Kobayashi T, Gyo K, Yanagihara N
Department of Otolaryngology, Ehime University School of Medicine, Japan.
Am J Otol. 1999 Mar;20(2):179-82.
Hearing loss caused by combined rupture of Reissner's membrane and the round window (RW) membrane (the double-membrane rupture) may differ depending on the site of the lesion on Reissner's membrane. The purpose of this experimental study was to reveal the relationship between the hearing impairment and the site of the lesion on Reissner's membrane.
According to experimental studies on perilymphatic fistula (PLF), profound hearing loss is not induced by rupture of RW alone, but by the double-membrane rupture. However, the mechanism responsible for hearing loss in the double-membrane rupture remains unclear.
Compound action potentials (CAPs) of the cochlear nerve in response to tone pip stimuli (1, 2, 4, and 8 kHz) were recorded before the lesion, 90 minutes after the Reissner's membrane rupture, and 90 minutes after subsequent laceration of the RW. Reissner's membrane was ruptured at one of the four turns for comparison.
The double-membrane rupture caused a more severe increase in CAP thresholds than seen with separate ruptures, when the Reissner's membrane was ruptured at the second turn. Such pronounced increase in threshold was not seen in ears with the rupture at other turns.
The double-membrane rupture causes varying degrees of hearing loss depending on the site of the lesion of Reissner's membrane. When the Reissner's membrane was ruptured at the second turn, the most severe hearing loss was detected.
由Reissner膜和圆窗膜联合破裂（双膜破裂）引起的听力损失可能因Reissner膜上病变的部位而异。本实验研究的目的是揭示听力损害与Reissner膜上病变部位之间的关系。
根据关于外淋巴瘘（PLF）的实验研究，单独的圆窗膜破裂不会导致严重听力损失，而是双膜破裂会导致。然而，双膜破裂导致听力损失的机制仍不清楚。
在损伤前、Reissner膜破裂后90分钟以及随后圆窗膜撕裂后90分钟，记录听神经对短纯音刺激（1、2、4和8千赫）的复合动作电位（CAP）。为了进行比较，在四个蜗转之一处使Reissner膜破裂。
当Reissner膜在第二蜗转处破裂时，双膜破裂导致CAP阈值的升高比单独破裂时更严重。在其他蜗转处破裂的耳朵中未观察到如此明显的阈值升高。
双膜破裂导致的听力损失程度因Reissner膜病变部位而异。当Reissner膜在第二蜗转处破裂时，检测到最严重的听力损失。
