Endolymphatic hydrops and Ménière's disease: a lesion meta-analysis

Pender, Daniel J.

doi:10.1017/s0022215114001972

Cited by 78 publications

(51 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The differences found in the substructures do not necessarily reflect visually perceptible differences. Research has been performed into the histopathology of MD (4, 21) also using proteomic techniques (22) and qualitative imaging techniques (7). This might provide an explanation for the observed differences in image features.…”

Section: Discussionmentioning

confidence: 99%

“…A distension, herniation, and rupture of the endolymph compartment were not necessarily confined to the cochlea. Pathologic changes were found to be present in the whole labyrinth, though the canals and common crus were affected the least (21). In another study, it was suggested that an inflammatory or autoimmune reaction in the inner ear may cause damage to the epithelial layers surrounding the endolymphatic space (22).…”

Section: Discussionmentioning

confidence: 99%

“…Results found in this study correspond with these findings, since a significant difference was found in all the substructures of the labyrinth. However, a meta-analysis of temporal bone reports showed that the lesion distribution was orderly from the cochlea to the saccule, utricle, ampullae, and then the canal system (21). In our study, we did not find this order, since there were more statistically significant image features in, for example, the anterior semicircular canal than in the cochlea.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

An Exploratory Study to Detect Ménière’s Disease in Conventional MRI Scans Using Radiomics

et al. 2016

View full text Add to dashboard Cite

ObjectiveThe purpose of this exploratory study was to investigate whether a quantitative image analysis of the labyrinth in conventional magnetic resonance imaging (MRI) scans using a radiomics approach showed differences between patients with Ménière’s disease (MD) and the control group.Materials and methodsIn this retrospective study, MRI scans of the affected labyrinths of 24 patients with MD were compared to the MRI scans of labyrinths of 29 patients with an idiopathic asymmetrical sensorineural hearing loss. The 1.5- and 3-T MRI scans had been previously made in a clinical setting between 2008 and 2015. 3D Slicer 4.4 was used to extract several substructures of the labyrinth. A quantitative analysis of the normalized radiomic image features was performed in Mathematica 10. The image features of the two groups were statistically compared.ResultsFor numerous image features, there was a statistically significant difference (p-value <0.05) between the MD group and the control group. The statistically significant differences in image features were localized in all the substructures of the labyrinth: 43 in the anterior semicircular canal, 10 in the vestibule, 22 in the cochlea, 12 in the posterior semicircular canal, 24 in the horizontal semicircular canal, 11 in the common crus, and 44 in the volume containing the reuniting duct. Furthermore, some figures contain vertical or horizontal bands (three or more statistically significant image features in the same image feature). Several bands were seen: 9 bands in the anterior semicircular canal, 1 band in the vestibule, 3 bands in the cochlea, 0 bands in the posterior semicircular canal, 5 bands in the horizontal semicircular canal, 3 bands in the common crus, and 10 bands in the volume containing the reuniting duct.ConclusionIn this exploratory study, several differences were found in image features between the MD group and the control group by using a quantitative radiomics approach on high resolution T2-weighted MRI scans of the labyrinth. Further research should be aimed at validating these results and translating them in a potential clinical diagnostic method to detect MD in MRI scans.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An Exploratory Study to Detect Ménière’s Disease in Conventional MRI Scans Using Radiomics

et al. 2016

View full text Add to dashboard Cite

show abstract

“…This shift in the mean threshold suggests that trauma occurring during the surgery damaged the inner ear in patients with MD. Among the temporal bones of donors diagnosed with definitive MD [18] , endolymphatic hydrops was found to occur in the cochlea. Whether this damage was localized or widespread to the rest of the structures of the inner ear is an issue still under investigation [19] .…”

Section: Discussionmentioning

confidence: 96%

Vestibulo-Cochlear Function After Cochlear Implantation in Patients With Meniere’s Disease

et al. 2018

View full text Add to dashboard Cite

OBJECTIVES:To measure the auditory (pure tone audiometry and word recognition scores) and vestibular (video head impulse test and vestibular myogenic potentials) outcomes in patients diagnosed with Meniere's disease (MD) who underwent cochlear implantation. MATERIAL AND METHODS:This prospective study included 23 cochlear implant users with MD and 29 patients diagnosed with far-advanced otosclerosis (the control group). RESULTS:The preoperative mean pure tone average thresholds were 99 and 122.5 dB for the Meniere's and control groups, respectively. Word recognition scores after cochlear implant yielded a median of 80% and 72% for the Meniere's and control groups, respectively. Semicircular canal gain was not observed to vary post implantation (mean variation for lateral, posterior, and anterior plane was 0, 0.03, and 0, respectively). The mean ocular and cervical myogenic potentials asymmetry varied as 9.65% and 18.39%, respectively. CONCLUSIONS:The auditory performance improved in patients with MD similar to the general cochlear implant population. No major dysfunction of otolithic or semicircular canal function was demonstrated after the implantation surgery.

