The human spiral ganglion: new insights into ultrastructure, survival rate and implications for cochlear implants.

This study was based on high-resolution SEM assessment of freshly fixed, normal-hearing, human inner ear tissue. In addition, semiquantitative observations were made in long-term deafened temporal bone material, focusing on the spiral ganglia and nerve projections, and a detailed study of the fine bone structure in macerated tissues was performed. Our main findings detail the presence of extensive bony fenestrae surrounding the nerve elements, permitting a relatively free flow of perilymph to modiolar structures. The clustering of the spiral ganglion cells in Rosenthal's canal and the detailed and intricate course of postganglionic axons are described. The close proximity of fibers to cell soma is demonstrated by impression in cell surfaces, and presence of small microvilli-like structures at the contact regions, anchoring nerve fibers to the cell wall. Extensive fenestrae and the presence of a fragile network of endosteal bony structures at the surfaces guiding nerve fibers are described in detail for the first time. This unique freshly prepared human material offers the opportunity for a detailed ultrastructural study not previously possible on postmortem fixed material and more accurate information to model electrostimulation of the human auditory nerve through a cochlear implant. On the basis of this study, we suggest that the concentration and high density of spiral ganglion cells, and the close physical interaction between neural elements, may explain the slow retrograde degeneration found in humans after loss of peripheral receptors. Moreover, the fragile bony columns connecting the spiral canal with the osseous spiral lamina may be a potential site for trauma in (perimodiolar) electrode positioning.