A calcareous concretion in the posterior semicircular duct of a human labyrinth

Temporal bones were acquired four hours post mortem from a 67-year-old cancer patient. During dissection of the left vestibular labyrinth, a glistening white, spherical concretion was found in the posterior semicircular duct near the ampulla. The object was subsequently studied by light and scanning electron microscopy, x-ray diffraction, and x-ray energy dispersive elemental analysis. It was composed of four concentric layers: an outer zone of tabular vaterite crystals, a colorless intermediate zone of spherulitic octacalcium phosphate (OCP), and a cloudy core with inner and outer zones both composed of OCP. Examination of the vestibular receptor organs revealed severe loss of hair cells on all three cristae. Very few otoconia were present in the utricle, although the gelatinous layer of the otoconial membrane was intact on the macular surface. During the year preceding his death, the patient had received 800 mg of the potentially ototoxic drug cis-platinum. The concretion described in this report was, however, probably connected with age-related degeneration rather than with any effect of the drug.