show abstract

“…A metaanalysis of temporal bone MRI reports on 184 specimens found that the lesion distribution was orderly and cochleocentric. Disease always begins in the cochlear apex, and then progresses sequentially to involve the saccule, utricle, ampullae and canal system [21]. A study correlating MRI confirmed EH, with other tests of audiovestibular functional tests demonstrated a clear correlation of EH of the cochlea and saccule with signal voids from these organs [22].…”

Section: Electronystagmographymentioning

confidence: 99%

What is the Current and Potential Future Role of Imaging in the Investigation of Patients with Suspected Meniere's Disease?

Mowat¹

2017

Br J Res

View full text Add to dashboard Cite

Meniere's disease (MD) represents a diagnostic challenge. It's symptoms of episodic vertigo, hearing loss, tinnitus, and a sense of aural fullness share overlap with multiple other conditions. It remains a diagnosis of exclusion, with imaging only used to rule out other pathologies, notably acoustic neuroma. Technological advance has brought increased resolution to the inner ear. In the future it is likely that MD will become a radiological diagnosis.Keywords: Hydrops; Imaging; Dizziness; Vertigo Meniere's DiseaseCurrently, the primary role of imaging in the investigation of suspected MD is to exclude other pathology. MD can present with asymmetrical hearing loss. In such circumstances it is usual to perform an MRI to exclude an acoustic neuroma or other forms of cerebellopontine angle tumour. The guidance on precisely when a patient requires an MRI to investigate asymmetrical SNHL is less clear. A comparison of eight screening protocols found that the best compromise between sensitivity and specificity was achieved by a criterion requiring either a 20 dB asymmetry at two neighbouring frequencies, or 15 dB asymmetry at two frequencies between 2 and 8 kHz [1]. Similarly, in the vertiginous patient an MRI can be used to exclude, space occupying lesions such as endolymphatic sac tumours, cholesteatoma fistulas, and brain metastasis [2].In the acute setting, the symptoms of a Meniere's attack can be mimicked by an anterior inferior cerebellar artery (AICA) stroke, which shares the symptoms of vertigo, tinnitus, deafness. The other symptoms of hemiplegia, and facial weakness offer greater distinction. However, all patients presenting with such a first episode of such symptoms should have a Computed Tomography (CT) scan to exclude a central cause [3]. The symptoms of AICA occlusion, display the lack of collateral vessels to the inner ear and its high metabolic rate, an anatomical fact which may have a bearing on the pathophysiology of MD.The future importance of imaging in the investigation of the suspected MD patient will depend on the other diagnostic modalities with which it is competing. Therefore it is necessary to comparatively discuss their diagnostic accuracy.A pure tone audiogram (PTA) is a basic step in the Meniere's diagnosis. MD classically produces a fluctuating low frequency hearing loss that becomes permanent as the disease progresses. However, it can cause many other patterns of hearing loss, which may mimic differentials such as otosclerosis, or noise induced losses [4]. Electronystagmography(ENG), is another routine investigation as MD causes a reduced vestibular response in the ear affected. However, it has limited sensitivity as recent work shows only a 50% positive rate in confirmed MD cases [5].Electrocochleography (ECoG) provides electrophysiological verification. An elevated summating potential/ nerve action potential of greater than 35% is a sign of MD. However, whilst a useful part of the diagnostic battery, specificity and sensitivity remains low particularly when performed in betwee...

show abstract

Endolymphatic hydrops and Ménière's disease: a lesion meta-analysis

Abstract: The orderly lesion progression in the otopathology associated with Ménière's disease suggests that the hydropic process has a graded non-random effect on the labyrinth. These findings suggest a pathological staging system that may be useful in temporal bone evaluation.

Cited by 78 publications

References 18 publications

An Exploratory Study to Detect Ménière’s Disease in Conventional MRI Scans Using Radiomics

An Exploratory Study to Detect Ménière’s Disease in Conventional MRI Scans Using Radiomics

Vestibulo-Cochlear Function After Cochlear Implantation in Patients With Meniere’s Disease

What is the Current and Potential Future Role of Imaging in the Investigation of Patients with Suspected Meniere's Disease?

Contact Info

Product

Resources

About