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Hisaki Fukushima, MD; Sebahattin Cureoglu, MD; Patricia A. Schachern, BS; Michael M. Paparella, MD; Tamotsu Harada, MD; Mehmet F. Oktay, MD

Arch Otolaryngol Head Neck Surg. 2006;132:934-938.

Objective  To evaluate the effects of type 2 diabetes mellitus on cochlear elements in humans.

Design  Comparative study of the histopathologic characteristics of human temporal bones.

Setting  Otopathology laboratory in a tertiary academic medical center.

Patients  Temporal bones from 18 patients with type 2 diabetes mellitus were divided into 2 groups according to the method of management of diabetes: insulin in 11 patients (mean age, 51.9 years; age range, 44-65 years) and oral hypoglycemic agents in 7 patients (mean age, 54.4 years; age range, 45-64 years). The diabetic groups and 26 age-matched controls (mean age, 52.9 years) were examined using light microscopy, and the cochlear changes were compared between groups.

Main Outcome Measures  Morphometric measurements of vessel wall thickness in the basilar membrane and stria vascularis were made in all turns of the cochlea at the midmodiolar level. Area measurements of the stria vascularis were made in all turns of the cochlea at the midmodiolar level. Cochlear reconstructions and standard cytocochleograms were prepared using an oil immersion objective. The number of spiral ganglion cells was determined for each segment of the cochlea. Comparisons were made in each segment between diabetic and control groups.

Results  In the insulin group, walls of the vessels of the basilar membrane and stria vascularis in all turns were significantly thicker than those of controls. Walls of the vessels of the stria vascularis in the basal turn were also significantly thicker in the oral hypoglycemic group than in controls. Atrophy of the stria vascularis in most turns of the insulin group and the lower middle turn of the oral hypoglycemic group was significantly greater than in the controls. Loss of cochlear outer hair cells was significantly greater in the lower and upper basal turns in both diabetic groups. No significant difference was found in the number of spiral ganglion cells or inner hair cells between groups.

Conclusion  This study demonstrates that cochlear microangiopathy and degeneration of the stria vascularis and cochlear outer hair cells are found in patients with type 2 diabetes mellitus.

Author Affiliations: International Hearing Foundation (Drs Fukushima, Cureoglu, Paparella, and Oktay), Department of Otolaryngology, Otitis Media Research Center, University of Minnesota (Drs Cureoglu and Paparella and Ms Schachern), and Minnesota Ear, Head and Neck Clinic (Dr Paparella), Minneapolis; and Department of Otolaryngology, Kawasaki Medical School, Kurashiki, Japan (Drs Fukushima and Harada).

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