Significance of tomography in meniere's disease: Visualization and morphology of the vestibular aqueduct

Sf, Hall; Af, O'Connor; Ch, Thakkar; Ig, Wylie; Aw, Morrison

doi:10.1288/00005537-198312000-00005

Cited by 13 publications

(1 citation statement)

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“…The ES is located partly within the VA (intra-osseous part) and partly between the layers of the dura mater in the posterior cranial fossa (extra-osseous part) (13). The VA can be visualized on computed tomography (CT), whereas the ED-ES system can be delineated on MRI (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Visualization and clinical relevance of the endolymphatic duct and sac in Ménière's disease

de Pont,

Houben,

Verhagen

et al. 2023

Front. Neurol.

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BackgroundMénière's disease (MD) is a chronic inner ear disorder with a multifactorial etiology. Decreased visualization of the endolymphatic duct (ED) and sac (ES) is thought to be associated with MD, although controversy exists about whether this finding is specific to MD. Recent literature has revealed that two distinct ES pathologies, developmental hypoplasia and epithelial degeneration, can be distinguished in MD using the angular trajectory of the vestibular aqueduct (ATVA) or ED-ES system as a radiographic surrogate marker. It has been suggested that these two subtypes are associated with distinct phenotypical features. However, the clinical differences between the ATVA subtypes require further validation.Research objectiveThe objective of this study is to investigate whether (1) non-visualization of the ED-ES system is a discriminative radiological feature for MD in a cohort of vertigo-associated pathologies (VAPs) and whether (2) different angular trajectories of the ED-ES system in MD are associated with distinguishable clinical features.SettingThe study was conducted in the Vertigo Referral Center (Haga Teaching Hospital, The Hague, the Netherlands).MethodsWe retrospectively assessed 301 patients (187 definite MD and 114 other VAPs) that underwent 4h-delayed 3D FLAIR MRI. We evaluated (1) the visibility of the ED-ES system between MD and other VAP patients and (2) measured the angular trajectory of the ED-ES system. MD patients were stratified based on the angular measurements into αexit ≤ 120° (MD-120), αexit 120°-140° (MD-intermediate), or αexit ≥ 140° (MD-140). Correlations between ATVA subgroups and clinical parameters were evaluated.ResultsNon-visualization of the ED-ES system was more common in definite MD patients compared with other VAPs (P < 0.001). Among definite MD patients, the MD-140 subtype demonstrated a longer history of vertigo (P = 0.006), a higher prevalence of bilateral clinical disease (P = 0.005), and a trend toward a male preponderance (p = 0.053). No significant differences were found between ATVA subgroups regarding the presence or severity of auditory symptoms, or the frequency of vertigo attacks.ConclusionNon-visualization of the ED-ES system is significantly associated with MD. Among MD patients with a visible ED-ES system, we demonstrated that the MD-140 subtype is associated with a longer disease duration, a higher prevalence of bilateral MD, and a trend toward a male preponderance.

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Section: Introductionmentioning

confidence: 99%