Horner K C
Inserm U 229, Hôpital Pellegrin, Université de Bordeaux II, France.
Rev Laryngol Otol Rhinol (Bord). 1991;112(2):145-8.
We have investigated by electrophysiology, morphology and pharmacology, the consequences of the surgical blocking of the endolymphatic duct in the guinea pig. We have demonstrated an immediate fluctuant CAP sensitivity loss on the low frequencies. Some weeks later a very high frequency loss can also be detected and finally after several months the mid frequencies are also affected and audiogram becomes relatively flat. This type of evolution of sensitivity loss corresponds remarkably well to the type of evolution of hearing loss observed in Ménière's patients. We have demonstrated that the early low frequency fluctuant losses are almost certainly a result of the selective atrophy of the short and middle stereocilia on the outer hair cells in the upper three cochlear turns, corresponding to a new hait cell pathology. Since ion channels are likely to be localised close to inter-stereocilia, row tip links this type of stereocilia atrophy could account for the low frequency fluctuant CAP sensitivity losses in hydropic cochleas. In addition this type of atrophy recalls a retrograde step in the ontogenesis of hair cells. Application of hydrostatic pressure directly to the endolymph via the endolymphatic duct provoked a high frequency sensitivity loss suggesting that endolymphatic pressure might be implicated in the late phase in the evolution of the hearing loss. Long-terme treatment by the diuretic chlorthalidone appeared to slow down the evolution of early low frequency CAP sensitivity loss and could reduce the volume of the hydrops. However in the long-term the CAP sensitivity loss was not arrested.(ABSTRACT TRUNCATED AT 250 WORDS)
我们通过电生理学、形态学和药理学方法,研究了豚鼠内淋巴管手术阻断的后果。我们已证实在低频时会立即出现波动性CAP敏感性丧失。几周后,也能检测到非常高频的丧失,最终在几个月后,中频也受到影响,听力图变得相对平坦。这种敏感性丧失的演变类型与梅尼埃病患者中观察到的听力丧失演变类型非常吻合。我们已证实,早期低频波动性丧失几乎肯定是耳蜗上三个螺旋中毛细胞上短和中静纤毛选择性萎缩的结果,这对应于一种新的毛细胞病理学。由于离子通道可能定位于静纤毛之间,这种静纤毛萎缩类型可解释积水耳蜗中低频波动性CAP敏感性丧失。此外,这种萎缩类型让人想起毛细胞个体发育中的逆行步骤。通过内淋巴管直接向内淋巴施加静水压力会引发高频敏感性丧失,这表明内淋巴压力可能与听力丧失演变的后期阶段有关。利尿剂氢氯噻嗪的长期治疗似乎减缓了早期低频CAP敏感性丧失的演变,并可减少积水体积。然而,从长期来看,CAP敏感性丧失并未停止。(摘要截断于250字)