Johnsson L G, Hawkins J E, Kingsley T C, Black F O, Matz G J
Acta Otolaryngol Suppl. 1981;383:1-19.
Temporal bones from five patients with hearing loss as a result of aminoglycoside treatment were examined by the method of microdissection and surface preparations, followed by celloidin embedding and serial sectioning of the modiolus. Three patients had received the newer antibiotics, gentamicin, tobramycin, and amikacin; the other two neomycin. In the cochleas from two patients of the first group there was only a small loss of hair cells, restricted to the lower end of the basal turn. The third, who had been treated with several antibiotics over a longer period of time, showed more extensive but strikingly asymmetrical patterns of degeneration in the two ears. This patient, as well as the fourth, who had received neomycin during peritoneal lavage, had numerous patchy areas of complete disappearance of Corti's organ in the basal turn, with incipient degeneration of the distal ends of the nerve fibers in adjacent portions of the osseous spiral lamina. The fifth patient, who had become deaf after prolonged treatment with neomycin by mouth, showed a complete loss of cochlear hair cells. Nerve fibers were present only in the middle and upper turns, where supporting cells remained. Midmodiolar sections showed a proportionately much greater loss of the distal than of the proximal processes of the cells of the spiral ganglion. These findings underscore once again the special hazard for the inner ear that is associated with the clinical use of neomycin, regardless of the route of administration.
对5例因氨基糖苷类药物治疗导致听力损失患者的颞骨进行了显微解剖和表面标本制备，随后用火棉胶包埋蜗轴并进行连续切片。3例患者使用了新的抗生素庆大霉素、妥布霉素和阿米卡星；另外2例使用的是新霉素。在第一组的2例患者的耳蜗中，仅毛细胞有少量损失，局限于蜗底的下端。第三例患者在较长时间内使用了多种抗生素，其双耳呈现出更广泛但明显不对称的退变模式。该患者以及第四例在腹膜灌洗期间使用新霉素的患者，在蜗底有许多柯替器完全消失的片状区域，骨螺旋板相邻部分的神经纤维远端开始退变。第五例患者因长期口服新霉素而致聋，其耳蜗毛细胞完全丧失。神经纤维仅存在于中、上蜗转，此处支持细胞尚存。蜗轴中部切片显示，螺旋神经节细胞的远端比近端的损失比例大得多。这些发现再次强调了新霉素临床应用对内耳造成的特殊危害，无论给药途径如何。
