title: Vascular and Neuroepithelial Histopathology of the Saccule in Humans With Diabetes Mellitus.
abstract: This study aimed to determine if there are quantitative differences in the neuroepithelium and microvasculature of the saccule between subjects with and without diabetes mellitus (DM).
  
  
  
  Histopathologic changes that may underlie the association between DM and vestibular dysfunction have not been characterized in humans.
  
  
  
  Human temporal bones (HTBs) from 39 subjects with DM (n = 16 type I DM [T1DM], n = 23 type II DM [T2DM]) were compared with 40 group age-matched controls. Vessel wall thickness was measured from the saccular arteriole. Type I and type II vestibular hair cell (VHC) counts were performed on perpendicularly oriented saccular maculae using differential interference contrast microscopy (T1DM: 5HTB/3 subjects; T2DM: 9HTB/8 subjects; controls: 25HTB/20 subjects).
  
  
  
  The mean density of type I VHCs was 16 to 17% lower in the DM groups compared to controls (T1DM 52.21 [4.26], T2DM 53.3 [5.34], control 63.14 [2.49] cells/mm, p = 0.02). There were no differences between T1DM, T2DM, and control groups in type II VHC density (T1DM 40.89 [5.17], T2DM 40.44 [6.93], control 42.80 [1.79] cells/mm, p = 0.92) or in mean vessel wall thickness (T1DM 2.23 [0.62], T2DM 2.18 [0.53], control 2.00 [0.53] μm, p = 0.26).
  
  
  
  Neuroepithelial pathology, manifested as lower density of type I VHCs, was observed in the saccules of subjects with DM. Saccular microangiopathy, expressed as alterations in arteriole thickness, was not observed. These findings are consistent with histologic observations in animals with experimentally induced diabetes. DM may have a selective and deleterious effect on human vestibular sensory epithelia.
authors.affiliation: *Department of Otolaryngology/Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A. †Department of Otolaryngology, Gebze Fatih State Hospital, Gebze, Kocaeli, Turkey ‡Department of Otolaryngology, Bagcilar Training and Research Hospital, Istanbul, Turkey §Paparella Ear Head and Neck Institute, Minneapolis, Minnesota, U.S.A.
authors.forename: Pelin
authors.initials: P
authors.lastname: Kocdor
authors.forename: Serdar
authors.initials: S
authors.lastname: Kaya
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erdil
authors.forename: Sebahattin
authors.initials: S
authors.lastname: Cureoglu
authors.forename: Michael M
authors.initials: MM
authors.lastname: Paparella
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Adams
mesh_terms: D003920:Diabetes Mellitus / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D012444:Saccule and Utricle / Q000473:pathology*