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Temporal bone histopathology 14 years after cytomegalic inclusion disease: a case study
1Department of Anatomy and Cell Biology, College of Medicine, University of Florida, Gainesville 32610.
Abstract:
Temporal bones were examined from a 14-year-old male who died of sequelae of congenital cytomegalic inclusion disease (CID). Cytomegalovirus (CMV) was not isolated from inner ear fluid or multiple systemic tissues at the time of death. Examination of temporal bones revealed chronic pathology of both cochlear and vestibular sensory and nonsensory tissues. Endolymphatic hydrops was observed in the basal turn of the cochlear duct, while Reissner's membrane was collapsed in the more apical turns. Strial atrophy and a loss of cochlear hair cells were observed along the entire length of the basilar membrane. Vestibular neuroepithelial regions were degenerated and fibrosis was seen within the vestibular perilymphatic tissue spaces, suggesting prior labyrinthitis within the perilymph compartment in addition to the more typical pattern of endolabyrinthitis associated with human CMV infection. Distention of the saccular membrane was evident. In both cochlear and vestibular tissues, there were isolated regions of calcifications that appeared characteristic to that reported in other organ systems of individuals with CID. Collectively, these chronic, pathological findings in this case of CID demonstrate more extensive injury than has been identified in the previously reported acute temporal bone pathology of CID.
Insights
Congenital cytomegalic inclusion disease (CID) caused chronic, extensive damage to the temporal bone, affecting both cochlear and vestibular systems. This case reveals more severe inner ear pathology than previously documented in CID.
Area of Science:
- Otolaryngology
- Pathology
- Virology
Background:
- Congenital cytomegalic inclusion disease (CID) is a viral infection with potential long-term health consequences.
- Human cytomegalovirus (CMV) is a common cause of CID, often associated with sensorineural hearing loss.
- Previous studies have primarily focused on acute temporal bone pathology in CID.
Observation:
- Temporal bones from a 14-year-old male with CID sequelae were analyzed.
- Despite no active CMV isolation, chronic pathological changes were evident in cochlear and vestibular tissues.
- Findings included endolymphatic hydrops, strial atrophy, cochlear hair cell loss, vestibular degeneration, and fibrosis.
Findings:
- The study identified chronic, extensive inner ear pathology in CID, including cochlear and vestibular damage.
- Specific observations included endolymphatic hydrops, Reissner's membrane collapse, strial atrophy, and significant hair cell loss.
- Vestibular tissues showed degeneration and fibrosis, suggesting prior labyrinthitis, alongside saccular membrane distention and calcifications.
Implications:
- This case demonstrates that congenital cytomegalic inclusion disease can lead to more severe and chronic temporal bone pathology than previously recognized.
- The findings suggest a need for long-term audiological and vestibular monitoring in individuals with a history of CID.
- Understanding the chronic effects of CID on the inner ear is crucial for developing targeted interventions and improving patient outcomes.