The Vestibular Aqueduct in Patients with Menière's Disease<i>A Tomographic and Clinical Investigation</i>

Stahle, Jan; Wilbrand, Hermann

doi:10.3109/00016487409126323

Cited by 106 publications

(32 citation statements)

References 8 publications

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“…In contrast with our findings, we have the pioneering study of Clemis and Valvassori (5) , correlating the non-visualization of VA with the Ménière's disease, a concept that is corroborated by other studies (7,8,(20)(21)(22) . On the other hand, our findings regarding the VA visibility compare to the control groups, excepting those reported by De Groot et al (20) , who have visualized the VA in only 74% of their control-group.…”

Section: Discussioncontrasting

confidence: 50%

Sistematização do estudo anatômico do aqueduto vestibular por tomografia computadorizada de alta resolução em pacientes com doenças de Ménière unilateral

et al. 2006

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OBJECTIVE: To systematize the assessment of vestibular aqueduct by high-resolution computed tomography (HRCT) in patients with unilateral Ménière's disease as compared with a control group. MATERIALS AND METHODS: We have selected 20 patients with unilateral Ménière's disease, according to the guidelines proposed by the American Academy of Otolaryngology -Head and Neck Surgery. The control group consisted of ten individuals with normal audiometric tests. Overall, we have studied 60 ears, equally divided into three groups: group I -Ménière's disease, affected ear; group II -Ménière's disease, non-affected ear; group III -control. All the individuals have undergone temporal bones HRCT. Images were blindly reviewed, trying to evaluate the visibility of the descendent portion of the ventricular aqueduct. Afterwards data were correlated with their respective groups. RESULTS: We have identified the vestibular aqueduct in 95% of ears in group I, 90% in group II, and 100% in group III. CONCLUSION: It is possible to perform a systematic evaluation of the vestibular aqueduct by axial HRCT, using the same radiological technique, anatomical knowledge and sequential images of inner ear structures. With this systematic approach we have obtained a high rate of vestibular aqueduct visualization, with no statistically significant difference between the groups. Keywords: Vestibular aqueduct; Temporal bone; Tomography -methods; Helicoidal computed tomography; Ménière's disease.Sistematização do estudo anatômico do aqueduto vestibular por tomografia computadorizada de alta resolução em pacientes com doença de Ménière unilateral. OBJETIVO: Sistematizar a avaliação do aqueduto vestibular por tomografia computadorizada de alta resolução (TCAR) em pacientes com doença de Ménière unilateral e comparar com um grupo-controle. MATERIAIS E MÉTODOS: Selecionamos 20 pacientes com doença de Ménière unilateral, segundo critérios da Academia Americana de Otorrinolaringologia -Cirurgia de Cabeça e Pescoço, e um grupo-controle composto por dez indivíduos com avaliação auditiva normal, totalizando 60 orelhas, distribuídas igualmente em três grupos: grupo I -doença de Ménière, orelha comprometida; grupo II -doença de Ménière, orelha não-comprometida; grupo III -controle. Submetemos os pacientes à TCAR de ossos temporais. O estudo das imagens foi feito de modo cego, procurando avaliar a visibilidade da porção descendente do aqueduto vestibular. Os dados obtidos foram correlacionados com os respectivos grupos. RESULTADOS: A visualização do aqueduto vestibular foi de 95% no grupo I, 90% no grupo II e 100% no grupo III. CONCLUSÃO: É possível sistematizar a avaliação por TCAR do aqueduto vestibular, com aquisição axial, usando a mesma técnica radiológica, conhecimento anatômico e seguimento seqüencial das estruturas da orelha interna. Com esta sistematização houve alta taxa de visualização do aqueduto vestibular, sem diferença estatisticamente significante entre os grupos. Unitermos: Aqueduto vestibular; Osso temporal; Tomografia -métodos; Tomografia comp...

