Histopathological changes in the temporal bone in kwashiorkor

The histopathological changes in human temporal bones are described for 2 cases of kwashiorkor--a protein/calorie malnutrition (PCM) state. There is photographic evidence of severe damge to the middle and inner ears and to the vestibulocochlear nerve. The middle ear shows evidence of chronic otitis media, a common clinical finding in kwashiorkor. Significantly, the round window membranes in both cases showed thickening and infiltration with inflammatory cells. The inner ear showed the loss of cellular elements and hair cell loss in the spiral organ. A marked decrease of spiral ganglion cells and demyelination of the vestibulocochlear nerve were also seen.