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Biopsy Technique and Identification of Endolympathic Sac Epithelium

I. Kaufman Arenberg, MD; Diane H. Norback, MD, PhD; George E. Shambaugh, Jr, MD

Arch Otolaryngol. 1982;108(5):292-298.

Abstract
• This study describes the technique and instrumentation necessary to perform a double-wall biopsy of the endolymphatic sac (ELS). Since this technique protects the lumen of the ELS, which is within the center of the biopsy sample surrounded by the lateral and medial wall, the ultrastructure of the ELS epithelium, luminal contents, and perisaccular connective tissue tends to represent the in vivo status. The biopsy specimen can be analyzed by electron microscopy for clinical-pathologic correlation. Ultrastructural analysis (1) provides definite identification of the ELS and epithelium, (2) may provide insight into a possible role of the ELS in the pathogenesis of endolymphatic hydrops, and (3) can provide much improved clinical-pathologic correlation over only light microscopic studies.

(Arch Otolaryngol 1982;108:292-298)

Author Affiliations
From the International Meniere's Disease Research Institute of the Colorado Otologic Research Center (CORC), Porter Memorial Hospital-Swedish Medical Center, Denver (Dr Arenberg); the Department of Pathology, the University of Wisconsin Hospitals and Clinics, Clinical Sciences Center, and the William S. Middleton Veterans Hospital, Madison, Wis (Dr Norback); and the Department of Otolaryngology and Maxillofacial Surgery, Northwestern University Medical School, Evanston, Ill, and the Shambaugh Ear Institute, Hinsdale, Ill (Dr Shambaugh).

Footnotes
Accepted for publication July 31, 1981.

Read in part before the American Neurotologic Society Meeting, Los Angeles, March 31, 1979. Reprint requests to Colorado Otologic Research Center, 2525 S Downing Ave, Denver, CO 80210 (Dr Arenberg).

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ABSTRACT