Viral Diseases

  • Yasuya Nomura
  • Yasuya Nomura
  • Yasuya Nomura


Some viral infections are known to cause sensorineural hearing loss, which may occur suddenly as an acute single insult, or insidiously with a slowly progressive course. When hearing loss occurs during the course of systemic viral infection, it will be apparent that the infection is responsible for the hearing loss. However, hearing loss is not uncommonly categorized as being of “unknown etiology” and left undiagnosed.

To promote better understanding of viral labyrinthitis, we will present human temporal bone histopathology and animal experiment results concerning three viruses: herpes simplex virus, cytomegalovirus, and mumps virus.

In human temporal bone specimens from patients with viral labyrinthitis, the degenerated tectorial membrane often becomes rolled-up and encapsulated on the limbus spiralis or in the inner sulcus. Such findings are seen in patients with mumps and measles. In experimental herpes simplex virus labyrinthitis in guinea pigs, a rolled-up tectorial membrane with viral antigen deposition has been observed, along with bulges of varying sizes in the tectorial membrane. These bulges were found on the surface of the membrane as well as within it. With electron microscopy, virions were observed in and around the bulges. Similar findings were observed in a patient with bilateral sudden deafness. Reactivation of latent HSV infection was suspected in that case. However, not all cases of viral labyrinthitis show changes in the tectorial membrane.


Cytomegalovirus Experimental viral labyrinthitis Herpes simplex virus Human temporal bone histopathology Mumps 


