Histopathological changes to the peripheral vestibular system following meningitic labyrinthitis.
Histopathological changes to the peripheral vestibular system following meningitic labyrinthitis.
复制标题
脑膜迷路炎后周围前庭系统的组织病理学变化。
DOI：
10.1002/lio2.349
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发表时间：
2020
影响因子：
1.9
通讯作者：
Kozin,ElliottD
中科院分区：
文献类型：
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作者：
Pauna,HenriqueF;Knoll,RenataM;Lubner,RoryJ;Brodsky,JacobR;Cushing,SharonL;Hyppolito,MiguelA;NadolJr,JosephB;Remenschneider,AaronK;Kozin,ElliottD
目的耳蜗骨化是脑膜炎迷路炎的常见后遗症，但目前对脑膜炎对前庭末梢周围器官的影响尚不清楚。在此，我们研究有脑膜炎迷路炎病史的患者前庭外周系统和耳蜗的组织病理学变化。方法对有脑膜炎病史患者的门静脉骨（TB）标本进行评估，并与年龄匹配的对照组进行比较。通过光镜对标本进行评估并评估质变，包括前庭和/或耳蜗内淋巴水肿的存在、炎症细胞的存在和位置、新骨形成和骨化性迷路炎；定量变化，包括斯卡帕神经节神经元（ScGN）和螺旋神经节神经元（SGN）计数。结果10例患者中有15例符合纳入和排除标准。5 TB可见炎性细胞和纤维组织。在这些病例中，有2例发现了骨化性迷路炎。在周围前庭系统中，60%的病例（n = 9 tb）发现轻度至重度前庭膜迷路变性。与年龄匹配的对照组相比，脑膜炎患者的ScGN平均总数减少了21.2%（范围，3% - 64%）。在耳蜗中，与年龄匹配的对照组（n = 14 tb）相比，SGN的平均总数减少了45%（范围，25.3% - 80.9%）。结论有脑膜炎迷路炎病史的结核患者的病理分析显示有明显的前庭外周病变。未来的研究可能有助于描述脑膜炎后观察到的耳病理变化的潜在机制。证据水平
ObjectiveWhile cochlear ossification is a common sequalae of meningitic labyrinthitis, less is known about the effects of meningitis on peripheral vestibular end organs. Herein, we investigate histopathologic changes in the peripheral vestibular system and cochlea in patients with a history of meningitic labyrinthitis.MethodsTemporal bone (TB) specimens from patients with a history of meningitis were evaluated and compared to age‐matched controls. Specimens were evaluated by light microscopy and assessed for qualitative changes, including the presence of vestibular and/or cochlear endolymphatic hydrops, presence and location of inflammatory cells, new bone formation, and labyrinthitis ossificans; and quantitative changes, including Scarpa's ganglion neuron (ScGN) and spiral ganglion neuron (SGN) counts.ResultsFifteen TB from 10 individuals met inclusion and exclusion criteria. Presence of inflammatory cells and fibrous tissue was found in 5 TB. Of these, evidence of labyrinthitis ossificans was found in 2 TB. In the peripheral vestibular system, mild to severe degeneration of the vestibular membranous labyrinth was identified in 60% of cases (n = 9 TBs). There was a 21.2% decrease (range, 3%‐64%) in the mean total count of ScGN in patients with meningitis, compared to age‐matched controls. In the cochlea, there was a 45% decrease (range, 25.3%‐80.9%) in the mean total count of SGN compared to age‐matched controls (n = 14 TBs).ConclusionsOtopathologic analysis of TB from patients with a history of meningitic labyrinthitis demonstrated distinct peripheral vestibular changes. Future research may help to delineate potential mechanisms for the observed otopathologic changes following meningitis.Level of EvidenceN/A