Kwok O T, Nadol J B
Department of Otology and Laryngology, Harvard Medical School, Boston.
Am J Otolaryngol. 1989 Jan-Feb;10(1):1-12. doi: 10.1016/0196-0709(89)90086-0.
Statistical analyses of histopathologic findings in the cochlea and spiral ganglion of 37 temporal bones with otosclerosis, 12 controls of similar age, and seven controls with normal hearing were performed. In temporal bones with otosclerosis there was significant atrophy of the spiral ligament and stria vascularis in regions with endosteal involvement by otosclerosis, compared with regions without endosteal involvement (P less than .0001). There was more generalized atrophy of the stria vascularis in cochleae with two or more sites of endosteal involvement by otosclerosis than in cochleae with only one site of endosteal involvement (P less than .02), cochleae in temporal bones with otosclerosis but without endosteal involvement (P less than .05), or cochleae of controls of similar age (P less than .007). In addition, there was more atrophy of the spiral ligament in cochleae with two or more sites of endosteal involvement than in cochleae of similar age from the control group (P less than .03). In temporal bones with otosclerosis, there was no significant difference in counts of outer hair cells and density of spiral ganglion cells between regions demonstrating endosteal involvement by otosclerosis and regions without such involvement. However, total outer hair cell counts were lower in cochleae with two or more sites of endosteal involvement of otosclerosis than in cochleae with one site of endosteal involvement (P less than .04), cochleae in temporal bones with otosclerosis but without endosteal involvement (P less than .02), or cochleae from individuals of similar age but without otosclerosis (P = .05). Comparison of the mean bone conduction threshold, as measured in life, in temporal bones with otosclerosis compared with the air conduction threshold in aged-matched controls, demonstrated that only cochleae with two or more sites of endosteal involvement had a mild but statistically significant (P = .05) decrease in hearing. There was no evidence to support the concept that otosclerotic foci without stapedial fixation frequently cause significant degeneration of the cochlea or elevation of bone conduction thresholds.
对37例患有耳硬化症的颞骨、12例年龄相仿的对照者颞骨以及7例听力正常的对照者颞骨的耳蜗和螺旋神经节组织病理学检查结果进行了统计学分析。与无骨内膜受累区域相比，在患有耳硬化症的颞骨中，耳硬化症累及骨内膜区域的螺旋韧带和血管纹有明显萎缩（P<0.0001）。与仅一处骨内膜受累的耳蜗相比，有两处或更多处骨内膜受累的耳硬化症耳蜗的血管纹普遍萎缩更明显（P<0.02），也比耳硬化症但无骨内膜受累的颞骨中的耳蜗更明显（P<0.05），比年龄相仿的对照者的耳蜗更明显（P<0.007）。此外，与对照组年龄相仿的耳蜗相比，有两处或更多处骨内膜受累的耳蜗的螺旋韧带萎缩更明显（P<0.03）。在患有耳硬化症的颞骨中，显示骨内膜受累区域与未受累区域之间，外毛细胞计数和螺旋神经节细胞密度无显著差异。然而，有两处或更多处骨内膜受累的耳硬化症耳蜗的外毛细胞总数，比仅一处骨内膜受累的耳蜗少（P<0.04），比耳硬化症但无骨内膜受累的颞骨中的耳蜗少（P<0.02），比年龄相仿但无耳硬化症个体的耳蜗少（P = 0.05）。将患有耳硬化症的颞骨生前测得的平均骨导阈值与年龄匹配的对照者的气导阈值进行比较，结果显示，只有有两处或更多处骨内膜受累的耳蜗听力有轻度但具有统计学意义的下降（P = 0.05）。没有证据支持无镫骨固定的耳硬化病灶常导致耳蜗明显退变或骨导阈值升高这一观点。
