Nelson Erik G, Hinojosa Raul
Section of Otolaryngology-Head and Neck Surgery, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 1035, Chicago, IL 60637, USA.
Laryngoscope. 2003 Oct;113(10):1672-86. doi: 10.1097/00005537-200310000-00006.
The purpose of this study was to determine the prevalence of stria vascularis atrophy in individuals with presbycusis and flat audiometric patterns of hearing loss. Individuals with presbycusis have historically been categorized by the shape of their audiograms, and flat audiometric thresholds have been reported to be associated with atrophy of the stria vascularis. Stria vascularis volume was not measured in these studies.
Retrospective case review.
Archival human temporal bones from individuals with presbycusis were selected on the basis of strict audiometric criteria for flat audiometric thresholds. Six temporal bones that met these criteria were identified and compared with 10 temporal bones in individuals with normal hearing. A unique quantitative method was developed to measure the stria vascularis volume in these temporal bones. The hair cell and spiral ganglion cell populations also were quantitatively evaluated.
Only one of the six individuals with presbycusis and flat audiometric thresholds had significant atrophy of the stria vascularis. This individual with stria vascularis atrophy also had reduced inner hair cell, outer hair cell, and ganglion cell populations. Three of the individuals with presbycusis had spiral ganglion cell loss, three individuals had inner hair cell loss, and all six individuals had outer hair cell loss.
The results of this investigation suggest that individuals with presbycusis and flat audiometric patterns of hearing loss infrequently have stria vascularis atrophy. Outer hair cell loss alone or in combination with inner hair cell or ganglion cell loss may be the cause of flat audiometric thresholds in individuals with presbycusis.
本研究旨在确定老年性聋且听力损失呈平坦听力图型的个体中血管纹萎缩的患病率。历史上，老年性聋个体是根据其听力图的形状进行分类的，据报道平坦的听力阈值与血管纹萎缩有关。在这些研究中未测量血管纹体积。
回顾性病例分析。
根据平坦听力阈值的严格听力标准，从老年性聋个体的存档颞骨中进行选择。确定了符合这些标准的6个颞骨，并与10个听力正常个体的颞骨进行比较。开发了一种独特的定量方法来测量这些颞骨中的血管纹体积。还对毛细胞和螺旋神经节细胞群体进行了定量评估。
在6例老年性聋且听力阈值平坦的个体中，只有1例有明显的血管纹萎缩。该血管纹萎缩个体的内毛细胞、外毛细胞和神经节细胞群体也减少。3例老年性聋个体有螺旋神经节细胞丢失，3例有内毛细胞丢失，所有6例均有外毛细胞丢失。
本研究结果表明，老年性聋且听力损失呈平坦听力图型的个体很少有血管纹萎缩。单独的外毛细胞丢失或与内毛细胞或神经节细胞丢失相结合可能是老年性聋个体平坦听力阈值的原因。
