Morphological Changes of the Vestibular Labyrinth by Experimental Perilymph Fistula

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  • KUKITA Naohito
    <I>Department of Otolaryngology, Showa University School of Medicine</I>
  • NOMURA Yasuya
    <I>Department of Otolaryngology, Showa University School of Medicine</I>

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The vestibular pathology of a perilymph fistula produced either by injecting an artificial perilymph into the subarachnoid space or by suctioning the perilymph through the round window was studied in animal models. Vestibular changes observed were the collapse of the otolithic organs or the semicircular ducts, which were demonstrated by computer graphics from serially sectioned specimens. Collapse of the utricular wall was common. In some animals, part of the utricular wall collapsed onto the otolithic membrane of the parts interna. When changes were severe, the whole macula utriculi was covered by the collapsed wall. The trabecular mesh was torn in the utricle and semi-circular canals. Collapse was irreversible. However, no otolithic membrane, sensory epithelium or nerve fibers were involved. Collapse of the ampullary wall, saccule and cochlea were also evident. The mechanism of the collapse is explained by the finding of the rupture of the Reissner's membrane. Withdrawal of the endolymph from the cochlea possibly caused the collapse of the vestibular membranous labyrinth. The sensory cells of the macula utriculi being stimulated by the collapsed utricular wall onto the otolithic membrane could explain the persistent dizziness of patients with preilymph fistula.

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