, loss of cochlear neurons, and for presence of endolymphatic hydrops and precipitate within endolymph or perilymph. Observed pathologies were correlated to nerve of origin, VS volume, and distance of VS from the cochlea. Hearing thresholds were also assessed. VS caused significantly more inner and outer hair cell loss, cochlear neuronal loss, precipitate in endolymph and perilymph, and decreased pure tone average, when compared to the opposite ear. Tumor size, distance from the cochlea, and nerve of origin did not correlate with structural changes in the cochlea or the hearing threshold. There is significant degeneration of cochlear structures in ears with VS. Cochlear dysfunction may be an important contributor to the hearing loss caused by VS, and can explain certain clinically observed phenomena in patients with VS.