Wang Tianying, Liu Huizhan, He David Z, Li Yi
Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, United States.
Front Neurol. 2022 Sep 15;13:997367. doi: 10.3389/fneur.2022.997367. eCollection 2022.
Vertigo is a debilitating disease affecting 15-20% of adults worldwide. Vestibular peripheral vertigo is the most common cause of vertigo, often due to Meniere's disease and benign paroxysmal positional vertigo. Although some vertigo symptoms can be controlled by conservative treatment and/or vestibular rehabilitation therapy, these treatments do not work for some patients. Semicircular canal occlusion surgery has proven to be very effective for these patients with intractable vertigo. However, its application is limited due to concern that the procedure will disrupt normal hearing. In this study, we investigated if occlusion of two semicircular canals would jeopardize auditory function by comparing auditory function and hair cell morphology between the surgical and contralateral ears before and after the surgery in a mouse model. By measuring the auditory brainstem response and distortion product otoacoustic emission 4 weeks post-surgery, we show that auditory function does not significantly change between the surgical and contralateral ears. In addition, confocal imaging has shown no hair cell loss in the cochlear and vestibular sensory epithelia, and scanning electron microscopy also indicates normal stereocilia morphology in the surgical ear. More importantly, the endocochlear potential measured from the surgical ear is not significantly different than that seen in the contralateral ear. Our study suggests that occlusion of two semicircular canals does not disrupt normal hearing in the mouse model, providing a basis to extend the procedure to patients, even those with normal hearing, benefitting more patients with intractable vertigo attacks.
眩晕是一种使人衰弱的疾病，影响着全球15%至20%的成年人。前庭周围性眩晕是眩晕最常见的病因，通常由梅尼埃病和良性阵发性位置性眩晕引起。尽管一些眩晕症状可以通过保守治疗和/或前庭康复治疗得到控制，但这些治疗方法对一些患者无效。半规管阻塞手术已被证明对这些患有顽固性眩晕的患者非常有效。然而，由于担心该手术会干扰正常听力，其应用受到限制。在本研究中，我们通过比较小鼠模型手术前后手术耳和对侧耳的听觉功能及毛细胞形态，研究阻塞两个半规管是否会损害听觉功能。通过在手术后4周测量听觉脑干反应和畸变产物耳声发射，我们发现手术耳和对侧耳之间的听觉功能没有显著变化。此外，共聚焦成像显示耳蜗和前庭感觉上皮中没有毛细胞丢失，扫描电子显微镜也表明手术耳中的静纤毛形态正常。更重要的是，手术耳测得的内淋巴电位与对侧耳相比没有显著差异。我们的研究表明，在小鼠模型中阻塞两个半规管不会破坏正常听力，为将该手术扩展到患者，甚至是听力正常的患者提供了依据，从而使更多顽固性眩晕发作的患者受益。
