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Inner ear circulatory disorders can cause cochlear ossification, leading to hearing loss. Prompt treatment with vasodilators and anticoagulants is suggested for suspected vascular causes of sudden sensorineural hearing impairment.
Area of Science:
- Otolaryngology
- Vascular Neurology
- Radiology
Background:
- Circulatory disorders are prevalent but under-documented in the inner ear.
- Experimental cochlear artery occlusion in animals causes significant cochlear damage.
Observation:
- Surgical removal of acoustic tumors can compromise cochlear blood supply, leading to degenerative changes.
- Progressive ossification of cochlear spaces observed in human cochleas post-surgery.
- Similar pathological changes noted in temporal bones of patients with sudden sensorineural hearing loss.
Findings:
- Deprivation of cochlear blood supply results in severe degenerative changes and ossification.
- Occlusive arterial disease (thrombotic, embolic, spastic) is implicated in some sudden sensorineural hearing losses.
- Cochlear ossification, identified via polytomography, indicates a vascular etiology for hearing impairment.
Implications:
- Vascular occlusive events may be a significant factor in sudden sensorineural hearing loss.
- Treatment with vasodilators and anticoagulants is warranted for suspected vascular hearing loss.
- Further diagnostic protocols are needed to confirm vascular causes and guide treatment.
Abstract:
Circulatory disorders, which are well documented in most parts of the human body, are not well documented in the inner ear, although they are expected to occur. It has been previously shown that experimental occlusion of the labyrinthine artery in animals results in severe degenerative changes, fibrosis, and new bone formation in the cochlea. Accordingly, this paper presents presumptive evidence that depriving the human cochlea of its blood supply after surgical removal of an acoustic tumor results in severe degenerative changes that progress to total ossification of the cochlear spaces. This paper also discusses similar changes seen in temporal bones of two patients with sudden sensorineural hearing impairment. Based on these observations, the author concludes that occlusive arterial disease, whether thrombotic, embolic, or spastic, plays a role in some sudden sensorineural hearing losses. Cochlea ossification, detected by polytomography, suggests a vascular etiology of the hearing impairment. Treatment with vasodilator drugs and anticoagulants is justified in these cases until a better diagnostic protocol is developed to eliminate other causes.