Academic literature on the topic 'Saccule and Utricle'

AbstractRecent advances in vestibular testing now permit functional testing of all peripheral vestibular sense organs (all three semicircular canals, utricle, and saccule). This makes it possible to identify patients with isolated dysfunction of the utricle or saccule, even though parallel pathways for vestibular information are ultimately integrated centrally. Selective, isolated unilateral loss of utricular function as measured by ocular vestibular-evoked myogenic potentials (VEMPs) has been observed in patients with normal semicircular canal function as measured by the video head impulse test of all six semicircular canals, and normal bilateral saccular function as determined by symmetrical cervical VEMPs. How these patients present clinically and how they recover is discussed and contrasted with acute vestibular neuritis. In some patients, the unilateral loss of otolith organ (utricle or saccule) function persists and yet the patient recovers functionally to their usual lifestyle. Until the testing of all peripheral vestibular sense organs is routine, the frequency of isolated loss of otolith function cannot be gauged.

The auditory system of the plainfin midshipman fish (<i>Porichthys notatus</i>) is an important sensory system used to detect and encode biologically relevant acoustic stimuli important for survival and reproduction including social acoustic signals used for intraspecific communication. Previous work showed that hair cell (HC) density in the midshipman saccule increased seasonally with reproductive state and was concurrent with enhanced auditory saccular sensitivity in both females and type I males. Although reproductive state-dependent changes in HC density have been well characterized in the adult midshipman saccule, less is known about how the saccule changes during ontogeny. Here, we examined the ontogenetic development of the saccule in four relative sizes of midshipman (larvae, small juveniles, large juveniles, and nonreproductive adults) to determine whether the density, total number, and orientation patterns of saccular HCs change during ontogeny. In addition, we also examined whether the total number of HCs in the saccule differ from that of the utricle and lagena in nonreproductive adults. We found that HC density varied across developmental stage. The ontogenetic reduction in HC density was concurrent with an ontogenetic increase in macula area. The orientation pattern of saccular HCs was similar to the standard pattern previously described in other teleost fishes, and this pattern of HC orientation was retained during ontogeny. Lastly, the estimated number of saccular HCs increased with developmental stage from the smallest larvae (2,336 HCs) to the largest nonreproductive adult (145,717 HCs), and in nonreproductive adults estimated HC numbers were highest in the saccule (mean ± SD = 28,479 ± 4,809 HCs), intermediate in the utricle (mean ± SD = 11,008 ± 1,619 HCs) and lowest in the lagena (mean ± SD = 4,560 ± 769 HCs).

Attention is directed towards the recently developed unilateral tests of saccular and utricular function. Together with the now widely used head-thrust test and the standard caloric test for semicircular canal function, these provide for a more comprehensive unilateral examination of labyrinth function. The efficacy of vestibular evoked myogenic potentials (VEMP) as a direct unilateral test of saccular function is currently being demonstrated in an increasing number of reports. Furthermore, the relevant neuronal pathways have been delineated in animal studies, so that all evidence points to the validity of the VEMP as a saccule-mediated response. Concerning utricular function, considerable headway has been made using the unilateral centrifugation paradigm. Testing is performed with a variable radius rotary chair with constant velocity rotation about the earth-vertical axis. Displacing the head by 3.5–4 cm from the rotation axis, the eccentrically positioned utricle is stimulated unilaterally by the resultant centrifugal force. This paradigm can be employed to elicit a utriculo-ocular response (UOR) or to permit measurement of the subjective visual vertical (SVV). More recently, it has also been demonstrated that testing during normal, on-centre yaw axis rotation is often sufficient to localise peripheral otolith dysfunction by means of SVV estimation. This test mode can be easily integrated into routine clinical testing. To illustrate the efficacy of such differential testing, the findings from two patients are presented that demonstrate for the first time an isolated unilateral utricular dysfunction.

