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Stria vascularis and cochlear hair cell changes in syphilis: A human temporal bone study

Published:February 06, 2016DOI:https://doi.org/10.1016/j.anl.2016.01.001

      Abstract

      Objective

      To observe any changes in stria vascularis and cochlear hair cells in patients with syphilis.

      Materials and methods

      We examined 13 human temporal bone samples from 8 patients with syphilis (our syphilis group), as well as 12 histopathologically normal samples from 9 age-matched patients without syphilis (our control group). We compared, between the two groups, the mean area of the stria vascularis (measured with conventional light microscopy connected to a personal computer) and the mean percentage of cochlear hair cell loss (obtained from cytocochleograms).

      Results

      In our syphilis group, only 1 (7.7%) of the 13 samples had precipitate in the endolymphatic or perilymphatic spaces; 8 (61.5%) of the samples revealed the presence of endolymphatic hydrops (4 cochlear, 4 saccular). The mean area of the stria vascularis did not significantly differ, in any turn of the cochlea, between the 2 groups (P > 0.1). However, we did find significant differences between the 2 groups in the mean percentage of outer hair cells in the apical turn (P < 0.026) and in the mean percentage of inner hair cells in the basal (P = 0.001), middle (P = 0.004), and apical (P = 0.018) turns. In 7 samples in our syphilis group, we observed either complete loss of the organ of Corti or a flattened organ of Corti without any cells in addition to the absence of both outer and inner hair cells.

      Conclusion

      In this study, syphilis led either to complete loss of the organ of Corti or to significant loss of cochlear hair cells, in addition to cochleosaccular hydrops. But the area of the stria vascularis did not change.

      Keywords

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      References

        • Dobbin J.M.
        • Perkins J.H.
        Otosyphilis and hearing loss: response to penicillin and steroid therapy.
        Laryngoscope. 1983; 93: 1540-1543
        • Phillips J.S.
        • Gaunt A.
        • Phillips D.R.
        Otosyphilis: a neglected diagnosis.
        Otol Neurotol. 2014; 35: 1011-1013
        • Miller M.E.
        • Makary C.
        • Lopez I.A.
        • Ishiyama A.
        Endolymphatic hydrops in otologic syphilis: a temporal bone study.
        Otol Neurotol. 2010; 31: 681-686
        • Fayad J.N.
        • Linthicum F.H.
        Temporal bone histopathology case of the month: otosyphilis.
        Am J Otol. 1999; 20: 259-260
        • Otte J.
        • Schunknecht H.F.
        • Kerr A.G.
        Ganglion cell populations in normal and pathological human cochleae. Implications for cochlear implantation.
        Laryngoscope. 1978; 88: 1231-1246
        • Merchant S.N.
        Methods of removal, preparation, and study.
        in: Merchant S.N. Nadol J.B. Schuknecht's pathology of the ear. People's Medical Publishing House, USA2010: 39-40
        • Schuknecht H.F.
        • Gacek M.R.
        Cochlear pathology in presbycusis.
        Ann Otol Rhinol Laryngol. 1993; 102: 1-16
        • Linthicum F.H.
        • el-Rahman A.G.
        Hydrops due to syphilitic endolymphatic duct obliteration.
        Laryngoscope. 1987; 97: 568-574
        • Paparella M.M.
        The cause (multifactorial inheritance) and pathogenesis (endolymphatic malabsorption) of Meniere's disease and its symptoms (mechanical and chemical).
        Acta Otolaryngol. 1985; 99: 445-451
        • Amenta C.A.
        • Dayal V.S.
        • Flaherty J.
        • Weil R.J.
        Luetic endolymphatic hydrops: diagnosis and treatment.
        Am J Otol. 1992; 13: 516-524
        • Jeans A.R.
        • Wilkins E.G.L.
        • Bonington A.
        Sensorineural hearing loss due to secondary syphilis.
        Int J STD AIDS. 2008; 19: 355-356
        • Chan S.Y.
        • Medhi M.
        • Ekbote A.
        • Moses S.
        • Sibtain N.
        • Andrews T.
        Syphilis causing hearing loss.
        Int J STD AIDS. 2008; 19: 721-722
        • Morrison A.W.
        On syphilis and the ear – an otologist's view.
        Genitourin Med. 1992; 68: 420-422
        • Karmody C.S.
        • Schuknecht H.F.
        Deafness in congenital syphilis.
        Arch Otolaryngol. 1966; 83: 18-27
        • Hızlı Ö.
        • Hızlı P.
        • Kaya S.
        • Monsanto R.d.C.
        • Paparella M.M.
        • Cureoglu S.
        Histopathologic ear findings of syphilis: a temporal bone study.
        Eur Arch Otorhinolaryngol. 2015;
        • Tsuji K.
        • Velázquez-Villaseñor L.
        • Rauch S.D.
        • Glynn R.J.
        • Wall C.
        • Merchant S.N.
        Temporal bone studies of the human peripheral vestibular system. Meniere's disease.
        Ann Otol Rhinol Laryngol Suppl. 2000; 181: 26-31
        • Von Bekesy G.
        Experiments in hearing.
        McGraw Hill, New York1960
        • Lopez-Escamez J.A.
        • Carey J.
        • Chung W.-H.
        • Goebel J.A.
        • Magnusson M.
        • Mandalà M.
        Diagnostic criteria for Menière's disease.
        J Vestib Res. 2015; 25: 1-7
        • Scott-Brown W.G.
        • Gleeson M.
        • Browning G.G.
        Scott-Brown's otolaryngology, head and neck surgery.
        Hodder Arnold, London2008
        • Kariya S.
        • Cureoglu S.
        • Fukushima H.
        • Nomiya S.
        • Nomiya R.
        • Schachern P.A.
        Vascular findings in the stria vascularis of patients with unilateral or bilateral Ménière's disease: a histopathologic temporal bone study.
        Otol Neurotol. 2009; 30: 1006-1012
        • Ito T.
        • Nishio A.
        • Wangemann P.
        • Griffith A.J.
        Progressive irreversible hearing loss is caused by stria vascularis degeneration in an Slc26a4-insufficient mouse model of large vestibular aqueduct syndrome.
        Neuroscience. 2015; 310: 188-197