Ultrastructural evidence for protection of the outer hair cells of the inner ear during intense noise exposure by application of the organic calcium channel blocker diltiazem.

Outer hair cells could be protected during intense noise exposure by the application of the calcium channel blocker diltiazem given before and after noise treatment. After various experimental approaches, the ultrastructural morphology was analysed for the different animal populations in the basal part of the second turn of the cochlea, which was the most destroyed area after an acute noise trauma caused by a gun shot (sound pressure at the ear drum 156 dB, frequency maximum between 4 and 6 kHz). Compared to untreated control specimens (experimental animal group I), the outer hair cells in the basal part of the second turn of the cochlea were mostly destroyed without any diltiazem application but after intense noise exposure (group II) or when the calcium channel blocker was given only before (group III) or only after an intense noise exposure (group IV). Only cellular debris of these receptor cells could be identified within this region of the cochlea at the electron-microscopic level. After diltiazem application before and after the intensive noise exposure (group V), the general morphology of the tissue was much better conserved and almost no destroyed outer hair cells were found. But nevertheless, the electron-microscopic analysis revealed that the cellular fine structure was altered. Compared to untreated control specimens, small invaginations were sometimes seen in the basolateral membranes of outer hair cells, and also the cuticular structures of the Deiters cells forming the lamina reticularis bulged into the outer hair cells. To get more information about possible physiological alterations, the amounts of precipitable calcium within the outer hair cells were determined by an image-processing system for the five different populations (groups I-V). The values obtained were compared to the calcium content in specimens which had received diltiazem without any additional noise exposure (group VI) and with an animal population which was exposed to a pure tone for 5 min at 90 dB (group VII). The results are discussed in respect of outer hair cell protection preventing morphological damage and/or physiological alterations.