From animal experiments by Cohen and Suzuki et al. in the 1960s to the first-in-human clinical trials now in progress, prosthetic electrical stimulation targeting semicircular canal branches of the vestibular nerve has proven effective at driving directionally appropriate vestibulo-ocular reflex eye movements, postural responses, and perception. That work was considerably facilitated by the fact that all hair cells and primary afferent neurons in each canal have the same directional sensitivity to head rotation, the three canals’ ampullary nerves are geometrically distinct from one another, and electrically evoked three-dimensional (3D) canal-ocular reflex responses approximate a simple vector sum of linearly independent components representing relative excitation of each of the three canals. In contrast, selective prosthetic stimulation of the utricle and saccule has been difficult to achieve, because hair cells and afferents with many different directional sensitivities are densely packed in those endorgans and the relationship between 3D otolith-ocular reflex responses and the natural and/or prosthetic stimuli that elicit them is more complex. As a result, controversy exists regarding whether selective, controllable stimulation of electrically evoked otolith-ocular reflexes (eeOOR) is possible. Using micromachined, planar arrays of electrodes implanted in the labyrinth, we quantified 3D, binocular eeOOR responses to prosthetic electrical stimulation targeting the utricle, saccule, and semicircular canals of alert chinchillas. Stimuli delivered via near-bipolar electrode pairs near the maculae elicited sustained ocular countertilt responses that grew reliably with pulse rate and pulse amplitude, varied in direction according to which stimulating electrode was employed, and exhibited temporal dynamics consistent with responses expected for isolated macular stimulation. NEW & NOTEWORTHY As the second in a pair of papers on Binocular 3D Otolith-Ocular Reflexes, this paper describes new planar electrode arrays and vestibular prosthesis architecture designed to target the three semicircular canals and the utricle and saccule. With this technological advancement, electrically evoked otolith-ocular reflexes due to stimulation via utricle- and saccule-targeted electrodes were recorded in chinchillas. Results demonstrate advances toward achieving selective stimulation of the utricle and saccule.

The otolith mass of the saccules and utricles of plaice, Pleuronectes platessa (n = 39) and turbot, Psetta maxima (n = 21) was measured using an electronic microbalance. In the right-eyed plaice, the left utricular otoliths were found to be significantly heavier than the right (p < 0.0001), whereas no significant difference was found between left and right saccular otoliths (p < 0.751). In the left-eyed turbot, both the right utricular and saccular otoliths were found to be significantly heavier (in both cases, p < 0.0001). While the gene and regulative protein responsible for the peripheral biomineralisation process have been identified, it remains unclear how the symmetry between the right and left otoliths in fish species is regulated. Here it is likely that an additional central mechanism is involved. It must be assumed that similar processes govern the systematic asymmetry observed in flatfish such as the plaice and turbot. Taken together these findings are strongly suggestive of concomitant CNS modification and metamorphic plasticity, presumably represented in genetic code.

This study was performed to determine the area in which and the circumstances under which stapedotomy can be relatively safely performed. Measurements were made from central areas of the medial surface of the stapedial footplate to the utricle, the saccule, and the cochlear duct in 10 normal and 11 otosclerotic temporal bones. The mean distances to the utricle ranged from 1.9 to 2.4 mm, and those to the saccule from 1.7 to 2.1 mm. The minimal distance to the utricle was measured from the posterior (0.58 mm) and superior (0.62 mm) borders of the stapedial footplate. The minimal distances to the saccule were from the anterior (0.76,0.86, and 1.00 mm) border of the stapedial footplate. All other measurements were of more than 1 mm. The shortest distance between the cochlear duct and the inferior border of the footplate was 0.2 mm. Statistical analysis has shown no significant differences for the mean values obtained in normal and otosclerotic temporal bones. Fathoming of the vestibule below the central and inferior thirds of the footplate surface has shown that there is no likely danger to the vestibular end organs or cochlear duct if manipulations are carried out no deeper than 1 mm below the surface. The safest place for a stapedotomy opening is in the central and inferior-central thirds of the footplate. A stapedotomy piston of 0.4 mm in diameter can be introduced relatively safely to a depth of 0.5 mm in the vestibule over the entire surface of the stapedial footplate.

The Otx1 and Otx2 genes are two murine orthologues of the Orthodenticle (Otd) gene in Drosophila. In the developing mouse embryo, both Otx genes are expressed in the rostral head region and in certain sense organs such as the inner ear. Previous studies have shown that mice lacking Otx1 display abnormal patterning of the brain, whereas embryos lacking Otx2 develop without heads. In this study, we examined, at different developmental stages, the inner ears of mice lacking both Otx1 and Otx2 genes. In wild-type inner ears, Otx1, but not Otx2, was expressed in the lateral canal and ampulla, as well as part of the utricle. Ventral to the mid-level of the presumptive utricle, Otx1 and Otx2 were co-expressed, in regions such as the saccule and cochlea. Paint-filled membranous labyrinths of Otx1−/− mutants showed an absence of the lateral semicircular canal, lateral ampulla, utriculosaccular duct and cochleosaccular duct, and a poorly defined hook (the proximal part) of the cochlea. Defects in the shape of the saccule and cochlea were variable in Otx1−/− mice and were much more severe in an Otx1−/−;Otx2(+/)- background. Histological and in situ hybridization experiments of both Otx1−/− and Otx1−/−;Otx2(+/)- mutants revealed that the lateral crista was absent. In addition, the maculae of the utricle and saccule were partially fused. In mutant mice in which both copies of the Otx1 gene were replaced with a human Otx2 cDNA (hOtx2(1)/ hOtx2(1)), most of the defects associated with Otx1−/− mutants were rescued. However, within the inner ear, hOtx2 expression failed to rescue the lateral canal and ampulla phenotypes, and only variable rescues were observed in regions where both Otx1 and Otx2 are normally expressed. These results suggest that both Otx genes play important and differing roles in the morphogenesis of the mouse inner ear and the development of its sensory organs.

