Huizing E H, de Groot J C
Department of Otolaryngology, University of Utrecht, The Netherlands.
Acta Otolaryngol Suppl. 1987;436:117-25. doi: 10.3109/00016488709124984.
The pathological findings due to aminoglycoside ototoxicity in man, as reported in the literature, is reviewed. 21 cases (40 ears) have been studied after serial sectioning, 8 cases (12 ears) have been investigated by the microdissection and surface preparation technique. The combination of both methods provides maximal information. OHCs are primarily affected, followed by IHC loss. Degeneration starts at the basal coil and proceeds towards the apex. The stria vascularis becomes involved in all turns. It is not clear whether stria degeneration is primary or secondary. Supporting cells, nerve fibres and ganglion cells degenerate secondary to hair cell loss. In some cases ingrowth of myelinated nerve fibres in areas with complete destruction of the organ of Corti has been observed. Ototoxic lesions can be asymmetric. Attention is drawn to the audiometric Z-curve in moderate lesions.
本文回顾了文献中报道的人类氨基糖苷类耳毒性的病理结果。对21例（40耳）进行了连续切片研究，8例（12耳）采用显微解剖和表面制备技术进行了研究。两种方法相结合可提供最大信息量。外毛细胞首先受到影响，随后是内毛细胞损失。变性从基底回开始，向蜗顶发展。血管纹在所有蜗转均受累。目前尚不清楚血管纹变性是原发性还是继发性的。支持细胞、神经纤维和神经节细胞在毛细胞损失后发生继发性变性。在某些病例中，观察到在柯蒂器完全破坏的区域有髓神经纤维长入。耳毒性损害可以是不对称的。文中提请注意中度损害时的听力Z形曲线。
