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Superior vestibular and “singular nerve” section — Animal and clinical studies
Author(s) -
Silverstein Herbert,
Makimoto Kazuo
Publication year - 1973
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-197309000-00004
Subject(s) - endolymph , vestibular system , cochlea , anatomy , perilymph , inner ear , vestibule , scarpa's ganglion , vestibular nerve , semicircular canal , medicine , vestibulocochlear nerve , audiology
Three patients are presented who experienced improved hearing for one month following a middle cranial fossa superior vestibular and “singular nerves” section. Depriving the vestibular labyrinth of its blood supply results in severe degeneration of the ampulla of the three semicircular canals and macula of the utricle, complete reversal of the sodium‐potassium ratio of the vestibular endolymph and elevation of vestibular endolymph and perilymph protein concentrations. If the blood supply is preserved denervation of either the cochlea or vestibular labyrinth does not result in degeneration of the sense organs or alterations in the biochemistry of the inner ear fluids. The cochlea appears normal histologically and cochlear endolymph has normal sodium‐potassium ion concentration after cutting the superior and “singular nerves” with accompanying vessels. This may be the first evidence that vestibular endolymph is secreted in the vestibular system and is independent of cochlear endolymph. The marked biochemical and histological changes observed in the vestibular labyrinth after cutting the superior vestibular and “singular nerves” with their blood supply in the internal auditory canal may have an effect on the clinical course of Ménière's disease.