Duckert L G
Laryngoscope. 1983 Jul;93(7):841-55. doi: 10.1288/00005537-198307000-00001.
The effects of chronic prosthetic implantation and interval electrical stimulation were studied in the normal and neomycin-perfused cochlea of the guinea pig. One group of guinea pigs was implanted with a multiple-electrode prosthesis in the scala tympani. During a 4-week period, the device was stimulated for 3 hours weekly with a continuous, 1 kHz sinusoidal current of constant intensity. A second group of guinea pigs underwent identical implantation and stimulation except that cochlear perfusion with .1 M neomycin was performed at the time of implantation. Current intensities ranged from .1 to .6 mA RMS. Two complementary control groups were implanted but not stimulated. The animals were sacrificed, the cochleae were perfused with a fixative, and the temporal bones were prepared for examination under a light, transmission, or scanning electron microscope. In the electrically stimulated cochleae, degenerative changes occurred in both the inner and outer hair cells and supporting elements. A decrease was apparent in spiral ganglion cell and nerve fiber populations in areas of inner hair cell depletion and did not seem to correspond to the survival of supporting cells. The electrically active electrodes were uniformly surrounded by a connective tissue matrix and areas of immature bone. These changes occurred at all the intensities tested, and did not monotonically relate in severity to current intensity. None of the changes was apparent in the normal control ears. Morphological changes induced by the ototoxic drug neomycin were so severe is both stimulated and unstimulated cochleae that comparison was not possible; this form of pretreatment is apparently unsuitable for use in studies of electrically induced damage. It appears that in the normal animal, chronic implantation with interval electrical stimulation results in a cumulative form of sensory and neural damage histologically similar to that proceeding from chronic noise exposure as well as other ototoxic agents. Such effects should be minimized if surviving sensorineural and supporting elements in the functionally compromised cochlea are to be preserved.
在豚鼠的正常耳蜗和新霉素灌注耳蜗中研究了慢性假体植入和间歇性电刺激的影响。一组豚鼠在鼓阶植入多电极假体。在4周的时间里,每周用强度恒定的1kHz连续正弦电流对该装置刺激3小时。第二组豚鼠接受相同的植入和刺激,但在植入时进行耳蜗灌注0.1M新霉素。均方根电流强度范围为0.1至0.6mA。两个互补的对照组植入但未刺激。处死动物,用固定剂灌注耳蜗,并制备颞骨用于光学显微镜、透射电子显微镜或扫描电子显微镜检查。在电刺激的耳蜗中,内、外毛细胞和支持细胞均出现退行性变化。在内毛细胞缺失区域,螺旋神经节细胞和神经纤维数量明显减少,且似乎与支持细胞的存活无关。电活性电极周围均匀地包裹着结缔组织基质和未成熟骨区域。这些变化在所有测试强度下均出现,且严重程度与电流强度无单调关系。正常对照耳未出现任何变化。耳毒性药物新霉素在刺激和未刺激的耳蜗中引起的形态学变化都非常严重,以至于无法进行比较;这种预处理形式显然不适用于电诱导损伤的研究。似乎在正常动物中,慢性植入并间歇性电刺激会导致一种累积性的感觉和神经损伤,在组织学上类似于慢性噪声暴露以及其他耳毒性药物引起的损伤。如果要保留功能受损耳蜗中存活的感觉神经和支持细胞,应尽量减少这种影响。