この作業は、国立難聴者協会のR01DC015824（KMS）およびT32DC00038（JESおよびSDをサポート）、国防総省のグラントW81XWH-14-1-0091（KMS）、Bertarelli財団（KMS） 、ナンシーセイレスデー財団（KMS）、ラウアー耳鳴り研究センター（KMS）、およびバーンズ財団（KMS）が含まれます。

<ol>
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著者は何も開示することはない。

この原稿は、VS研究のための統一された方法論的枠組みを記述し、下流の研究の応用のためにヒトVSとGAN標本の同時処理を概説している。 VS研究が精密医学の時代に入っても、多数の研究問題に答えることができる形で同じサンプルを調製することで、個々の患者に特有の分子、細胞、遺伝子、プロテオームの洞察を発見することができます。 ヒトSchwann細胞およびVS培養?...

前庭神経鞘腫（VS）は小脳門角の最も一般的な新生物であり、10万人に1人と診断されている。非転移性ではあるが、これらの腫瘍は、患者の生活の質に1,2,3,4,5,6に深刻な影響を与える。冒された個人は、通常、難聴、耳鳴り、および聴覚充満の感覚で生きる。腫瘍が成長するにつれて症状がますます衰弱し、バランスの問題、顔面の麻痺、および他の脳神経機能の障害を引き起こす。脳幹圧迫による生命を脅かす複雑な合併症も起こり得る7 。 VSの管理オプションは、本質的に静的腫瘍および定位放射線療法または成長する腫瘍のための外科的切除を待つことに制限されている VSは末梢感覚神経（ すなわち、前庭神経）から生じるので、VS関連の観察を、人間の大耳神経（GAN）などの適切な制御神経から得られたものと比較することが重要である。健康なGANは、胸腺摘除術または頸部切開の間に定期的に屠殺され、健康なシュワン細胞生理学の頑強なモデルとして使用することができる9 。 散発性VSの治療または予防のためのFDA認可の薬物は存在しないため、研究者は根底にある分子メカニズムを解明することが不可欠です治療標的を同定するために疾患の病因を同定する。 VEGF、シクロオキシゲナーゼ2（COX-2）、核因子κB（NF-κB）、腫瘍壊死因子アルファ（TNF-α）、胃腸管壊死因子α（TNF-α）などのVS病因に役割を果たすことが示されているタンパク質は、 、表皮成長因子受容体（EGFR）、および関連するシグナル伝達分子10,11,12,13,14,15,16,17が含まれる。 最近の進歩は、初代ヒト前庭神経鞘腫および健康な神経組織の収集、処理、培養、および下流の調査のためのプロトコールを拡大および改良した18,19 。しかし、ほとんどの既存のプロトコルは、単一の下流の研究適用（ すなわち、細胞培養のみ）のためのそのような組織の導入。この記事では、細胞型特異的培養、タンパク質抽出、RNA保存、腫瘍分泌回収、および組織固定など、複数の下流アプリケーションのための単一の初代ヒトVSまたはGANサンプルの同時処理のための統一された方法論的フレームワークを提示します。これらの密接に関連した組織は、VSに対するバイオマーカーの重要な供給源として役立つ可能性があるので、この研究は、トランスアライントリンVS切除の間のヒト脳脊髄液（CSF）および外リンパ球の外科的採取および処理について詳述する。最後に、このプロトコールは、遺伝子治療に使用するためのこの組織の新規適用として、培養における初代ヒトVS細胞のウイルス形質導入のためのステップを提示する。