As part of the inner ear, the vestibular system is responsible for sense of balance, which consists of three semicircular canals, the utricle, and the saccule. Increasing evidence has indicated that the noncanonical Wnt/PCP signaling pathway plays a significant role in the development of the polarity of the inner ear. However, the role of canonical Wnt signaling in the polarity of the vestibule is still not completely clear. In this study, we found that canonical Wnt pathway-related genes are expressed in the early stage of development of the utricle and change dynamically. We conditionally knocked out β-catenin, a canonical Wnt signaling core protein, and found that the cilia orientation of hair cells was disordered with reduced number of hair cells in the utricle. Moreover, regulating the canonical Wnt pathway (Licl and IWP2) in vitro also affected hair cell polarity and indicated that Axin2 may be important in this process. In conclusion, our results not only confirm that the regulation of canonical Wnt signaling affects the number of hair cells in the utricle but also provide evidence for its role in polarity development.

Background: The otoliths act as gravito-inertial force sensors and contribute to the perception of spatial orientation. The perception of gravitational vertical can be assessed by asking a subject to adjust a light bar to the vertical. Prior to clinical use of the SVV (subjective visual vertical) test, normative data and test-retest reliability must be established. Purpose: To obtain normative data and d etermine the test-retest reliability for the SVV test performed in static and dynamic test conditions. Research Design: A descriptive design was used to obtain normative data. Study Sample: Twenty-four young adults with no history of neurological disease, middle-ear pathology, open or closed head injury, cervical injury, or audiovestibular disorder participated in the study. Data Collection and Analysis: The SVV angle was measured in the static position and in three dynamic conditions: (1) on-axis clockwise (CW) rotation, (2) off-axis CW rotation of right ear, and (3) off-axis CW rotation of left ear. Results: In young healthy individuals, the SVV was Conclusions: The normative data obtained in this study may be useful in identifying patients with chronic utricular dysfunction. We recommend the use of difference angles (on-axis SVV ‐ off-axis SVV) to remove baseline bias and decrease the variability of the SVV angles for the off-axis conditions.

Young adults are more likely to suffer blast injury and traumatic brain injury (TBI) than other age groups. This article reviews the literature on the vestibular consequences of blast exposure and TBI and concussion. In addition, the vestibular test findings obtained from 31 veterans with a history of blast exposure and/or mild TBI are presented. The authors discuss loss of horizontal semicircular canal function and postural instability related to head injury. Preliminary data suggest the novel theory that otolith organs are uniquely vulnerable to head injury and blast exposure.

