Ganglion cell populations in labyrinthitis ossificans.

Ossification of the perilymphatic spaces of the inner ear is frequently found in patients with profound deafness who may be candidates for cochlear implantation. The ossification may be a hindrance in electrode insertion and has previously been considered a relative contraindication to implantation. The quantity of peripheral auditory elements remaining in a series of patients with labyrinthitis ossificans has not been reviewed. We performed a histopathologic study of 16 temporal bones with partial cochlear ossification of multiple etiologies. The organ of Corti and spiral ganglion were graphically reconstructed. The degree of obstruction was estimated for each millimeter of the scala tympani and scala vestibuli. A quantitative evaluation of the sensorineural elements of the inner ear (spiral ganglion cells, inner and outer hair cells, and peripheral auditory axons) was performed. The results were compared with 16 control patients with normal hearing and no evidence of cochlear ossification. Our results show that the greatest amount of damage is found in the organ of Corti with preservation of a significant number of spiral ganglion cells in most cases. A wide range of ganglion cells (6,310 to 28,196) was found in patients with labyrinthitis ossificans with the mean number of ganglion cells being 17,152. A profound sensorineural hearing loss was noted in all patients except one. Meningogenic labyrinthitis and otosclerosis were associated with the greatest loss of ganglion cells. The location of ossification could be correlated with the region showing loss of the organ of Corti. In the majority of patients, the location of ossification and fibrosis could not be correlated with the region of the spiral ganglion showing loss of ganglion cells. The implications of these findings for cochlear implantation is discussed.