<table><tbody><tr><td>BioCoat Poly-D-Lysine/Laminin 12 mm #1 German Glass Coverslip</td><td>Corning</td><td>354087</td><td>Or prepare coverslips with Corning Laminin (CB-40232) and Cultrex Poly-L-Lysine (3438-100-01)</td></tr><tr><td>CELLSTAR 15 mL Centrifuge Tubes, Conical bottom, Graduation, Sterile</td><td>Greiner Bio-One</td><td>188161</td><td></td></tr><tr><td>CELLSTAR 50 mL Centrifuge Tubes, Conical bottom, Graduation, Sterile</td><td>Greiner Bio-One</td><td>227261</td><td></td></tr><tr><td>CELLSTAR Cell Culture Dish, 60 mm</td><td>Greiner Bio-One</td><td>628160</td><td></td></tr><tr><td>Collagenase from Clostridium histolyticum, Sterile-filtered</td><td>Sigma-Aldrich</td><td>C1639</td><td></td></tr><tr><td>Costar 24 Well Clear TC-Treated Multiple Well Plates, Sterile</td><td>Corning</td><td>3526</td><td></td></tr><tr><td>DAPI (4&#039;,6-Diamidino-2-Phenylindole, Dihydrochloride)</td><td>Thermo Fisher Scientific</td><td>D1306</td><td></td></tr><tr><td>DMEM, high glucose, pyruvate, no glutamine, 500 mL</td><td>Thermo Fisher Scientific</td><td>10313-039</td><td></td></tr><tr><td>DMEM/F-12, 500 mL</td><td>Thermo Fisher Scientific</td><td>11320-033</td><td></td></tr><tr><td>Dumont #3 Forceps, Dumoxel</td><td>Fine Science Tools</td><td>11231-30</td><td>Autoclave prior to use</td></tr><tr><td>Dumont #5 Forceps, Standard tip, Inox</td><td>Fine Science Tools</td><td>11251-20</td><td>Autoclave prior to use</td></tr><tr><td>Fetal Bovine Serum, qualified, USDA-approved regions, 500 mL</td><td>Thermo Fisher Scientific</td><td>10437-028</td><td>Aliquot in 50 mL tubes and store in -20&amp;deg;C freezer</td></tr><tr><td>Hyaluronidase from Bovine Testes, Type I-S, Lyophilized Powder</td><td>Sigma-Aldrich</td><td>H3506</td><td></td></tr><tr><td>Millex-GP Syringe Filter Unit, 0.22 &amp;micro;m, polyethersulfone, 33 mm, sterile</td><td>EMD Millipore</td><td>SLGP033RS</td><td></td></tr><tr><td>Paraformaldehyde, Reagent Grade, Crystalline</td><td>Sigma-Aldrich</td><td>P6148</td><td>Prior to use: Establish Standard Operating Procedures based on protocols available online</td></tr><tr><td>PBS, pH 7.4, 500 mL</td><td>Thermo Fisher Scientific</td><td>10010-023</td><td>Autoclave prior to use</td></tr><tr><td>Penicillin-Streptomycin (10,000 U/mL), 100 mL</td><td>Thermo Fisher Scientific</td><td>15140-122</td><td></td></tr><tr><td>PhosSTOP Phosphatase Inhibitor Tablets</td><td>Roche</td><td>04906845001</td><td></td></tr><tr><td>Pierce Protease Inhibitor Tablets</td><td>Thermo Fisher Scientific</td><td>88666</td><td></td></tr><tr><td>Pipettes and pipette tips, 5/10/25 mL</td><td>Variable</td><td>Variable</td><td></td></tr><tr><td>Plastic Homogenization Pestle for 1.5/2.0 mL Microtubes</td><td>E&amp;amp;K Scientific</td><td>EK-10539</td><td></td></tr><tr><td>PrecisionGlide Needles, 27 G x 1 1/2 in</td><td>BD</td><td>301629</td><td></td></tr><tr><td>RIPA Buffer</td><td>Boston BioProducts</td><td>BP-115</td><td></td></tr><tr><td>RNAlater (RNA stabilization solution)</td><td>Thermo Fisher Scientific</td><td>AM7021</td><td></td></tr><tr><td>Safe-Lock Microcentrifuge Tubes, Polypropylene, 0.5 mL</td><td>Eppendorf</td><td>022363719</td><td>Autoclave prior to use</td></tr><tr><td>Safe-Lock Microcentrifuge Tubes, Polypropylene, 1.5 mL</td><td>Eppendorf</td><td>022363204</td><td>Autoclave prior to use</td></tr><tr><td>Saline - 0.9% Sodium Chloride Injection, bacteriostatic, 20 mL</td><td>Hospira</td><td>0409-1966-05</td><td></td></tr><tr><td>Scalpel Blades - #15</td><td>Fine Science Tools</td><td>10015-00</td><td></td></tr><tr><td>Schuknecht Suction Tube 24 gauge</td><td>Bausch + Lomb</td><td>N1698 42</td><td>Useful for the surgical approach (in addition to common otologic surgical instruments) and &lt;em&gt;e.g.&lt;/em&gt; a blue surgical marker</td></tr><tr><td>Specimen Container, OR sterile, 4OZ</td><td>Medline</td><td>DYND30331H</td><td></td></tr><tr><td>Stemi 2000-C Stereo Microscope</td><td>Zeiss</td><td>000000-1106-133</td><td></td></tr><tr><td>Syringe/Needle Combination, Luer-Lok Tip, 5 mL, 22 G x 1 in.</td><td>BD</td><td>309630</td><td></td></tr><tr><td>Tuberculin Syringe Only, Slip tip, 1 mL</td><td>BD</td><td>309659</td><td></td></tr><tr><td>Tuberculin Syringe Only, Slip tip, 3 mL</td><td>BD</td><td>309656</td><td></td></tr><tr><td>Ultrasonic homogenizer, 4710 Series, CV18 probe</td><td>Cole-Parmer</td><td>CP25013</td><td></td></tr></tbody></table>

