Takeda Taizo, Takeda Setsuko, Kakigi Akinobu
Kochi Medical School, Kochi, Japan.
Department of Otorhinolaryngology Head and Neck Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
Front Surg. 2021 Jan 11;7:596383. doi: 10.3389/fsurg.2020.596383. eCollection 2020.
Recently, several lines of evidence have suggested that the inner ear is under hormonal control. It is likely that steroids have some influence on the inner ear. Many clinicians have been empirically using steroids for the treatment of diseases associated with endolymphatic hydrops. The theoretical grounds for this are not clear, and there have been a number of debates on the effectiveness of steroid treatment. Furthermore, there are few reports on histological observations of the influences of steroids on the cochlea. Fifteen guinea pigs (30 ears) were divided into three groups. In the control group, physiological saline solution was administered intra-peritoneally for 3 days. In two steroid groups, 40 mg/kg/day of hydrocortisone or 4 mg/kg/day of dexamethasone was administered intra-peritoneally for 3 days. Extension of Reissner's membrane and volume change of the scala media were checked 6 h after the last administration. The degree of Reissner's membrane extension and volumetric change of the scala media were quantitatively measured with the use of a video-digitizer. We did not identify any distinct changes in the cochlea of the control group. In contrast, the extension of Reissner's membrane and endolymphatic hydrops were observed in the animals in the steroid groups. Statistical analysis revealed that Reissner's membrane extended significantly in the steroid groups, and that the volume of the scala media also increased significantly. This is the first report to investigate the effects of systemic administration of glucocorticoids on guineapig cochlea. The extension of Reissner's membrane and dilated endolymphatic space were evident in the steroid groups. However, the underlying mechanism of histological changes was not clear, marked care needs to be taken when administering steroids to patients with Meniere's disease whose histological feature is endolymphatic hydrops.
最近，有几条证据表明内耳受激素控制。类固醇可能对内耳有一定影响。许多临床医生一直在凭经验使用类固醇治疗与内淋巴积水相关的疾病。其理论依据尚不清楚，关于类固醇治疗的有效性也存在诸多争论。此外，关于类固醇对耳蜗影响的组织学观察报告很少。15只豚鼠（30只耳）被分为三组。对照组腹腔注射生理盐水3天。在两个类固醇组中，腹腔注射40mg/kg/天的氢化可的松或4mg/kg/天的地塞米松，持续3天。在最后一次给药6小时后检查Reissner膜的伸展情况和中阶的体积变化。使用视频数字化仪对Reissner膜的伸展程度和中阶的体积变化进行定量测量。我们在对照组的耳蜗中未发现任何明显变化。相比之下，在类固醇组的动物中观察到了Reissner膜的伸展和内淋巴积水。统计分析显示，类固醇组中Reissner膜明显伸展，中阶的体积也显著增加。这是第一份研究全身应用糖皮质激素对豚鼠耳蜗影响的报告。类固醇组中Reissner膜的伸展和内淋巴间隙扩张明显。然而，组织学变化的潜在机制尚不清楚，对于组织学特征为内淋巴积水的梅尼埃病患者使用类固醇时需格外谨慎。
