By Richard R. ed. Gacek
New morphologic proof in human temporal bones from sufferers with vestibular neuronitis, Meniere's affliction, benign paroxysmal positional vertigo, and idiopathic facial paralysis is recommend to aid the concept those neuropathies are as a result of re-activation of a latent neurotropic virus (Herpes relatives) situated within the sensory ganglia. formerly unreported adjustments point out that the efferent neuronal pathways to the auditory and vestibular finish organs may well degenerate because of their path during the infected vestibular ganglion. Such paralysis of the efferent procedure can be liable for secondary indicators (tinnitus, movement intolerance) linked to those neuropathies. Case histories with magnetic resonance imaging of the 7th and 8th cranial nerves are defined in aid of the viral neuropathy thought. In end, a few ideas at the boundaries and effectiveness of antiviral treatment are provided.
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Additional info for Viral Neuropathies in the Temporal Bone (Advances in Otorhinolaryngology, Vol. 60)
Vestibular neurons to the cristae of superior division canals were markedly degenerated with some preservation of innervation to the maculae (fig. 19). In the left TB, the FN and GG were normal. There were several degenerated neurons in the MG (fig. 20) but none in the GG. There was a severe loss of spiral ganglion cells with only 5% of neurons remaining, and the organ of Corti was normal. The vestibular sense organs and ganglion were normal. Gacek/Gacek 44 Fig. 14. The GG in case 3 contained normal ganglion cells and satellite cells.
Both of these nerve divisions are primarily afferent in function and Neuroanatomy of the Nerves in the Temporal Bone 19 Kinocilium KC Stereocilia Cuticle Supporting cell Nerve chalice Efferent nerve ending Synaptic bar Efferent nerve ending Afferent nerve ending Type 2 Type 1 Hair cells Fig. 9. Drawing of the afferent and efferent innervation of type 1 and 2 vestibular hair cells. KC ϭ Kinocilium. composed of bipolar ganglion cells derived from the auditory vesicle . They are of placodal origin.
A more distal section of the same specimen as in figure 12 demonstrates the olivocochlear bundle (OCB) as it leaves the saccular nerve (S) to join the cochlear nerve (C). Vestibular efferent fibers (VE) travel as bundles in the superior division and as scattered fibers in the posterior canal nerve (PC) and saccular nerve. F ϭ FN. The human cochlear nerve is composed of approximately 30,000 bipolar ganglion cells, of which 95% are type 1 with myelinated axons, and 5% are type 2 ganglion cells with unmyelinated cell processes .
Viral Neuropathies in the Temporal Bone (Advances in Otorhinolaryngology, Vol. 60) by Richard R. ed. Gacek