Makary Chadi, Shin Jennifer, Caruso Paul, Curtin Hugh, Merchant Saumil
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Mass. 02114, USA. Chadi_Makary @ meei.harvard.edu
Audiol Neurootol. 2010;15(6):383-93. doi: 10.1159/000307345. Epub 2010 Apr 10.
Scala communis or interscalar septum (IS) defect is a developmental abnormality of the inner ear characterized by a dehiscence in the partition separating the turns of the cochlea. The goals of the present study were to (1) study this anomaly and describe its characteristics compared to control ears using a histological analysis of temporal bones, (2) discuss radiological implications regarding its diagnosis, and (3) describe its embryological derivation.
Out of 1775 temporal bones assessed, 22 specimens were found to have scala communis in cochleae containing all 3 turns (basal, middle and apical). These 22 ears were studied in detail by qualitative and quantitative methods using light microscopy.
Scala communis occurred as an isolated inner ear anomaly, or in association with other congenital cochlear and/or vestibular anomalies. The defect occurred most often between the middle and apical turns of the cochlea. Compared to control ears, scala communis ears were found to have a smaller modiolar area (p < 0.0001) and flattening of the interscalar ridge (point of attachment of the IS to the inner lumen of the cochlea; p < 0.0001). Scala communis was compatible with normal hearing.
Flattening of the interscalar ridge has the potential to improve the diagnosis of scala communis in patients using CT scanning. The anomaly may result from a mesodermal defect such as excessive resorption of mesenchyme during the formation of the scalae, an error in the formation of bone, or both.
总脚或蜗内间隔(IS)缺损是内耳的一种发育异常,其特征是分隔耳蜗各圈的间隔出现裂隙。本研究的目的是:(1)通过颞骨组织学分析研究这种异常并描述其与对照耳相比的特征;(2)讨论其诊断的放射学意义;(3)描述其胚胎学起源。
在评估的1775块颞骨中,发现22个标本的耳蜗中有总脚,包含所有3个蜗圈(基部、中部和顶部)。使用光学显微镜通过定性和定量方法对这22只耳朵进行了详细研究。
总脚作为一种孤立的内耳异常出现,或与其他先天性耳蜗和/或前庭异常相关。缺损最常发生在耳蜗的中部和顶部蜗圈之间。与对照耳相比,发现有总脚的耳朵蜗轴面积较小(p < 0.0001),蜗内嵴变平(IS附着于耳蜗内腔的点;p < 0.0001)。总脚与正常听力相符。
蜗内嵴变平有可能改善使用CT扫描对患者总脚的诊断。这种异常可能是由于中胚层缺陷,如在蜗管形成过程中中胚层过度吸收、骨形成错误或两者兼而有之。