Kusunoki Takeshi, Cureoglu Sebahattin, Schachern Patricia A, Sampaio Andre, Fukushima Hisaki, Oktay Mehmet F, Paparella Michael M
International Hearing Foundation, Minneapolis, MN, USA.
Auris Nasus Larynx. 2004 Dec;31(4):383-8. doi: 10.1016/j.anl.2004.09.011.
Although there have been numerous reports on the relationship between the period of aminoglycoside administration and cochlear damage in animals, to date there have been no such studies in humans. The purpose of this study is to observe the early and late cochlear effects of aminoglycoside administration on hair cells, spiral ganglion cells, stria vascularis, and spiral ligament.
Specimens were divided into three groups. Group I included "normal" temporal bones with no histopathologic findings of otitis media and no history of otologic or ototoxic drug administration. Group II consisted of temporal bones that received aminoglycosides within 2 weeks before death and group III of temporal bones that had aminoglycosides from 2 weeks to 6 months prior to death. Patients in groups II and III received gentamycin, kanamycin or tobramycin. Temporal bones were excluded from groups II and III if patients had a history of otologic disease or other ototoxic drugs. All temporal bones were examined under light microscopy. Standard cytocochleograms and spiral ganglion cell reconstructions were done on all temporal bones. Morphometric measurements of areas of stria vascularis were made in all turns of the cochlea on mid-modiolar sections. Spiral ligament was divided into four segments according to the locations of different types of fibrocytes. The mean loss of fibrocytes in each segment was estimated.
The percentages of intact outer hair cells in the basal turn were significantly greater in group I compared to groups II and III. The mean area of the stria vascularis in the apical turn was significantly less in groups II and III compared to group I.
This study demonstrates that in a short period (within 2 weeks) after aminoglycoside administration, a decrease in hair cells and in the area of the stria vascularis occurred.
尽管已有大量关于氨基糖苷类药物给药时间与动物耳蜗损伤关系的报道,但迄今为止尚无针对人类的此类研究。本研究的目的是观察氨基糖苷类药物给药对毛细胞、螺旋神经节细胞、血管纹和螺旋韧带的早期和晚期耳蜗效应。
标本分为三组。第一组包括“正常”颞骨,无中耳炎的组织病理学表现,也无耳科或耳毒性药物给药史。第二组由死亡前2周内接受氨基糖苷类药物的颞骨组成,第三组由死亡前2周至6个月接受氨基糖苷类药物的颞骨组成。第二组和第三组的患者接受庆大霉素、卡那霉素或妥布霉素治疗。如果患者有耳科疾病或其他耳毒性药物史,则将其颞骨排除在第二组和第三组之外。所有颞骨均在光学显微镜下检查。对所有颞骨进行标准的细胞耳蜗图和螺旋神经节细胞重建。在中膜蜗轴切片上对耳蜗各圈的血管纹面积进行形态计量测量。根据不同类型纤维细胞的位置,将螺旋韧带分为四段。估计每段纤维细胞的平均损失。
与第二组和第三组相比,第一组基底圈完整外毛细胞的百分比显著更高。与第一组相比,第二组和第三组顶圈血管纹的平均面积显著更小。
本研究表明,在氨基糖苷类药物给药后的短时间内(2周内),毛细胞数量和血管纹面积会减少。