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Ante mortem ruptures of the endolymphatic membranes in children: real finding or artifact?
Edgar Bachor1, Collin S Karmody
1Department of Otorhinolaryngology, Universität Ulm, Germany. edgar.bachor@medizin.uni-ulm.de
Insights
Ante mortem ruptures of infantile endolymphatic membranes occur in 11.1% of cases, frequently in the saccule. These ruptures are linked to specific infant conditions and treatments, impacting inner ear structures.
Area of Science:
- Otolaryngology
- Pediatric Pathology
- Histopathology
Background:
- Endolymphatic membrane ruptures in infants are not well-documented.
- Understanding these ruptures is crucial for diagnosing inner ear conditions in children.
- Previous research noted bulging of Reissner's membrane in pediatric temporal bones.
Purpose of the Study:
- To determine the occurrence and location of ante mortem endolymphatic membrane ruptures in infants.
- To assess the statistical correlation between these ruptures and bulging of Reissner's membrane.
- To identify factors associated with endolymphatic membrane ruptures in pediatric temporal bones.
Main Methods:
- Examination of 128 temporal bones from 80 children (newborn to 12 years).
- Celloidin technique preparation and light microscopy analysis.
- Histopathological identification of ante mortem ruptures based on specific criteria (rolled edges, adhesions).
Main Results:
- Ante mortem ruptures were observed in 11.1% of specimens.
- Ruptures occurred in Reissner's membrane (2.4%), saccular membrane (6.3%), and utricular membrane (2.4%).
- Associated histopathological findings included stria vascularis atrophy and organ of Corti collapse.
Conclusions:
- Ante mortem endolymphatic membrane ruptures are a naturally occurring phenomenon in the infantile inner ear.
- Infants with congenital anomalies or those treated with chemotherapy and aminoglycosides are at higher risk.
- These findings contribute to understanding pediatric inner ear pathologies.
Abstract:
We undertook this study to determine whether or not ante mortem ruptures of the endolymphatic membranes occurred naturally in the infantile labyrinth, what were the most frequent locations and to assess the statistical correlation of an earlier finding of bulging of Reissner's membrane in pediatric temporal bones. We examined 128 temporal bones from 80 children between the ages of newborn to 12 years with an average age of 15.4 months. All temporal bones were prepared by the celloidin technique and studied by light microscopy. The endolymphatic membranes of the cochlear duct, saccule, utricle and semicircular ducts were examined for ruptures. A rupture of the saccule and utricle was considered to be an ante mortem event if its edges were rolled and bound with fine adhesions and could be identified in adjacent sections. Ante mortem ruptures were seen in 11.1% of the specimens and occurred in 2.4% in Reissner's membrane, in 6.3% in the saccular membrane and in 2.4% in the utricular membrane. In these specimens, the histopathological changes included atrophy of the stria vascularis and collapse of the organ of Corti, which provided further evidence of an ante mortem event. Infants with extralabyrinthine congenital anomalies or children who were treated with chemotherapy were more likely to develop ruptures of the endolymphatic membranes if they also received aminoglycosides.