L’instabilité posturale est fréquente chez les séniors et peut entrainer la chute. La chute chez les séniors est un problème majeur de santé publique. Les chiffres épidémiologiques sont éloquents : une personne sur trois âgées de plus de 70 ans fera une chute dans l’année. Les causes sont multifactorielles : ostéo-articulaire, visuelle, cognitive, vestibulaire…. Dans cette étude, nous nous sommes intéressés à l’évolution de la fonction des récepteurs vestibulaires périphériques avec l’âge et à la perception de rotation à partir des entrées canalaires horizontales (système vestibulaire central et projections vestibulaires corticales). Notre but est d’essayer de comprendre l’implication du vieillissement du système vestibulaire dans l’instabilité posturale des séniors. Au niveau périphérique, nous avons quantifié la fonction des canaux semi-circulaires horizontaux par le test calorique et le vidéo-head impulse test. La fonction des récepteurs otolithiques (utriculaire et sacculaire) a été évaluée par les potentiels évoqués myogéniques recueillis au niveau cervical (voies sacculo-spinales) et oculaire (voies utriculo-oculaires). Au niveau central, la perception de l’entrée vestibulaire canalaire horizontale a été appréciée après irrigation à l’eau chaude du conduit auditif externe en appliquant un score de perception (présence ou absence de sensation rotatoire). Finalement, l’équilibre a été quantifié grâce au test d’organisation sensorielle sur l’Equitest et grâce à un système que nous avons récemment mis au point en collaboration avec le Professeur Curthoys à Sydney, comprenant une Wii Balance Board, un tapis mousse et un masque de réalité virtuelle (Oculus Rift). Les résultats ont montré une diminution des réponses oculaires au test calorique après 70 ans mais une absence de baisse du gain du réflexe vestibulo-oculaire horizontal au vidéo-head impulse test. La fonction otolithique, sacculaire et utriculaire, est altérée avec l’âge quelle que soit la stimulation utilisée (aérienne ou osseuse). La perception de l’entrée vestibulaire canalaire horizontale induite par une stimulation calorique nous a permis de montrer pour la première fois que certains séniors ne percevaient pas la sensation de rotation malgré une réponse oculaire normale (vitesse maximale de la phase lente du nystagmus oculaire supérieure à 15°/s). Dans notre population, nous avons pu ainsi définir deux types de séniors : un groupe présentant une perception de vertige rotatoire et un groupe « négligeant » ne pouvant pas reconstruire une sensation rotatoire à partir des entrées vestibulaires canalaires horizontales. La comparaison de ces deux groupes de séniors appariés sur l’âge ne montre aucune différence de la fonction canalaire horizontale ni de la fonction otolithique sacculaire et utriculaire. Néanmoins, les séniors négligents présentent en majorité des performances anormales (chute ou score diminué) à l’Equitest notamment en conditions 5 et 6. De plus, leur score au DHI est plus élevé relevant ainsi le handicape ressenti par ces séniors à cause de leur instabilité. En conclusion, les troubles de l’équilibre chez certains seniors pourraient résulter en partie d’une dysfonction vestibulaire centrale. Des études ultérieures permettront de déterminer si l’augmentation du seuil de perception rotatoire est un bon facteur prédictif du risque de chute
Postural instability is common in seniors and can lead to falls which seniors are a major problem for Public Health. Epidemiological studies clearly show the magnitude of this problem: one in three people aged than more 70 years will fall in a year. This is caused by multiple factors including: musculoskeletal, visual, cognition, vestibular… The present study concerns the effect of age on the vestibular peripheral receptors function and on the perception of rotation from horizontal canal inputs (central vestibular processing and vestibular cortical projection). The aim is to try to understand the vestibular mechanisms involved in postural instability and mobility with age. At the peripheral level, the horizontal canal function was assessed using caloric test and video-Head Impulse Test. Otolith function (saccular and utricular) was assessed using vestibular evoked myogenic potentials recorded at cervical level (sacculo-spinal pathways) and at ocular level (utriculo-ocular pathways). At the central level, perception of motion from vestibular horizontal canal inputs was studied after caloric stimulation with warm water using a subjective perceptual score (presence or absence of rotatory vertigo). Finally, postural equilibrium was assessed with the Sensory Organization Test on the Equitest machine and also with a new system developed in collaboration with Prof. Curthoys (Sydney) using a Wii Balance Board, a foam rubber pad and a virtual reality headset (Oculus Rift DK2). Results showed decreased ocular responses induced by caloric stimulation after 70 years of age but healthy horizontal gain of the vestibulo-ocular reflex assessed by video-head impulse testing. The otolithic (saccular and utricular) function is impaired with age for all the stimuli used (air or bone conducted). Perception of motion induced by caloric stimulation (vestibular horizontal canal inputs) allowed us to show for the first time that some seniors are unable to feel the induced rotatory vertigo even with normal ocular responses (peak of the slow phase eye velocity higher than 15°/s). We defined two types of seniors: one senior group having a normal feeling of vertigo and one senior ‘neglect’ group who did not feel any sensation of rotation from horizontal canal inputs. The comparison of these two age-matched groups showed no difference in horizontal canal function, or otolithic function. The majority of the ‘neglect’ seniors with an absence of perception exhibited falls or a decreased score in conditions 5 and 6 during the Equitest. Moreover, their DHI scores were higher, showing the handicap induced by postural instability in these seniors. In conclusion, postural instability and falls in seniors may result from central vestibular impairment (inadequate central processing). A prospective study is needed to determine whether the increase perceptual threshold of rotation could be a good predictor of fall risk in seniors

After his groundbreaking work in the mid-1860s, Josef Breuer continued to perform experiments on the inner ear balance receptors in animals. He studied the macules of fish, reptiles, and birds and noted that all these creatures had three macules arranged in the planes of the semicircular canals, perpendicular to one another. By contrast, mammals had only two macules located in the utricle (horizontal plane) and saccule (vertical plane), again perpendicular to each other. He developed the concept of “slip” to describe the movement of the otoconial membrane over the underlying sensory epithelium that occurred with linear displacement or gravity. He developed a mathematical model to hypothesize that in humans there was only one combination of responses from the two macules on each side for a single head position in space.

The inner ear contains three major sensory receptors: the crista of the semicircular canals for sensing angular acceleration, the macule of the utricle and saccule for sensing linear acceleration, and the organ of Corti of the cochlea for sensing sound. Vertigo is an illusion of movement—usually spinning or turning but occasionally linear movement or tilt. Abnormalities of the inner ear or its connections in the brain cause an illusion of movement—vertigo. Benign paroxysmal positional vertigo (BPPV) is by far the most common cause of vertigo. Sudden violent spells of spinning are triggered by a change in position, such as turning over in bed, getting in and out of bed, and extending the head back to look up. This book tells the story of how the cause of BPPV was discovered and how a simple bedside cure was developed.