  1. 1.
    Hondo R, Kurata T, Nomura Y, Kanzaki J, Yanagita N, Koide J, Miyake H (1982) A seroepidemiological study of herpes simplex virus infection in the patients of sudden deafness. Otologia (Fukuoka) 28(Suppl 3):878–884Google Scholar
  2. 2.
    Kurata T, Hondo R, Sato S, Oda A, Aoyama Y, McCormick JB (1983) Detection of viral antigen in formalin-fixed specimens by enzyme treatment. Ann N Y Acad Sci 420:192–207PubMedCrossRefGoogle Scholar
  3. 3.
    Nomura Y, Kurata T, Saito K (1985) Sudden deafness. Human temporal bone studies and an animal model. In: Nomura Y (ed) Hearing and dizziness. Igaku-Shoin, Tokyo, pp 58–67Google Scholar
  4. 4.
    Nomura Y, Hara M, Kurata T (1988) Experimental herpes simplex virus and cytomegalovirus labyrinthitis. Acta Otolaryngol (Stockh) 457(Suppl):57–66CrossRefGoogle Scholar
  5. 5.
    Nomura Y, Kurata T, Saito K (1985) Cochlear changes after herpes simplex virus infection. Acta Otolaryngol (Stockh) 99:419–427CrossRefGoogle Scholar
  6. 6.
    Saito K, Kurata T, Nomura Y (1984) Ultrastructure of the membranous cochlea with herpes simplex virus. 1983 Annual report of acute profound sensorineural hearing loss study group. Ministry of Health, Labor and Welfare, pp 111–113Google Scholar
  7. 7.
    Wildy P, Russell WC, Horne RW (1960) The morphology of herpes virus. Virology 12:204–222PubMedCrossRefGoogle Scholar
  8. 8.
    Kurata T, Hondo R, Koide J, Nomura Y (1983) Experimental herpes simplex infection in the inner ear of guinea pig (IV). 1982 Annual report of acute profound sensorineural hearing loss study group. Ministry of Health, Labor and Welfare, pp 54–57Google Scholar
  9. 9.
    Saito K, Kurata T, Nomura Y (1985) Surface structure of the tectorial membrane with herpes simplex virus. 1984 Annual report of acute profound sensorineural hearing loss study group. Ministry of Health, Labor and Welfare, pp 165–168Google Scholar
  10. 10.
    Woolf NK (1990) Experimental congenital cytomegalovirus labyrinthitis and sensorineural hearing loss. Am J Otolaryngol 11:299–303PubMedCrossRefGoogle Scholar
  11. 11.
    Barbi M, Binda S, Caroppo S, Ambrosetti U, Corbetta C, Sergi P (2003) A wider role for congenital cytomegalovirus infection in sensorineural hearing loss. Pediatr Infect Dis J 22(1):39–42PubMedCrossRefGoogle Scholar
  12. 12.
    Koyano S, Inoue N, Oka A, Moriuchi H, Asano K, Ito Y, Yamada H, Yoshikawa T, Suzutani T (2011) Screening for congenital cytomegalovirus infection using newborn urine samples colleted on filter paper: feasibility and outcomes from a multicentre study. BMJ Open1:000118. doi: 10.1136/bmjopen-000118
  13. 13.
    Ogawa H, Suzutani T, Baba Y, Koyano S, Nozawa N, Ishibashi K, Fujieda K, Inoue N, Omori K (2007) Etiology of severe sensorineural hearing loss in children:independent impact of congenital cytomegalovirus infection and GJB2 mutations. J Infect Dis 195:782–788PubMedCrossRefGoogle Scholar
  14. 14.
    Myers EN, Stool S (1968) Cytomegalic inclusion disease of the inner ear. Laryngoscope 78:1904–1915PubMedCrossRefGoogle Scholar
  15. 15.
    Strauss M (1990) Human cytomegalovirus labyrinthitis. Am J Otolaryngol 11:292–298PubMedCrossRefGoogle Scholar
  16. 16.
    Davis LE, Spector GJ, Strauss M (1977) Cytomegalovirus endolabyrinthitis. Arch Pathol Lab Med 101:118–121PubMedGoogle Scholar
  17. 17.
    Katano H, Sato Y, Tsutsui Y, Sata T, Maeda A, Nozawa N, Inoue N, Nomura Y, Kurata T (2007) Pathogenesis of cytomegalovirus-associated labyrinthitis in a guinea pig model. Microbes Infect 9:183–191PubMedCrossRefGoogle Scholar
  18. 18.
    Nomura Y, Harada T, Hara M (1988) Viral infection and the inner ear. ORL J Otorhinolaryngol Relat Spec 50:201–211PubMedCrossRefGoogle Scholar
  19. 19.
    Saito K, Kurata T, Nomura Y (1988) Electron microscopic observations on the membranous cochlea after guinea pig cytomegalovirus infection. 1987 Annual report of the acute profound hearing loss study group. pp 47–49Google Scholar
  20. 20.
    Morgensen SC (1979) Role of macrophages in natural resistance to virus infections. Microbiol Rev 43:1–26Google Scholar
  21. 21.
    Nomura Y, Hara M, Okuno T, Yagi M, Kurata T, Nariuchi H (1989) Modality of endolymphatic hydrops. In: Nadol JB Jr (ed) Second international symposium on Meniere’s disease. Kugler Ghedini Publications, Amsterdam, Berkeley, Milano, pp 89–96Google Scholar
  22. 22.
    Harris JP, Fan ST, Keitley EM (1990) Immunologic responses in experimental cytomegalovirus labyrinthitis. Am J Otolaryngol 11:304–308PubMedCrossRefGoogle Scholar
  23. 23.
    Saunders WH, Lippy WH (1959) Sudden deafness and Bell’s palsy: a common cause. Ann Otol Rhinol Laryngol 68:830–837PubMedGoogle Scholar
  24. 24.
    Van Dishoeck HA, Bierman TA (1957) Sudden perceptive deafness and viral infection; Report of the first one hundred patients. Ann Otol Rhinol Laryngol 66:963–980Google Scholar
  25. 25.
    Lindsay JR, Davey PR, Ward PH (1960) Inner ear pathology in deafness due to mumps. Ann Otol Rhinol Laryngol 69:918–935PubMedGoogle Scholar
  26. 26.
    Smith GA, Gussen R (1976) Inner ear pathologic features following mumps infection. Report of a case in an adult. Arch Otolaryngol 102:108–111PubMedCrossRefGoogle Scholar
  27. 27.
    Tanaka K, Fukuda S, Suenaga T, Terayama Y (1988) Experimental mumps virus-induced labyrinthitis: immunohistochemical and ultrastructural studies. Acta Otolaryngol (Stockh) 456(Suppl):98–105CrossRefGoogle Scholar
  28. 28.
    Tanaka K, Fukuda S, Terayama Y, Toriyama M, Ishidoya J, Ito T, Sugiura A (1988) Experimental mumps labyrinthitis in monkeys (macaca irus)-Immunohistochemical and ultrastructural studies. Auris Nasus Larynx 15:89–96PubMedGoogle Scholar
  29. 29.
    Nomura Y (1988) Diagnostic criteria for sudden deafness, mumps deafness and perilymph fistula. Acta Otolaryngol (Stockh) 456(Suppl):7–8CrossRefGoogle Scholar
  30. 30.
    Sakata H, Tsurudome M, Hishiyama M, Ito Y, Sugiura A (1985) Enzyme-linked immunosorbent assay for mumps IgM antibody: comparison of IgM capture and indirect IgM assay. J Virol Methods 12:303–311PubMedCrossRefGoogle Scholar
  31. 31.
    Nomura Y, Harada T, Sakata H, Sugiura A (1988) Sudden deafness and asymptomatic mumps. Acta Otolaryngol (Stockh) 456(Suppl):9–11CrossRefGoogle Scholar
  32. 32.
    Okamoto M, Shitara T, Nakayama M, Takamiya H, Nishiyama K, Ono Y, Sano H (1994) Sudden deafness accompanied by asymptomatic mumps. Acta Otolaryngol 514(Suppl):45–48CrossRefGoogle Scholar
  33. 33.
    Fukuda S, Chida E, Kuroda T, Kashiwamura M, Inuyama Y (2001) An anti-mumps IgM antibody level in the serum of idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 28(Suppl):S3–S5PubMedCrossRefGoogle Scholar
  34. 34.
    Westmore GA, Pickard BH, Stern H (1979) Isolation of mumps virus from the inner ear after sudden deafness. Br Med J 1:14–15PubMedCrossRefGoogle Scholar
  35. 35.
    Okamoto M, Shitara T, Higuchi A, Nakahara M (1984) Comparison of unilateral deafness in mumps and sudden deafness patients. Clinical Otology 11:154–155Google Scholar
  36. 36.
    Azimi PH, Cramblett HG, Haynes RE (1969) Mumps meningoencephalitis in children. JAMA 207:509–512PubMedCrossRefGoogle Scholar
  37. 37.
    Mizushima N, Murakami Y (1986) Deafness following mumps: the possible pathogenesis and incidence of deafness. Auris Nasus Larynx 13(Suppl 1):55–57Google Scholar
  38. 38.
    Kanra C, Kara A, Cenqiz AB, Isik P, Ceyhan M, Atas A (2002) Mumps meningoencephalitis effect on hearing. Pediatr Infect Dis J 21:1167–1169PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2014

Authors and Affiliations

  • Yasuya Nomura
    • 1
  • Yasuya Nomura
    • 2
  • Yasuya Nomura
    • 3
  1. 1.The Society for Promotion of International Oto-Rhino-LaryngologyTokyoJapan
  2. 2.The University of TokyoTokyoJapan
  3. 3.Showa UniversityTokyoJapan

Personalised recommendations