Endolymphatic Hydrops in Children

Bachor, Edgar; Karmody, Collin S.

doi:10.1159/000276725

Cited by 12 publications

(8 citation statements)

References 16 publications

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“…In total, 69 publications were selected after database searching and citation and reference retrieval for estimating the prevalence of EH and neuro-otologic symptoms in different types of study populations [3,9,12,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Based on the available data, three vestibular disorders were selected for prevalence estimation: (1) The clinical diagnosis of Menière's disease based on diagnostic criteria (Table 1) [16], (2) The diagnosis of vestibular schwannoma confirmed by MRI, (Table 2), and (3) The clinical diagnosis of vestibular migraine based on diagnostic criteria (Table 3) [17].…”

Section: Study Selectionmentioning

confidence: 99%

The “hype” of hydrops in classifying vestibular disorders: a narrative review

et al. 2020

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Background Classifying and diagnosing peripheral vestibular disorders based on their symptoms is challenging due to possible symptom overlap or atypical clinical presentation. To improve the diagnostic trajectory, gadolinium-based contrast-enhanced magnetic resonance imaging of the inner ear is nowadays frequently used for the in vivo confirmation of endolymphatic hydrops in humans. However, hydrops is visualized in both healthy subjects and patients with vestibular disorders, which might make the clinical value of hydrops detection on MRI questionable. Objective To investigate the diagnostic value of clinical and radiological features, including the in vivo visualization of endolymphatic hydrops, for the classification and diagnosis of vestibular disorders. Methods A literature search was performed in February and March 2019 to estimate the prevalence of various features in healthy subjects and in common vestibular disorders to make a graphical comparison between healthy and abnormal. Results Of the features studied, hydrops was found to be a highly prevalent feature in Menière’s disease (99.4%). Though, hydrops has also a relatively high prevalence in patients with vestibular schwannoma (48.2%) and in healthy temporal bones (12.5%) as well. In patients diagnosed with (definite or probable) Menière’s disease, hydrops is less frequently diagnosed by magnetic resonance imaging compared to the histological confirmation (82.3% versus 99.4%). The mean prevalence of radiologically diagnosed hydrops was 31% in healthy subjects, 28.1% in patients with vestibular migraine, and 25.9% in patients with vestibular schwannoma. An interesting finding was an absolute difference in hydrops prevalence between the two diagnostic techniques (histology and radiology) of 25.2% in patients with Menière’s disease and 29% in patients with vestibular schwannoma. Conclusions Although the visualization of hydrops has a high diagnostic value in patients with definite Menière’s disease, it is important to appreciate the relatively high prevalence of hydrops in healthy populations and other vestibular disorders. Endolymphatic hydrops is not a pathognomic phenomenon, and detecting hydrops should not directly indicate a diagnosis of Menière’s disease. Both symptom-driven and hydrops-based classification systems have disadvantages. Therefore, it might be worth to explore features “beyond” hydrops. New analysis techniques, such as Radiomics, might play an essential role in (re)classifying vestibular disorders in the future.

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Section: Study Selectionmentioning

confidence: 99%

The “hype” of hydrops in classifying vestibular disorders: a narrative review

et al. 2020

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“…The aetiology of DELH is not adequately proven. Bachor et al proved pathologically that ELH could derive from juvenile-onset unilateral profound deafness and from congenital deafness [9,10]. However, most labyrinthitis caused by virus infection, for example by measles, rubella or mumps, causes collapse of the inner ear [11,12].…”

Section: Discussionmentioning

confidence: 99%

Endolymphatic space imaging in patients with delayed endolymphatic hydrops

Kasai

Teranishi²,

Katayama³

et al. 2009

Acta Oto-Laryngologica

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“…Dohlman [8] was the first who theorized that the sudden episodes of vertigo in Ménière's disease are caused by a mixture of endolymph with perilymph after rupture of the endolymphatic membranes. Endolymphatic hydrops, however, can occur in adults [12] and children [9] without clinical Ménière's disease, but it is still not known whether a slowly increasing volume of endolymph will result in spontaneous ruptures, especially because the endolymph/perilymph system is a low-pressure system [13]. Furthermore it is not clear, whether or not the guinea pig model for endolymphatic hydrops (ablation of the endolymphatic sac [4] or ductus reuniens [3]) is relevant to the human labyrinth in the pathophysiology of Ménière's disease.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study we described bulging of the endolymphatic membranes in the temporal bones of children [9]. Based on the postulate that endolymphatic hydrops might cause ruptures, we were interested to see if there were also ruptures of endolymphatic membranes in a group of children with an average age of 15 months.…”

Section: Introductionmentioning

confidence: 99%

Ante mortem Ruptures of the Endolymphatic Membranes in Children: Real Finding or Artifact?

Bachor

Karmody

2002

ORL

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We undertook this study to determine whether or not ante mortem ruptures of the endolymphatic membranes occurred naturally in the infantile labyrinth, what were the most frequent locations and to assess the statistical correlation of an earlier finding of bulging of Reissner’s membrane in pediatric temporal bones. We examined 128 temporal bones from 80 children between the ages of newborn to 12 years with an average age of 15.4 months. All temporal bones were prepared by the celloidin technique and studied by light microscopy. The endolymphatic membranes of the cochlear duct, saccule, utricle and semicircular ducts were examined for ruptures. A rupture of the saccule and utricle was considered to be an ante mortem event if its edges were rolled and bound with fine adhesions and could be identified in adjacent sections. Ante mortem ruptures were seen in 11.1% of the specimens and occurred in 2.4% in Reissner’s membrane, in 6.3% in the saccular membrane and in 2.4% in the utricular membrane. In these specimens, the histopathological changes included atrophy of the stria vascularis and collapse of the organ of Corti, which provided further evidence of an ante mortem event. Infants with extralabyrinthine congenital anomalies or children who were treated with chemotherapy were more likely to develop ruptures of the endolymphatic membranes if they also received aminoglycosides.

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Endolymphatic Hydrops in Children

Cited by 12 publications

References 16 publications

The “hype” of hydrops in classifying vestibular disorders: a narrative review

The “hype” of hydrops in classifying vestibular disorders: a narrative review

Endolymphatic space imaging in patients with delayed endolymphatic hydrops

Ante mortem Ruptures of the Endolymphatic Membranes in Children: Real Finding or Artifact?

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