MRI of endolymphatic hydrops in patients with vestibular schwannomas: a case-controlled study using non-enhanced T2-weighted images at 3 Teslas

Karch-Georges, Aurélie; Veillon, F.; Vuong, Hella; Rohmer, Damien; Karol, Anne; Charpiot, Anne; Meyer, Nicolás; Venkatasamy, Aïna

doi:10.1007/s00405-019-05395-8

Cited by 17 publications

(17 citation statements)

References 18 publications

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“…As most subjects with VS benefit from a wait-and-scan strategy, based on these MRI results, they suggest that a treatment leading to decreased EH could be administrated to achieve better hearing outcomes (44). In a recent paper (45), a saccular dilatation on the ipsilateral side was demonstrated in 30% of VSs (53 out of 183 patients with typical VS). In this study, a 3D non-contrast high-resolution T2-weighted sequence was used.…”

Section: Biological Markersmentioning

confidence: 94%

Biomarkers in Vestibular Schwannoma–Associated Hearing Loss

et al. 2019

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Vestibular schwannomas (VSs) are benign tumors composed of differentiated neoplastic Schwann cells. They can be classified into two groups: sporadic VS and those associated with neurofibromatosis type 2 (NF2). VSs usually grow slowly, initially causing unilateral sensorineural hearing loss (HL) and tinnitus. These tumors cause HL both due to compression of the auditory nerve or the labyrinthine artery and due to the secretion of different substances potentially toxic to the inner ear or the cochlear nerve. As more and more patients are diagnosed and need to be managed, we are more than ever in need of searching for biomarkers associated with these tumors. Owing to an unknown toxic substance generated by the tumor, HL in VS may be linked to a high protein amount of perilymph. Previous studies have identified perilymph proteins correlated with tumor-associated HL, including μ-Crystallin (CRYM), low density lipoprotein receptor-related protein 2 (LRP2), immunoglobulin (Ig) γ-4 chain C region, Ig κ-chain C region, complement C3, and immunoglobulin heavy constant γ 3. Besides, the presence of specific subtypes of heat shock protein 70 has been suggested to be associated with preservation of residual hearing. It has been recently demonstrated that chemokine receptor-4 (CXCR4) is overexpressed in sporadic VS as well as in NF2 tumors and that hearing disability and CXCR4 expression may be correlated. Further, the genetic profile of VS and its relationship with poor hearing has also been studied, including DNA methylation, deregulated genes, growth factors, and NF2 gene mutations. The knowledge of biomarkers associated with VS would be of significant value to maximize outcomes of hearing preservation in these patients.

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Section: Biological Markersmentioning

confidence: 94%

Biomarkers in Vestibular Schwannoma–Associated Hearing Loss

et al. 2019

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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%

“…No post-mortem studies were found published on the prevalence of EH in patients with vestibular migraine. Due to the lack of contrast-enhanced imaging studies in patients with a vestibular schwannoma, two studies were selected that used non-contrast-enhanced MRI to diagnose EH [18,19].…”

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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“…VM not only has vertigo symptoms similar to MD, but also the pathological manifestations are similar. Actually, ELH has been described in many other diseases, such as acute low-tone sensorineural hearing loss, sudden deafness, immune inner ear disease, ears with pathologic third window lesions, even vestibular schwannomas [Yamasoba et al, 1994;Shimono et al, 2013;Yoshida et al, 2015;Sone et al, 2016;Okazaki et al, 2017;Inui et al, 2019;Karch-Georges et al, 2019]. So maybe the ELH was only the common pathophysiologic mechanism or the pathologic result of these inner ear diseases.…”

Section: Introductionmentioning

confidence: 99%

Audiological Findings in Patients with Vestibular Migraine and Migraine: History of Migraine May Be a Cause of Low-Tone Sudden Sensorineural Hearing Loss

Xue

Lin

et al. 2020

Audiol Neurotol

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Introduction: The aim of this study was to investigate and compare the auditory findings in migraine, vestibular migraine (VM), and healthy controls. Methods: Twenty-eight migraine patients (56 ears), 18 VM (36 ears), and 25 healthy controls (50 ears) were included. Audiometry, speech discrimination scores, distortion product optoacoustic emission (DPOAE), and auditory brainstem response were tested. Results: The pure tone in the VM group showed higher thresholds at lower frequencies (250, 500, 1,000, 2,000 Hz) than the control group, with statistical differences observed (P_{250 Hz} = 0.001, P_{500 Hz} = 0.003, P_{1,000 Hz} = 0.016, P_{2,000 Hz} = 0.002). Compared with the healthy controls, the patients with VM had significantly lower amplitudes of DPOAE at 1 kHz (p < 0.001) and 2 kHz (p = 0.020), and the patients with migraine had lower amplitudes at 2 kHz (p = 0.042). Compared with the control group, the patients with migraine reported prolonged latency of wave V (p = 0.016) and IPL I–V (p = 0.003). The patients with VM had significant prolongation of IPL I–V (p = 0.024). Conclusion: Not only the peripheral, but also the central auditory system was involved in patients with migraine and VM. In particular, lower frequencies of the auditory system were more likely to be involved in VM. The history of migraine may be a cause of low-tone sudden sensorineural hearing loss.

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MRI of endolymphatic hydrops in patients with vestibular schwannomas: a case-controlled study using non-enhanced T2-weighted images at 3 Teslas

Cited by 17 publications

References 18 publications

Biomarkers in Vestibular Schwannoma–Associated Hearing Loss

Biomarkers in Vestibular Schwannoma–Associated Hearing Loss

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

Audiological Findings in Patients with Vestibular Migraine and Migraine: History of Migraine May Be a Cause of Low-Tone Sudden Sensorineural Hearing Loss

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