a unified methodological framework for vestibular schwannoma research

前庭神経鞘腫は、脳脊髄の角度の最も一般的な新生物であり、すべての頭蓋内成長の6-8％を占める。これらの腫瘍は、冒された個体の最大95％において感音難聴を引き起こすが、この難聴の根底にある分子メカニズムは依然として分かり難い。この資料では、前庭神経鞘腫の研究に不可欠な下流の研究アプリケーションのための様々な初代ヒト組織サンプルの収集と処理を容易にするために、私たちの研究室で確立された手順を概説します。具体的には、この研究は、外科用試料からのシュワン細胞およびシュワン細胞腫細胞の収集、処理および培養のための統一された方法論的枠組みを記載する。これは、現在の研究にとって不可欠である平行処理工程と統合されています：腫瘍および神経分泌の収集、RNAの保存および収集された組織からのタンパク質の抽出、切片の調製のための組織の固定、d遺伝子療法への適用のためのアデノ随伴ウイルスへの一次ヒト細胞の曝露。さらに、この研究は、内耳および外リンパからヒトの感覚上皮を得る独特な機会として、この腫瘍を採取するためのトランスアラインメント手術アプローチを強調している。実験的品質を改善するためのヒントが提供され、一般的な落とし穴が強調表示されます。

セクション5で確立されているように、培養中の初代ヒトVS細胞は、多くの下流の研究アプリケーション（ 図1 ）において疾患関連プロセスの有益なモデルとして扱うことができる。第6節で培養された健康なシュワン細胞は、直接的で教示的な比較点を提供する。以下に概説するように、統一された方法論的フレームワークに従って処理されたVS?...

Watch this Scientific Journal Video about A Unified Methodological Framework for Vestibular Schwannoma Research at JoVE.com

A Unified Methodological Framework for Vestibular Schwannoma Research

このプロトコールの目的は、前庭神経鞘腫およびシュワン細胞研究における複数の下流適用のためのヒト外科用サンプルの収集および処理を概説することである。

前庭シュワン細胞腫研究のための統一方法論的枠組み

Vestibular schwannomas are the most common neoplasms of the cerebellopontine angle, making up 6-8% percent of all intracranial growths. Though these ...

a-unified-methodological-framework-for-vestibular-schwannoma-research

Research

JoVE Journal

Cancer Research

7.3K ビュー.  Massachusetts Eye and Ear. このプロトコールの目的は、前庭神経鞘腫およびシュワン細胞研究における複数の下流適用のためのヒト外科用サンプルの収集および処理を概説することである。 

ビデオ: A Unified Methodological Framework for Vestibular Schwannoma Research

Three Dimensional Vestibular Ocular Reflex Testing Using a Six Degrees of Freedom Motion Platform

