Wells, Meher D.; (1990) A clinico-pathological study of the ear in fetuses and neonates. Doctoral thesis (M.D), University of London, University College Hospital Medical School.

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Abstract

There are important causes of impairment of hearing which affect the fetus in utero. Little work has been done on the histopathology of the fetal temporal bone. One of the main reasons has been that the conventional processing technique is very slow. A new technique for the study of temporal bone pathology is described and used in many of the temporal bones studied. The new method which utilises an annular saw is quick and allows thin slices of fixed bone to be cut. Close examination of the microslices and radiological examination of these slices is hence possible. Utilising the new technique histological changes in the normal development of the ear are described based on the findings of 22 fetuses of healthy mothers where the pregnancy was terminated on social and/or psychological grounds at well established gestational periods; 18 spontaneous abortions and 10 premature births were also studied. The changes observed were consistent with those of previous workers using the conventional processing techniques. Histological changes in the normal development of the fetal ear may be used as a new and additional factor in determining fetal age. The histological appearances in 171 temporal bones <108 cases) from fetuses, neonates and stillbirths at post mortem examination have been studied with a view to increasing the understanding of the pathology in congenital deafness. The absorption of embryonic mesenchyme in the middle ear has been studied in detail and its persistence is adduced as a factor in the early onset of secretory otitis media in premature infants and those with Down's Syndrome. The histopathological changes of the temporal bones in early maternal Rubella infection were those of delay and failure of maturation and degenerative changes in later months of pregnancy. Temporal bone observations which have not been previously described include those in cases of spina bifida which included abnormalities of the stapes and cochlea which should alert clinicians to the possibility of deafness in these children. Fetal temporal bones in Treacher-Collins Syndrome, Edwards' Syndrome, Potter's Syndrome and anticonvulsant drugs during pregnancy have also been presented for the first time.

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