Mastoid and Inner Ear Measurements in Patients With Menière's Disease

Sugihara, Eric M.; Marinica, Alexander L.; Vandjelovic, Nathan D.; Kelley, Benjamin M.; Sana, Said S.; Starkey, Nicholas E.; Babu, Seilesh

doi:10.1097/mao.0000000000001576

Cited by 8 publications

(10 citation statements)

References 15 publications

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“…Numerous previous studies have attempted to identify disease-specific morphological alterations of the VA in MD based on intraoperative anatomy (8), postmortem histology (9–11), CT imaging (12–17), or MRI (18–21). However, those studies did not consider distinct etiologies (endotypes) of MD or their potentially different effects on VA morphology.…”

Section: Discussionmentioning

confidence: 99%

Vestibular Aqueduct Morphology Correlates With Endolymphatic Sac Pathologies in Menière's Disease—A Correlative Histology and Computed Tomography Study

Bächinger¹,

Luu²,

Kempfle³

et al. 2019

Otology &Amp; Neurotology

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Hypothesis: The vestibular aqueduct (VA) in Menière's disease (MD) exhibits different angular trajectories depending on the presenting endolymphatic sac (ES) pathology, i.e., 1) ES hypoplasia or 2) ES degeneration. Background: Hypoplasia or degeneration of the ES was consistently found in inner ears affected by MD. The two etiologically distinct ES pathologies presumably represent two disease “endotypes,” which may be associated with different clinical traits (“phenotypes”) of MD. Recognizing these endotypes in the clinical setting requires a diagnostic tool. Methods: 1) Defining the angular trajectory of the VA (ATVA) in the axial plane. 2) Measuring age-dependent normative data for the ATVA in postmortem temporal bone histology material from normal adults and fetuses. 3) Validating ATVA measurements from normative CT imaging data. 4) Correlating the ATVA with different ES pathologies in histological materials and CT imaging data from MD patients. Results: 1) The ATVA differed significantly between normal adults and MD cases with ES degeneration, as well as between fetuses and MD cases with ES hypoplasia; 2) a strong correlation between ATVA measurements in histological sections and CT imaging data was found; 3) a correlation between the ATVA, in particular its axial trajectory in the opercular region (angle α exit ), with degenerative ( α exit < 120°) and hypoplastic ES pathology ( α exit > 140°) was demonstrated. Conclusion: We established the ATVA as a radiographic surrogate marker for ES pathologies. CT-imaging-based determination of the ATVA enables endotyping of MD patients according to ES pathology. Future studies will apply this method to investigate whether ES endotypes distinguish clinically meaningful subgroups of MD patients.

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Section: Discussionmentioning

confidence: 99%

Vestibular Aqueduct Morphology Correlates With Endolymphatic Sac Pathologies in Menière's Disease—A Correlative Histology and Computed Tomography Study

Bächinger¹,

Luu²,

Kempfle³

et al. 2019

Otology &Amp; Neurotology

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“…The evaluation of the auditory status of the patient is important, both in the diagnosis and in follow-up. 64 -Audiometry: This is the most useful test for MD. A pure tone audiogram should be performed in all patients with an episodic vestibular syndrome.…”

Section: Hearing Testsmentioning

confidence: 99%

“…-Otoacoustic emissions: This audiological test measures the sound generated from the outer hair cells of the cochlea and can be considered in selected patients with MD. 64 -Electrocochleography (ECoG): ECoG is an electrophysiological record of the cochlear function. It has variable sensitivity and specificity in patients with a clinical history consistent with MD.…”

Section: Hearing Testsmentioning

confidence: 99%

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

Pérez-Carpena

Lopez-Escamez

2019

Semin Neurol

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Meniere's disease (MD) is a set of uncommon disorders with core phenotype of tinnitus, episodic vertigo, and sensorineural hearing loss. MD shows a genetic predisposition and a family history is found in 10% cases, with an autosomal dominant inheritance pattern. It is a multifactorial condition whose onset and development are triggered by the combined effect of genetic and environmental factors. Histopathological studies have associated MD with the accumulation of endolymph in the cochlea and the vestibular organs. However, endolymphatic hydrops does not fully explain the persistence of tinnitus, hearing loss progression, or the frequency of vertigo attacks.There are several comorbidities associated with MD, such as migraine, anxiety, autoimmune, and autoinflammatory disorders, adding more complexity to the phenotype. This “extended phenotype” can make the diagnosis and clinical management more complex, but it could also lead to a better characterization, understanding, and treatment of MD patients.We have conducted a systematic review on MD to update current knowledge, focusing on its mechanisms, diagnosis, comorbidities, and practical management.

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“…We also followed instructions in 35 to compute the height and three width measures of the common crus. The height and width of the vestibule were described in 55 . The total inner ear length was described in 56 (Fig.…”

Section: Methodsmentioning

confidence: 99%

IE-Map: a novel in-vivo atlas and template of the human inner ear

Ahmadi

Raiser

Ruehl

et al. 2021

Sci Rep

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Brain atlases and templates are core tools in scientific research with increasing importance also in clinical applications. Advances in neuroimaging now allowed us to expand the atlas domain to the vestibular and auditory organ, the inner ear. In this study, we present IE-Map, an in-vivo template and atlas of the human labyrinth derived from multi-modal high-resolution magnetic resonance imaging (MRI) data, in a fully non-invasive manner without any contrast agent or radiation. We reconstructed a common template from 126 inner ears (63 normal subjects) and annotated it with 94 established landmarks and semi-automatic segmentations of all relevant macroscopic vestibular and auditory substructures. We validated the atlas by comparing MRI templates to a novel CT/micro-CT atlas, which we reconstructed from 21 publicly available post-mortem images of the bony labyrinth. Templates in MRI and micro-CT have a high overlap, and several key anatomical measures of the bony labyrinth in IE-Map are in line with micro-CT literature of the inner ear. A quantitative substructural analysis based on the new template, revealed a correlation of labyrinth parameters with total intracranial volume. No effects of gender or laterality were found. We provide the validated templates, atlas segmentations, surface meshes and landmark annotations as open-access material, to provide neuroscience researchers and clinicians in neurology, neurosurgery, and otorhinolaryngology with a widely applicable tool for computational neuro-otology.

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Mastoid and Inner Ear Measurements in Patients With Menière's Disease

Cited by 8 publications

References 15 publications

Vestibular Aqueduct Morphology Correlates With Endolymphatic Sac Pathologies in Menière's Disease—A Correlative Histology and Computed Tomography Study

Vestibular Aqueduct Morphology Correlates With Endolymphatic Sac Pathologies in Menière's Disease—A Correlative Histology and Computed Tomography Study

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

IE-Map: a novel in-vivo atlas and template of the human inner ear

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