The vestibular organ is a sensor that measures angular and linear accelerations with six degrees of freedom (6DF). Complete or partial defects in the vestibular organ results in mild to severe equilibrium problems, such as vertigo, dizziness, oscillopsia, gait unsteadiness nausea and/or vomiting. A good and frequently used measure to quantify gaze stabilization is the gain, which is defined as the magnitude of compensatory eye movements with respect to imposed head movements. To test vestibular function more fully one has to realize that 3D VOR ideally generates compensatory ocular rotations not only with a magnitude (gain) equal and opposite to the head rotation but also about an axis that is co-linear with the head rotation axis (alignment). Abnormal vestibular function thus results in changes in gain and changes in alignment of the 3D VOR response.
Here we describe a method to measure 3D VOR using whole body rotation on a 6DF motion platform. Although the method also allows testing translation VOR responses 1, we limit ourselves to a discussion of the method to measure 3D angular VOR. In addition, we restrict ourselves here to description of data collected in healthy subjects in response to angular sinusoidal and impulse stimulation.
Subjects are sitting upright and receive whole-body small amplitude sinusoidal and constant acceleration impulses. Sinusoidal stimuli (f = 1 Hz, A = 4&deg;) were delivered about the vertical axis and about axes in the horizontal plane varying between roll and pitch at increments of 22.5&deg; in azimuth. Impulses were delivered in yaw, roll and pitch and in the vertical canal planes. Eye movements were measured using the scleral search coil technique 2. Search coil signals were sampled at a frequency of 1 kHz.
The input-output ratio (gain) and misalignment (co-linearity) of the 3D VOR were calculated from the eye coil signals 3.
Gain and co-linearity of 3D VOR depended on the orientation of the stimulus axis. Systematic deviations were found in particular during horizontal axis stimulation. In the light the eye rotation axis was properly aligned with the stimulus axis at orientations 0&deg; and 90&deg; azimuth, but gradually deviated more and more towards 45&deg; azimuth.
The systematic deviations in misalignment for intermediate axes can be explained by a low gain for torsion (X-axis or roll-axis rotation) and a high gain for vertical eye movements (Y-axis or pitch-axis rotation (see Figure 2). Because intermediate axis stimulation leads a compensatory response based on vector summation of the individual eye rotation components, the net response axis will deviate because the gain for X- and Y-axis are different.
In darkness the gain of all eye rotation components had lower values. The result was that the misalignment in darkness and for impulses had different peaks and troughs than in the light: its minimum value was reached for pitch axis stimulation and its maximum for roll axis stimulation.
Case Presentation
Nine subjects participated in the experiment. All subjects gave their informed consent. The experimental procedure was approved by the Medical Ethics Committee of Erasmus University Medical Center and adhered to the Declaration of Helsinki for research involving human subjects.
Six subjects served as controls. Three subjects had a unilateral vestibular impairment due to a vestibular schwannoma. The age of control subjects (six males and three females) ranged from 22 to 55 years. None of the controls had visual or vestibular complaints due to neurological, cardio vascular and ophthalmic disorders.
The age of the patients with schwannoma varied between 44 and 64 years (two males and one female). All schwannoma subjects were under medical surveillance and/or had received treatment by a multidisciplinary team consisting of an othorhinolaryngologist and a neurosurgeon of the Erasmus University Medical Center. Tested patients all had a right side vestibular schwannoma and underwent a wait and watch policy (Table 1; subjects N1-N3) after being diagnosed with vestibular schwannoma. Their tumors had been stabile for over 8-10 years on magnetic resonance imaging.

A method is described to measure three-dimensional vestibulo ocular reflexes (3D VOR) in humans using a six degrees of freedom (6DF) motion simulator. The gain and misalignment of the 3D angular VOR provide a direct measure of the quality of vestibular function. Representative data on healthy subjects are provided

フリーダムモーションプラットフォーム度6を使用した三次元前庭眼反射テスト

The vestibular organ is a sensor that measures angular and linear accelerations with six degrees of freedom (6DF). Complete or partial defects in the ...

神経科学

An Isolated Semi-intact Preparation of the Mouse Vestibular Sensory Epithelium for Electrophysiology and High-resolution Two-photon Microscopy

Understanding vestibular hair cells function under normal conditions, or how trauma, disease, and aging disrupt this function is a vital step in the development of preventative approaches and/or novel therapeutic strategies. However, the majority of studies looking at abnormal vestibular function have not been at the cellular level but focused primarily on behavioral assays of vestibular dysfunction such as gait analyses and vestibulo-ocular reflex performance. While this work has yielded valuable data about what happens when things go wrong, little information is gleaned regarding the underlying causes of dysfunction. Of the studies that focus on the cellular and subcellular processes that underlie vestibular function, most have relied on acutely isolated hair cells, devoid of their synaptic connections and supporting cell environment. Therefore, a major technical challenge has been access to the exquisitely sensitive vestibular hair cells in a preparation that is least disrupted, physiologically. Here we demonstrate a semi-intact preparation of the mouse vestibular sensory epithelium that retains the local micro-environment including hair cell/primary afferent complexes.

