By Richard R. ed. Gacek
New morphologic facts in human temporal bones from sufferers with vestibular neuronitis, Meniere's disorder, benign paroxysmal positional vertigo, and idiopathic facial paralysis is recommend to aid the concept those neuropathies are attributable to re-activation of a latent neurotropic virus (Herpes kinfolk) positioned within the sensory ganglia. formerly unreported adjustments point out that the efferent neuronal pathways to the auditory and vestibular finish organs might degenerate due to their direction in the course of the infected vestibular ganglion. Such paralysis of the efferent approach will be answerable 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 idea. In end, a few concepts at the obstacles and effectiveness of antiviral treatment are provided.
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Additional resources for Viral Neuropathies in the Temporal Bone (Advances in Otorhinolaryngology, Vol. 60)
The stippled area denotes the efferent cochlear pathway. DCN ϭ Dorsal cochlear nucleus; VCN ϭ Ventral cochlear nucleus; LVN ϭ Lateral vestibular nucleus; MVN ϭ Medial vestibular nucleus; V ϭ Descending trigeminal nucleus; VII ϭ Facial nerve genu; ASO ϭ Accessory superior olivary nucleus; VI ϭ Abdueens nucleus; LSO ϭ Lateral superior olivary nucleus; Coch. eff. ϭ Cochlear efferent. the inferior portion of the superior vestibular division. The ganglion cells for the posterior canal crista are located most caudally in the inferior vestibular ganglion and project their axons rostrally to join those of the superior division cristae before entering the brainstem.
A transmission electron micrograph of the base of IHC shows bundles of nerve fibers (NF) and endings (NE) tightly surrounded by supporting cells (S) after penetrating the basilar membrane (BM). Efferent fibers in a spiral bundle (E) pass near the hair cell. Fig. 16. A phase contrast micrograph of the organ of Corti in the cat illustrates the relationship of outer spiral bundles (open arrows) at the base of OHC. D ϭ Deiters’ cells; H ϭ Hensen’s cells; P ϭ pillars; S ϭ supporting cells with IHC; T ϭ tectorial membrane.
Pooling of gadolinium in dilated vessels surrounding  and within the FN  in the tympanic and mastoid portions of the fallopian canal is likely responsible for delayed enhancement in the distal segments of the facial canal. The initial location of virus infection may spread from the MG to the GG along the nervus intermedius. The characteristic lymphocytic infiltrate between nerve bundles typifies a viral infection. The recovery of viral DNA from the geniculate region in IFP is not contradictory.