Nakamoto Yoshinori, Iino Yukiko, Kodera Kazuoki
Department of Otolaryngology, Teikyo University School of Medicine, Tokyo.
Nihon Jibiinkoka Gakkai Kaiho. 2005 Feb;108(2):172-81. doi: 10.3950/jibiinkoka.108.172.
To examine the relationship between hearing and changes in the inner ear, we investigated human temporal bone specimens from 2 patients with noise-induced hearing loss and prepared audio-cytocochleograms as described by Schuknecht et al. Patient 1 was a 50-year-old male who died of thyroid cancer and had worked at a printing house for 38 years. Patient 2 was a 58-year old male who died of maxillary sinus cancer and had worked in construction for 22 years. A pure-tone audiogram showed high-tone sensorineural hearing loss with c5-dip-type hearing disorder in both ears in Patient 1, and a high-tone abrupt form of sensorineural hearing loss in Patient 2. Pathological examination of the temporal bone revealed degeneration and disappearance of the organ of Corti at the basal turn and disappearance of cochlear neurons in both patients. Audio-cytocochleograms revealed hearing disorder consistent with the changes in the inner ear in both patients. Marked degeneration and disappearance of the organ of Corti and stria vascularis were present in patient 1. It is generally known that disorders of the organ of Corti for a long period is involved in the etiology of noise-induced hearing loss. This degeneration of the organ of Corti is produced at a basilar membrane with the maximum amplitude related to exposure to noise according to a physical and mechanical factors. Moreover, animal experiments have shown that exposure to noise decrease cochlear blood flow. In Patient 1 both the organ of Corti and the stria vascularis exhibited degeneration, suggesting that not only physical and mechanical factors but a cochlear circulatory disorder related to exposure to noise was involved in the etiology of the pathological changes in the temporal bone related to noise-induced hearing loss.
为了研究听力与内耳变化之间的关系,我们调查了2例噪声性听力损失患者的颞骨标本,并按照Schuknecht等人描述的方法制备了听-细胞-耳蜗图。患者1为50岁男性,死于甲状腺癌,曾在印刷厂工作38年。患者2为58岁男性,死于上颌窦癌,曾从事建筑工作22年。纯音听力图显示,患者1双耳为高音感音神经性听力损失,呈c5- dip型听力障碍,患者2为高音突发型感音神经性听力损失。颞骨病理检查显示,两名患者基底转的柯蒂氏器均有退变和消失,耳蜗神经元也消失。听-细胞-耳蜗图显示两名患者的听力障碍与内耳变化一致。患者1的柯蒂氏器和血管纹有明显退变和消失。一般认为,长期的柯蒂氏器功能障碍与噪声性听力损失的病因有关。根据物理和机械因素,柯蒂氏器的这种退变发生在与噪声暴露相关的最大振幅的基底膜处。此外,动物实验表明,噪声暴露会减少耳蜗血流量。在患者1中,柯蒂氏器和血管纹均出现退变,这表明与噪声暴露相关的耳蜗循环障碍不仅涉及物理和机械因素,还参与了与噪声性听力损失相关的颞骨病理变化的病因。