OBJECTIVE:Previous studies of the microvascular bed of the rat inner ear showed vascular constriction after i.v. application of endothelin-1 (ET-1). Luminal narrowing together with multiple circumscribed constrictions were observed on vascular corrosion casts of initial and small calibre veins. These constrictions were interpreted as being caused by contractile cytoplasmic fibrils, most probably of pericytes; pericytes reportedly respond to ET-1 and the frequency, distribution and dimension of pericytes and their cytoplasmic processes closely corresponded to the constrictions observed. In the present study we analysed the distribution of actin and myosin in order to directly show the presence of contractile cytoplasmic fibrils.MATERIAL AND METHODS:We performed standard immunostaining for actin, smooth muscle actin, smooth muscle myosin and tropomyosin in the cochlea. We used different fixation protocols (methacarn, neutral formalin, Bouin's fluid) and compared observations in two species (rat and guinea pig).RESULTS:Immunohistochemistry confirmed the presence of contractile cytoplasmic fibrils in cochlear pericytes and vascular smooth muscle cells. Microvessels in the cochlea were much better provided with contractile fibrils in rats compared to guinea pigs. The distribution of contractile fibrils in rats corresponded well to the luminal constrictions observed on vascular corrosion casts.CONCLUSIONS:Our results support the assumption that active myofibrillar contraction (in response to ET-1 stimulation of pericytes) causes luminal constriction in cochlear microvessels. Contraction of myofibrils can be influenced by intrinsic or extrinsic agents, which offers new therapeutic regimens to govern cochlear blood flow. As the frequency of contractile cells on cochlear microvessels varied with the species studied, evaluation of human material will be the next step.

Histological procedures were used to evaluate the risk of cochlear damage during electrode insertion using the suprameatal approach. In comparison to the classic surgical technique, the suprameatal approach shows equal or less trauma.

For cochlear implantation, the suprameatal approach can be an alternative safe surgical technique. Typical conventional mastoidectomy and posterior tympanotomy are not necessary. This suprameatal approach is a simple, safe and effective procedure; chorda tympani is prevented in all cases, and there is no danger for the facial nerve.

The topic about the patients benefit of bilateral cochlear implantation still causes a controversial discussion. We report about our experience of bilateral cochlear implantation and the importance of bilateral cochlear implantation in meningitis deafened patients.

The distribution of endothelin-1 (ET-1) and endothelin-3 (ET-3) was studied by indirect immunostaining of decalcified guinea pig and rat cochleae. No species differences were observed. Perikarya and processes of spiral ganglion cells were highly reactive for both ET-1 and ET-3. The epithelial lining of the cochlear duct stained for ET-1 and ET-3, but reactivity for ET-1 was higher in the lining cells of the inner sulcus, Claudius', and Hensen's cells, while the tympanic covering layer of the basilar membrane stained stronger for ET-3 compared to ET-1. In the stria vascularis, all cell types stained for ET-3, while marginal cells were more reactive for ET-1. Spiral ligament fibroblasts were reactive for ET-1, but not for ET-3. Connective tissue cells of the spiral limbus stained for both endothelins. The region of synapses on outer hair cells reacted for ET-1 and ET-3 but sensory cells remained unstained. Endothelins are discussed to act as modulatory peptides, possibly interfering with nitric oxide, prostaglandins, and atrial natriuretic peptide in the lateral cochlear wall (lateral cochlear wall, i.e. stria vascularis and spiral ligament). The occurrence of endothelins in cochlear neurons suggest their potential role as neurotransmitters.