Journal
OTOLOGY & NEUROTOLOGY
Volume 35, Issue 4, Pages 686-694Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MAO.0000000000000206
Keywords
Utricle; Benign paroxysmal positional vertigo; Saccule; Otolith organs; Cervical vestibular evoked myogenic potential; Ocular vestibular evoked myogenic potential; Otoconia
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Background The architecture of human otoconia has been only poorly understood up to now. Currently, it is assumed that otoconia contain a central core surrounded by a shell. Objectives To investigate the inner structure of human otoconia. Methods Human otoconia were investigated by environmental scanning electron microscopy (ESEM). The diffraction behavior was analyzed using X-ray techniques (XRD). Focused ion beam (FIB) slices of otoconia were investigated by transmission electron microscopy (TEM). The results were correlated with observations on degenerate human otoconia and decalcification experiments using ethylenediaminetetraacetic acid (EDTA). Artificial otoconia (calcite-gelatine and calcite-gelatine/agarose composites) were investigated in the same way and compared with human otoconia. Results Human otoconia represent highly mosaic-controlled calcite-based nanocomposites. The inner structure is composed of 3 + 3 branches with an ordered arrangement of nanocomposite particles and parallel orientation of fibrils. The surrounding belly is less ordered and appears more porous. Degenerate otoconia show a successive dissolution of the belly region exposing to the inner structure (branches) in later stages of degeneration. Artificial otoconia reveal identical chemical, crystallographic and morphologic patterns. They are, however, larger in size. Conclusion Human otoconia show an inner architecture consisting of a less dense belly region and 3 + 3 more dense branches meeting at a central point (center of symmetry). The differences in volume densities and the resulting solubility may play a role in BPPV. Artificial otoconia may serve as a model for further investigations.
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