Analysis of vestibular hair cell function is complicated by their location deep within the hardest part of the skull, the petrous temporal bone. Most functional hair cell studies have used acutely isolated hair cells. Here we describe a semi-intact preparation of mouse vestibular epithelium for electrophysiological and two-photon microscopy studies.

電気生理学および高分解能二光子顕微鏡用マウス前庭感覚上皮の切り抜き半無傷準備

Understanding vestibular hair cells function  under normal conditions, or how trauma, disease, and aging disrupt this  function is a vital step in the ...

Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction

The vestibular system provides information about head movement and mediates reflexes that contribute to balance control and gaze stabilization during daily activities. Vestibular sensors are located in the inner ear on both sides of the head and project to the vestibular nuclei in the brainstem. Vestibular dysfunction is often due to an asymmetry between input from the two sides. This results in asymmetrical neural inputs from the two ears, which can produce an illusion of rotation, manifested as vertigo. The vestibular system has an impressive capacity for compensation, which serves to rebalance how asymmetrical information from the sensory end organs on both sides is processed at the central level. To promote compensation, various rehabilitation programs are used in the clinic; however, they primarily use exercises that improve multisensory integration. Recently, visual-vestibular training has also been used to improve the vestibulo-ocular reflex (VOR) in animals with compensated unilateral lesions. Here, a new method is introduced for rebalancing the vestibular activity on both sides in human subjects. This method consists of five unidirectional rotations in the dark (peak velocity of 320&#176;/s) toward the weaker side. The efficacy of this method was shown in a sequential, double-blinded clinical trial in 16 patients with VOR asymmetry (measured by the directional preponderance in response to sinusoidal rotations). In most cases, VOR asymmetry decreased after a single session, reached normal values within the first two sessions in one week, and the effects lasted up to 6 weeks. The rebalancing effect is due to both an increase in VOR response from the weaker side and a decrease in response from the stronger side. The findings suggest that unidirectional rotation can be used as a supervised rehabilitation method to reduce VOR asymmetry in patients with longstanding vestibular dysfunction.

A new rehabilitation method is presented for rebalancing the vestibular system in patients with asymmetric responses, which consists of unidirectional rotations toward the weaker side. By directly modifying the vestibular pathway rather than enhancing the multisensory aspects of compensation, asymmetry can be normalized within 1-2 sessions and show lasting effects.

前庭機能不全患者における前庭系非対称性の改善に単方向回転を使用する

The vestibular system provides information about head movement and mediates reflexes that contribute to balance control and gaze stabilization during ...

行動学

Primary Culture of Human Vestibular Schwannomas

Vestibular schwannomas (VSs) represent Schwann cell (SC) tumors of the vestibular nerve, compromising 10% of all intracranial neoplasms. VSs occur in either sporadic or familial (neurofibromatosis type 2, NF2) forms, both associated with inactivating defects in the NF2 tumor suppressor gene. Treatment for VSs is generally surgical resection or radiosurgery, however the morbidity of such procedures has driven investigations into less invasive treatments. Historically, lack of access to fresh tissue specimens and the fact that schwannoma cells are not immortalized have significantly hampered the use of primary cultures for investigation of schwannoma tumorigenesis. To overcome the limited supply of primary cultures, the immortalized HEI193 VS cell line was generated by transduction with HPV E6 and E7 oncogenes. This oncogenic transduction introduced significant molecular and phenotypic alterations to the cells, which limit their use as a model for human schwannoma tumors. We therefore illustrate a simplified, reproducible protocol for culture of primary human VS cells. This easily mastered technique allows for molecular and cellular investigations that more accurately recapitulate the complexity of VS disease.

Vestibular Schwannomas (VSs) are non-malignant tumors of Schwann cell (SC) origin, associated with mutations in the NF2 tumor suppressor gene. We report a reproducible, efficient protocol for primary human VS cell culture that allows for molecular and cellular experimental manipulation and analysis and recapitulates the heterogeneous nature of human disease.

人間の前庭神経鞘腫の初代培養

Vestibular schwannomas (VSs) represent Schwann cell (SC) tumors of the vestibular nerve, compromising 10% of all intracranial neoplasms. VSs occur in ...

