Two-phase endolymphatic hydrops

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Two-phase endolymphatic hydrops a dynamic model for Menière s disease E.A. Dunnebier

RIJKSUNIVERSITEIT GRONINGEN Two-phase endolymphatic hydrops a dynamic model for Menière s disease Proefschrift ter verkrijging van het doctoraat in de Medische Wetenschappen aan de Rijksuniversiteit Groningen op gezag van de Rector Magnificus, dr. D.F.J. Bosscher, in het openbaar te verdedigen op woensdag 9 december 1998 om 14.45 uur door Erwin Alexander Dunnebier geboren op 26 maart 1967 te Lexington (Kentucky, USA) GRONINGEN 1998

Promotores: Prof. Dr. F.W.J. Albers Prof. Dr. Ir. H.P. Wit ISBN 90-9012183-8

Promotiecommissie: Prof.dr. P. van den Broek Prof.dr.ir. H.J. Busscher Prof.dr. J.H.A. de Keyser Paranimfen: M.J. Dunnebier R. Alefs

Acknowledgement This study was supported by the Heinsius Houbolt Foundation and is part of the research program of our department: Communication through Hearing and Speech. The program is incorporated in the Sensory Systems Group of the Groningen Graduate School for Behavioural and Cognitive Neurosciences (BCN). Financial support was provided by: Schoonenberg Hoortoestellen (Groeneveld Winkelbedrijven B.V.) Schering-Plough B.V. (producent van Claritine ) ARTU Biologicals B.V.,ASTRA Pharmaceutica B.V., Audicom Hoortoestellen B.V., Audire B.V., Beltone Nederland, Dunnebier Vermogensbeheer, Electro Medical Instruments B.V., Entermed B.V., Glaxo Wellcome B.V., GN Danavox Nederland B.V., Oticon Nederland B.V., Lorex Synthélabo, Medin KNO-instrumenten, Mediprof Holland B.V., Moduvice B.V. Medical Products, Nobel Biocare Benelux B.V., A.C.M. Ooms Allergie B.V., Prof.dr.Eelco Huizinga Stichting, ReSound, Rhône-Poulenc Rorer B.V., Rockmed, SmithKline Beecham Farma B.V., Smith&Nephew Nederland B.V., Stryker, Veenhuis Medical Audio B.V. Internet An electronic version of this thesis is available on Internet http://www.ub.rug.nl/eldoc/dis/medicine/e.a.dunnebier 1998 E.A. Dunnebier, Groningen Druk: Van Denderen B.V. Groningen

Acknowledgement This study was supported by the Heinsius Houbolt Foundation and is part of the research program of our department: Communication through Hearing and Speech. The program is incorporated in the Sensory Systems Group of the Groningen Graduate School for Behavioural and Cognitive Neurosciences (BCN). Financial support was provided by: Schoonenberg Hoortoestellen (Groeneveld Winkelbedrijven B.V.) Schering-Plough B.V. (producent van Claritine ) ARTU Biologicals B.V.,ASTRA Pharmaceutica B.V., Audicom Hoortoestellen B.V., Audire B.V., Beltone Nederland, Dunnebier Vermogensbeheer, Electro Medical Instruments B.V., Entermed B.V., Glaxo Wellcome B.V., GN Danavox Nederland B.V., Oticon Nederland B.V., Lorex Synthélabo, Medin KNO-instrumenten, Mediprof Holland B.V., Moduvice B.V. Medical Products, Nobel Biocare Benelux B.V., A.C.M. Ooms Allergie B.V., Prof.dr.Eelco Huizinga Stichting, ReSound, Rhône-Poulenc Rorer B.V., Rockmed, SmithKline Beecham Farma B.V., Smith&Nephew Nederland B.V., Stryker, Veenhuis Medical Audio B.V. Internet An electronic version of this thesis is available on Internet http://www.ub.rug.nl/eldoc/dis/medicine/e.a.dunnebier 1998 E.A. Dunnebier, Groningen Druk: Van Denderen B.V. Groningen

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Contents page Chapter 1 Introduction 1 Chapter 2 Endolymphatic hydrops after total dissection or 7 cauterization of the distal portion of the endolymphatic sac Chapter 3 Two-phase endolymphatic hydrops; 19 a new dynamic guinea pig model Chapter 4 Low-voltage field-emission scanning electron microscopy 35 of non-coated guinea-pig hair cell stereocilia Chapter 5 New ultrastructural evidence for the existence of 53 glycocalyx on hair cells of the organ of Corti Chapter 6 Sensory cell damage in two-phase endolymphatic hydrops; 75 a morphologic evaluation of a new experimental model by low-voltage scanning techniques Chapter 7 Cochlear ultrastructure in two-phase endolymphatic hydrops 93 in the guinea pig Chapter 8 Ultrastructure of the endolymphatic sac in two-phase 111 endolymphatic hydrops in the guinea pig Chapter 9 Longitudinal recording of the compound action potential 123 in two-phase endolymphatic hydrops Chapter 10 Summary and conclusions 137 Publications related to the subject 145 Samenvatting en conclusies 147 Dankwoord 161 Curriculum Vitae 163