Overall, the researchers hope that a better understanding of these mechanisms may help in devising ways to counteract various kinds of hearing impairment -- either through mechanical aids such as improved cochlear implants, or medical interventions such as drugs that may alter the nanopores or the properties of the fluid in the tectorial membrane
. "If the size of the pores is important for the functioning of hearing, there are things you could do," Freeman says.
(2,6) Additionally, the tectorial membrane is typically intact and firmly attached both to the clivus and at its inferior attachment at the posterior mid axis body.
MRI will best show typically high T1 methemoglobin extending distal to the mid-axis body, overlying the intact, uninjured tectorial membrane at the craniocervical junction.
The principal stabilisers of the CCJ are the tectorial membrane, transverse ligament and the alar ligaments (1) (see Fig.
Only a few of these patients proceed to have MRI studies performed, where direct demonstration of tectorial membrane injury and REH is made possible.
MRI was performed to evaluate the soft tissues, which demonstrated multiple injuries of the main stabilizing ligaments, including complete disruption of the left alar and left transverse ligament, and focal disruption of the left side of the tectorial membrane
. Edema was present in the bilateral facet joints at the AOJ, C1-C2, and C2-C3, reflecting mild capsular disruption.
Furthermore, the maturation of reinnervation of the regenerated HCs and the function of the reformed ribbon synapse remain open to question, such as the contact between stereocilium and tectorial membrane
, reorganization of the innervation of afferent Type I and Type II spiral ganglion neuron, and the integral interplay of outer hair cell based cochlear amplification.
(Figure 7) MRI can show injuries that involve the articular capsules, tectorial membrane
, and other atlantoaxial ligaments.