医学

In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Meni&#232;re's Disease Ears and Normal Hearing Ears

Analysis of neural structures in Meni&#232;re's Disease (MD) is of importance, since a loss of such structures has previously been proposed for this patient group but has yet to be confirmed. This protocol describes a method of in vivo evaluation of neural changes especially well suitable for cranial nerve analysis using magnetic resonance imaging (MRI). MD-patients and normal hearing persons were examined in a 3-T MR-scanner using a scan protocol including strongly T2-weighted 3D gradient-echo-sequence (3D-CISS). In the patient group, MD was additionally confirmed using MRI-based assessment of endolymphatic hydrops. Morphometric analysis was performed using a freeware DICOM viewer. Evaluation of cranial nerves included measurements of cross-sectional areas (CSAs) of the nerves at different levels as well as orthogonal diametric measurements.

To evaluate morphological changes of cranial nerves such as loss of neural structures or swelling of cranial nerves in Meni&#232;re&#39;s Disease (MD) or in healthy persons in vivo, a protocol of evaluation has been developed using magnetic resonance imaging (MRI). Additional MRI-based confirmation of MD was performed.

生体内でMenière の病気耳と健聴耳の磁気共鳴イメージ投射を使用して人間の脳神経の形態計測的解析

Analysis of neural structures in Meni&#232;re's Disease (MD) is of importance, since a loss of such structures has previously been proposed for this ...

Stochastic Noise Application for the Assessment of Medial Vestibular Nucleus Neuron Sensitivity In Vitro

Galvanic vestibular stimulation (GVS) has been shown to improve balance measures in individuals with balance or vestibular impairments. This is proposed to be due to the stochastic resonance (SR) phenomenon, which is defined as application of a low-level/subthreshold stimulus to a non-linear system to increase detection of weaker signals. However, it is still unknown how SR exhibits its positive effects on human balance. This is one of the first demonstrations of the effects of sinusoidal and stochastic noise on individual neurons. Using whole-cell patch clamp electrophysiology, sinusoidal and stochastic noise can be applied directly to individual neurons in the medial vestibular nucleus (MVN) of C57BL/6 mice. Here we demonstrate how to determine the threshold of MVN neurons in order to ensure the sinusoidal and stochastic stimuli are subthreshold and from this, determine the effects that each type of noise has on MVN neuronal gain. We show that subthreshold sinusoidal and stochastic noise can modulate the sensitivity of individual neurons in the MVN without affecting basal firing rates.

Galvanic vestibular stimulation in humans exhibits improvements in vestibular function. However, it is unknown how these effects occur. Here, we describe how to apply sinusoidal and stochastic electrical noise and evaluate appropriate stimulus amplitudes in individual medial vestibular nucleus neurons in the C57BL/6 mouse.

インビトロにおける中間前庭核感受性の評価のための確率的ノイズアプリケーション

Galvanic vestibular stimulation (GVS) has been shown to improve balance measures in individuals with balance or vestibular impairments. This is proposed ...

An Endoscopic Transcanal Transpromontorial Approach for Vestibular Schwannomas using a Computer-Based Three-Dimensional Imaging System

A 2D monocular endoscope has been used in transcanal transpromontory vestibular schwannoma surgery instead of craniotomy. However, the absence of depth perception is the limitation of this approach. With the loss of depth perception, the surgeon will be not able to perform delicate and particularly complicated surgery. A binocular endoscope has been developed to provide stereoscopic vision with better depth perception for complicated anatomic structures and has been applied in some endoscopic surgeries. However, the diameter of the endoscope is a limitation in the performance of transcanal otologic surgeries. A small diameter endoscope facilitates easier surgery in a restricted space. A computer-based 3D imaging system can obtain 3D images in real-time using a small monocular endoscope. In this study, to evaluate the feasibility of a computer-based 3D imaging system for endoscopic lateral skull base surgery, we applied this 3D imaging system in a transcanal transpromontorial approach in two patients with vestibular schwannomas. The surgical procedure was completed without complication in these two cases. There was no mortality, perioperative complications, nor notable postoperative complications. Using this computer-based 3D imaging system, a better depth perception and stereoscopic vision was observed compared to a conventional 2D endoscope. The improvement in depth perception offers superior management of the complicated surgical anatomy.

Here, we present a transcanal transpromontorial approach for vestibular schwannomas using a computer-based three-dimensional (3D) imaging system combined with a two-dimensional (2D) endoscope. This system provided stereoscopic vision, better depth perception and reduced visual fatigue. This 3D imaging system enabled the application of 3D vision technology in endoscopic lateral skull base surgery.

A 2D monocular endoscope has been used in transcanal transpromontory vestibular schwannoma surgery instead of craniotomy. However, the absence of depth ...

