Otoconia and otolithic membrane fragments within the posterior semicircular canal in benign paroxysmal positional vertigo
Otoconia and otolithic membrane fragments within the posterior semicircular canal in benign paroxysmal positional vertigo
复制标题
DOI：
10.1002/lary.26115
复制
发表时间：
2017-03-01
期刊：
影响因子：
2.6
通讯作者：
Chole, Richard A.
中科院分区：
文献类型：
--
作者：
Kao, Wee Tin K.;Parnes, Lorne S.;Chole, Richard A.
目的/假设：良性阵发性位置性眩晕（BPPV）是最常见的前庭疾病，发病率为10.7 - 17.3/10万人/年。据推测，BPPV的机制与耳石移位有关，导致泪小管结石。虽然颗粒物已被观察到在受影响的患者进行后半规管闭塞手术的内淋巴，耳圆锥起源的疾病仍然是questioned.Study Design：在这项研究中，颗粒物被提取从后半规管的两名患者和检查与扫描电子显微镜。将颗粒固定，储存在乙醇中，并进行化学脱水。对样品进行溅射涂层并在扫描电子显微镜下观察。结果：完整和退化的耳石，有或没有连接丝被发现附着在无定形颗粒物质。许多耳石似乎部分嵌入在凝胶基质中，可能是将耳石包裹并锚定在耳石膜内，而其他耳石则单独存在，没有附着的细丝和基质。耳石长度约2 ~ 8 μ m，外形呈均匀的圆柱形球状体，两端各有一个3 + 3菱形面。结论：BPPV患者半规管内颗粒物的来源是椭圆囊耳石膜的断裂碎片。
Objectives/Hypothesis: Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder with an incidence between 10.7 and 17.3 per 100,000 persons per year. The mechanism for BPPV has been postulated to involve displaced otoconia resulting in canalithiasis. Although particulate matter has been observed in the endolymph of affected patients undergoing posterior canal occlusion surgery, an otoconial origin for the disease is still questioned.Study Design: In this study, particulate matter was extracted from the posterior semicircular canal of two patients and examined with scanning electron microscopy.Methods: The samples were obtained from two patients intraoperatively during posterior semicircular canal occlusion. The particles were fixed, stored in ethanol, and chemically dehydrated. The samples were sputter coated and viewed under a scanning electron microscope. Digital images were obtained.Results: Intact and degenerating otoconia with and without linking filaments were found attached to amorphous particulate matter. Many otoconia appeared to be partially embedded in a gel matrix, presumably that which encases and anchors the otoconia within the otolith membrane, whereas others stood alone with no attached filaments and matrix. The otoconia measured roughly 2 to 8 mu m in length and displayed a uniform outer shape with a cylindrical bulbous body and a 3 + 3 rhombohedral plane at each end.Conclusions: These findings suggest that the source of the particulate matter in the semicircular canals of patients with BPPV is broken off fragments of the utricular otolithic membrane with attached and detached otoconia.