Open AccessHistopathological changes to the peripheral vestibular system following meningitic labyrinthitis
Author(s) -
Pauna Henrique F.,
Knoll Renata M.,
Lubner Rory J.,
Brodsky Jacob R.,
Cushing Sharon L.,
Hyppolito Miguel A.,
Nadol Joseph B.,
Remenschneider Aaron K.,
Kozin Elliott D.
Publication year - 2020
Publication title -
laryngoscope investigative otolaryngology
Language(s) - English
Resource type - Journals
ISSN - 2378-8038
DOI - 10.1002/lio2.349
Subject(s) - labyrinthitis , medicine , vestibular system , cochlea , meningitis , pathology , vestibular nerve , scarpa's ganglion , temporal bone , inner ear , anatomy , hearing loss , audiology , surgery
Objective While cochlear ossification is a common sequalae of meningitic labyrinthitis, less is known about the effects of meningitis on peripheral vestibular end organs. Herein, we investigate histopathologic changes in the peripheral vestibular system and cochlea in patients with a history of meningitic labyrinthitis. Methods Temporal bone (TB) specimens from patients with a history of meningitis were evaluated and compared to age‐matched controls. Specimens were evaluated by light microscopy and assessed for qualitative changes, including the presence of vestibular and/or cochlear endolymphatic hydrops, presence and location of inflammatory cells, new bone formation, and labyrinthitis ossificans; and quantitative changes, including Scarpa's ganglion neuron (ScGN) and spiral ganglion neuron (SGN) counts. Results Fifteen TB from 10 individuals met inclusion and exclusion criteria. Presence of inflammatory cells and fibrous tissue was found in 5 TB. Of these, evidence of labyrinthitis ossificans was found in 2 TB. In the peripheral vestibular system, mild to severe degeneration of the vestibular membranous labyrinth was identified in 60% of cases (n = 9 TBs). There was a 21.2% decrease (range, 3%‐64%) in the mean total count of ScGN in patients with meningitis, compared to age‐matched controls. In the cochlea, there was a 45% decrease (range, 25.3%‐80.9%) in the mean total count of SGN compared to age‐matched controls (n = 14 TBs). Conclusions Otopathologic analysis of TB from patients with a history of meningitic labyrinthitis demonstrated distinct peripheral vestibular changes. Future research may help to delineate potential mechanisms for the observed otopathologic changes following meningitis. Level of Evidence N/A