Assessment of Static Graviceptive Perception in the Roll-Plane using the Subjective Visual Vertical Paradigm

Vestibular disorders are among the most common syndromes in medicine. In recent years, new vestibular diagnostic systems have been introduced that allow the examination of all semicircular canals in the clinical setting. Assessment methods of the otolithic system, which is responsible for the perception of linear acceleration and perception of gravity, are far less in clinical use. There are several experimental approaches for measuring the perception of gravity. The most frequently used method is the determination of the subjective visual vertical. This is usually measured with the head in an upright position. We present here an assessment method for testing otolith function in the roll plane. The subjective visual vertical is measured in the head upright position as well as with head inclination of &#177; 15&#176; and &#177; 30&#176; in the roll plane. This extended functional paradigm is an easy-to-perform clinical test of otolith function and ensures increased information content for the detection of impaired graviceptive perception.

The perception of gravity is commonly determined by the subjective visual vertical in the head upright position. The additional assessment at head tilts of &#177; 15&#176; and &#177; 30&#176; in the roll plane ensures increased information content for the detection of impaired graviceptive perception.

主観的視覚的垂直パラダイムを用いたロールプレーンにおける静的なグラビゼーション知覚の評価

Vestibular disorders are among the most common syndromes in medicine. In recent years, new vestibular diagnostic systems have been introduced that allow ...

Measuring the Influence of Magnetic Vestibular Stimulation on Nystagmus, Self-Motion Perception, and Cognitive Performance in a 7T MRT

Strong magnetic fields induce dizziness, vertigo, and nystagmus due to Lorentz forces acting on the cupula in the semi-circular canals, an effect called magnetic vestibular stimulation (MVS). In this article, we present an experimental setup in a 7T MRT scanner (MRI scanner) that allows the investigation of the influence of strong magnetic fields on nystagmus as well as perceptual and cognitive responses. The strength of MVS is manipulated by altering the head positions of the participants. The orientation of the participants&#39; semicircular canals with respect to the static magnetic field is assessed by combining a 3D magnetometer and 3D constructive interference in steady-state (3D-CISS) images. This approach allows to account for intra- and inter-individual differences in participants&#8217; responses to MVS. In the future, MVS can be useful for clinical research, for example, in the investigation of compensatory processes in vestibular disorders. Furthermore, it could foster insights into the interplay between vestibular information and cognitive processes in terms of spatial cognition and the emergence of self-motion percepts under conflicting sensory information. In fMRI studies, MVS can elicit a possible confounding effect, especially in tasks influenced by vestibular information or in studies comparing vestibular patients with healthy controls.

In this article, we describe the experimental setup, material, and procedures to assess reflexive eye movements, self-motion perception, and cognitive tasks under magnetic vestibular stimulation, as well as the anatomical orientation of the vestibular organs, in a 7 Tesla Magnetic resonance tomography (7T-MRT) scanner.

磁気前庭刺激が眼振,自己運動知覚,認知能力に及ぼす影響の測定(7T MRT)

Strong magnetic fields induce dizziness, vertigo, and nystagmus due to Lorentz forces acting on the cupula in the semi-circular canals, an effect called ...

Surgical Treatment of an Endolymphatic Sac Tumor

Endolymphatic sac tumors (ELST) are low-grade papillary adenocarcinoma originating from the endolymphatic sac. Usually slow-growing, with local aggressiveness and a low risk of distant metastases, ELST can be sporadic but also frequently associated with von Hippel Lindau disease. The current treatment of ELST is primarily surgical resection. A 55-year-old woman accessed our otologic tertiary level referral center for a sudden worsening of hearing loss in her left ear and vertigo. A magnetic resonance (MRI) and computer tomography scan study subsequently showed a mass in the petrous bone; hence, the presence of an ELST was hypothesized. After embolization of the mass, the patient underwent surgical removal of the lesion. The resection of the mass was done through a translabirinthine approach, with an uneventful procedure. No residual disease remained after surgery. After 24 months of radiologic follow up with MRI, there are no signs of recurrence disease. This paper reports the management of this sporadic ELST, as well as the follow up results, providing clinicians this protocol for the handling of such a challenging otologic skull base surgery and rare disease.

Here, we discuss clinical and radiological features of endolymphatic sac tumors and report the methodology and results of a surgical removal in a case in care at our otologic referral center.