Membranous labyrinth volumes in normal ears and Ménière disease: A three‐dimensional reconstruction study

Abstract

Objectives The purpose of this study was to determine the normal volume ranges of cochlear duct, saccule, and utricle, and to assess endolymphatic hydrops in Ménière disease. Study Design Retrospective temporal bone study. Methods Three-dimensional (3-D) images of membranous labyrinth were reconstructed from 31 normal temporal bones, six temporal bones from three patients with bilateral Ménière disease, and 16 temporal bones from eight patients with unilateral Ménière disease. Volumes of each part of membranous labyrinth were measured in each temporal bone group after 3-D reconstruction. Results The mean volumes and upper normal volume limits (over the 95% confidence interval) of the cochlear duct, saccule, and utricle were 7.67 and 9.77 mm3, 2.42 and 3.68 mm3, and 10.65 and 16.45 mm3, respectively. All three patients with bilateral Ménière disease showed endolymphatic hydrops (excess of volume over normal limits) in both ears. Of eight patients with unilateral Ménière disease, five had no symptom in the contralateral ear, whereas three patients had histories of progression from uni-lateral to bilateral Ménière disease 13–21 years after the initial onset. All of the diseased and three of eight contralateral ears showed endolymphatic hydrops. In contrast, no hydrops was observed in any part of the membranous labyrinth in asymptomatic ears. Conclusions Our findings suggest that cochleosaccular hydrops is a sensitive finding in Ménière disease. In addition, the volume data obtained from this study could be useful as a standard value for the assessment of hydrops in diagnostic imaging of the inner ear in Ménière disease.

Contrast enhancement of the inner ear in magnetic resonance images taken at 10 minutes or 4 hours after intravenous gadolinium injection

“…In the present study, significant EH was observed in either the cochlea or vestibule in three of four asymptomatic ears in patients with unilateral MD. These MRI findings are consistent with histopathology findings of the temporal bone showing that the contralateral ears of patients with unilateral MD occasionally develop asymptomatic EH [17,18]. We experienced one patient with barotrauma in whom Gd enhancement was observed in the fundus of the internal auditory meatus.…”

Geometrical and Volume Changes of the Membranous Vestibular Labyrinth in Guinea Pigs with Endolymphatic Hydrops

“…These findings are in line with previous studies about experimental EH and MD [21,22]. In the current study, the volume of the utricle was also increased, but that of the lateral canal ampulla did not change.…”

Reliability of Magnetic Resonance Imaging Performed After Intratympanic Administration of Gadolinium in the Identification of Endolymphatic Hydrops in Patients With Ménière's Disease

“…To demonstrate that the reduced perilymphatic enhancement is caused by EH, it could be useful to verify whether medical or surgical treatment known to influence hydrops may modify imaging outcomes. Interestingly, anecdotal descriptions have recently been reported on cases of patients with atypical or definite MD, showing improvement both in hearing threshold and inner ear enhancement in MRI, after medical treatment (21,27).…”