title: Quantitative Vestibular Labyrinthine Otopathology in Temporal Bones with Vestibular Schwannoma.
abstract: OBJECTIVE
  Dizziness associated with vestibular schwannoma is usually ascribed to retrolabyrinthine mechanisms. The goal of this study was to determine if quantitative peripheral vestibular (labyrinthine) otopathology was present in a series of patients with vestibular schwannoma.
  
  
  METHODS
  Comparative human temporal bone study.
  
  
  METHODS
  Otopathology laboratory.
  
  
  METHODS
  Temporal bones from 12 subjects with unilateral sporadic vestibular schwannoma were included. Based on differential interference contrast microscopy, type I and II vestibular hair cell counts were performed on each vestibular sense organ with minimal autolysis in which the neuroepithelium was oriented perpendicular to the plane of section. Hair cell densities (cells per 0.01-mm(2) surface area) and the presence of endolymphatic hydrops and precipitate within the endolymph or perilymph were compared between the tumor ears and the contralateral (control) ears.
  
  
  RESULTS
  Compared with the contralateral ears, vestibular schwannoma ears had significantly more endolymphatic hydrops (P = .049) and precipitate in the endolymph and perilymph (P = .005), lower densities of type I and II vestibular hair cells in the lateral canal cristae (mean differences, respectively: 25.2 [P = .001] and 10.8 [P < .001]) and utricle (mean differences, respectively: 26.8 and 10.4 [P < .001]), and lower densities of type I hair cells and the same density of type II hair cells in the saccule (mean differences, respectively: 26.5 [P < .001] and 0.9 [P = .46]).
  
  
  CONCLUSIONS
  Peripheral vestibular otopathology, manifested as reductions of vestibular hair cell densities, was identified in ears with vestibular schwannoma. Labyrinthine as well as retrolabyrinthine pathology may contribute to tumor-related vestibular dysfunction.
authors: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Giresun A. Ilhan Ozdemir State Hospital, Giresun, Turkey.
authors: Ömer
authors: Ö
authors: Hızlı
authors: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors: Sebahattin
authors: S
authors: Cureoglu
authors: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Gebze Fatih State Hospital, Gebze, Kocaeli, Turkey.
authors: Serdar
authors: S
authors: Kaya
authors: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors: Patricia A
authors: PA
authors: Schachern
authors: Paparella Ear Head and Neck Institute, Minneapolis, Minnesota, USA.
authors: Michael M
authors: MM
authors: Paparella
authors: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA meadams@umn.edu.
authors: Meredith E
authors: ME
authors: Adams
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications* / Q000473:pathology*; D013701:Temporal Bone / Q000473:pathology*; D015837:Vestibular Diseases / Q000209:etiology* / Q000473:pathology*
keywords: acoustic neuroma; human temporal bone; labyrinthine; otopathology; vestibular; vestibular schwannoma