A study of changes apparent in the spiral ligament on light microscopy has been made on 151 human temporal bones. Thirty-six ears with normal hearing were studied to establish age changes through eight decades. The normal ligament showed a progressive loss of fibrocytes and increasing areas of acellularity but little variation in ligament width. Of 42 otosclerotic ears studied, 20 showed involvement of the cochlear endosteum with spiral ligament atrophy. Audiograms available on 11 of these ears showed a sensorineural loss with a descending pattern. Stapes fixation was present in each case. Fifteen ears with sensorineural hearing loss of a descending pattern due to aging were found to have severe spiral ligament atrophy. Four of these patients had cochlea duct ruptures and gave a history of rapid onset of profound hearing loss before death.
Wright JL, Schuknecht HF. Atrophy of the Spiral Ligament. Arch Otolaryngol. 1972;96(1):16–21. doi:10.1001/archotol.1972.00770090054005
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