Vestibular Pathology in Meniere's Disease

项目描述（由申请人提供）：项目总体目标是描述梅尼埃病对个体终末器官和前庭神经节的影响，以及病理与临床病史和常规检查前庭功能的关系。我们建议对梅尼埃病的前庭周围进行前瞻性研究，使用从消融内耳手术和死后标本获得的标本。该项目将使用1)组织病理学分析，免疫组织化学和电子显微镜来研究前庭病理；2)无偏立体学来获得多个水平的形态测量：同一受试者的神经上皮，神经纤维和斯卡帕神经节神经元；3)临床-病理相关性以及形态测量参数和标准化前庭测试之间的比较。拟研究的形态学参数包括：1)5个前庭内各器官I型、II型和支持细胞的区域总数；2)前庭神经纤维的数量和直径分布；3)斯卡帕神经节神经元的数量和体积分布。梅尼埃病患者的颞骨档案将用于斯卡帕神经节神经元计数。通过这种系统的、前瞻性的设计，我们希望能够回答一些重要的临床问题，例如：1)梅尼埃病对个体终末器官的影响是否不同？2)神经上皮内器官损伤模式是否与临床病史相关？3)梅尼埃病是否影响前庭神经和神经节？4)梅尼埃氏病是否与斯卡帕神经节神经元萎缩有关？5)诸如图马金跌落、迟发性内淋巴积液和慢性失衡等临床现象是否与特定类型的神经上皮或不同的内器官损伤有关？还是神经元数量或大小的改变？6)在传统的前庭测试中，形态计量学与异常有什么关系：热量轻瘫、步进旋转测试的增益和时间常数下降？

DESCRIPTION (provided by applicant): The Overall goal of the proposed project is to describe the effects of Meniere's disease on the individual endorgans and vestibular ganglion, and how the pathology relates to the clinical history and vestibular function on routine testing. We propose a prospective study of the vestibular periphery in Meniere's disease using specimens obtained from ablative inner ear surgery and postmortem specimens. The project will use 1) histopathologic analysis, immunohistochemistry, and electron microscopy to study vestibular pathology 2) unbiased stereology to obtain morphometric measures at multiple levels: neuroepithelium, the nerve fibers, and Scarpa's ganglion neurons in the same subject 3) clinico-pathological correlations and comparisons between morphometric parameters and standarized vestibular testing. Morphometric parameters to be studied include 1) regional total type I, type II, and supporting cell counts in each of the five vestibular endorgans 2) vestibular nerve fiber counts and diameter distribution 3) Scarpa's ganglion neuronal counts and volume distribution. Archival temporal bones from patients with Meniere's disease will be used for Scarpa's ganglion neuronal counts. Using this systematic, prospective design we hope to answer important clinical questions such as 1) Does Meniere's disease affect the individual endorgans differently? 2) Can the patterns of neuroepithelial endorgan damage be correlated with clinical history? 3) Does Meniere's disease affect the vestibular nerve and ganglion? 4) Is Meniere's disease associated with an atrophy of the Scarpa's ganglion neurons? 5) Are clinical phenomenon such as Tumarkin falls, delayed endolymphatic hydrops, and chronic dysequilibrium associated with particular patterns of neuroepithelial or differential endorgan damage? or with alterations in neuronal number or size? 6) What are the morphometric correlates to abnormalities on traditional vestibular testing: caloric paresis, and decreased gain and time constant on step rotational testing?