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Section: Discussioncontrasting

confidence: 50%

Sistematização do estudo anatômico do aqueduto vestibular por tomografia computadorizada de alta resolução em pacientes com doenças de Ménière unilateral

et al. 2006

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“…These findings were later confirmed by Dau phin et al [7]. Stahle and Wilbrand [6] con cluded that sclerosis and hypoplasia of the retrolabyrinthine portion of the temporal bone may represent a more specific radiolog ical symptom of Ménière's disease than mere aqueduct (VA) stenosis. However, they em phasize that there are no radiologic signs directly pathognomonic of Ménière's disease.…”

Section: Introductionsupporting

confidence: 71%

“…However, they em phasize that there are no radiologic signs directly pathognomonic of Ménière's disease. The differences in aqueductal dimensions and mastoid pneumatization between healthy persons and Ménière patients are only a statistical manifestation and cannot be used as a diagnostic criterion in the individ ual case [6]. We have made an attempt to demonstrate radiologcal changes in temporal bones of Ménière patients and have been par ticularly interested in the visualization of the VA and in the pneumatization as well as con figuration of the retrolabyrinthine portion of the temporal bone.…”

Section: Introductionmentioning

confidence: 99%

“…However, a critical review of the current literature shows that there appears to be little justification for sac surgery [17], Other authors [4] conclude that size, pa tency and configuration of the VA have no predictive value regarding the presence of bilateral Ménière's disease. Still they con sider tomography important for diagnostic reasons [5], Recently Stahle and Wilbrand [6] observed that the retrolabyrinthine width of the temporal bone was diminished in Mé nière's patients and, compared to normals, more frequently showed marked sclerosis. These findings were later confirmed by Dau phin et al [7].…”

Section: Introductionmentioning

confidence: 99%

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Computed Tomographic Findings in Ménière’s Disease

Nidecker

Pfaltz

Matéfi

et al. 1985

ORL

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Symptoms in Ménière’s disease are explained by hydrops of the endolymphatic system with recurrent ruptures of the membranous labyrinth. The primary cause of the increased endolymphatic volume appears to be an imbalance between secretion and resorption of endolymph which may be due to an obstruction of the endolymphatic duct and sac, located in the vestibular aqueduct (VA). Non-visualization or narrowing of the latter have been demonstrated by conventional tomography. Also, sclerosis and hypoplasia of the retrolabyrinthine portions of the temporal bone have been documented. By high resolution computed tomography (CT) we prospectively tried to demonstrate morphological alterations in 10 patients with Ménière’s disease. These were compared with a group of 14 non-Ménière patients. Visualization of the VA as well as perilabyrinthine pneumatization were assessed and the width of the retrolabyrinthine part of the temporal bone was measured. Whereas there was a slight difference in the average retrolabyrinthine width (3.8 mm in Ménière versus 5.8 in non-Ménière cases) and degree of pneumatization, there was a distinctly decreased visualization of the VA in the Ménière group. As findings were always bilateral and only 3 of 20 temporal bones showed peripheral hypopneumatization, possibly due to chronic otitis mediathe theory of a predisposing constitutional abnormality must be taken into consideration. However, we were not able to confirm a statistically proven usefulness of the CT technique in identifying an anatomical abnormality which is directly in correlation with the side of the lesion in cases of unilateral Ménière’s disease.

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“…Many reports have shown a low frequency of visualization of the vestibular aqueduct in Ménière's disease using X-ray tomography and computed tomography [7][8][9]. On the other hand, Kraus and Dubois [10] noted no difference in the frequency of visualization of the endolymphatic sac between patients with Ménière's disease and control subjects.…”

Section: Introductionmentioning

confidence: 98%

Magnetic Resonance Imaging of Endolymphatic Sac in Acute Low-Tone Sensorineural Hearing Loss without Vertigo

Sugiura¹,

Naganawa

Nakashima³

et al. 2003

ORL

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The etiology of acute low-tone sensorineural hearing loss (ALHL) may be associated with deteriorated function of the endolymphatic sac. Using magnetic resonance (MR) imaging on a 1.5-tesla MR system, we evaluated the frequency of visualization and contrast enhancement of the endolymphatic sac in 25 patients (9 men and 16 women; age range 11–64 years) with ALHL and 21 control subjects. The present study demonstrated that the frequency of visualization and enhancement of the endolymphatic sac in patients with ALHL was not significantly higher than in control subjects.

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The Vestibular Aqueduct in Patients with Menière's DiseaseA Tomographic and Clinical Investigation

Cited by 106 publications

References 8 publications

Sistematização do estudo anatômico do aqueduto vestibular por tomografia computadorizada de alta resolução em pacientes com doenças de Ménière unilateral

Sistematização do estudo anatômico do aqueduto vestibular por tomografia computadorizada de alta resolução em pacientes com doenças de Ménière unilateral

Computed Tomographic Findings in Ménière’s Disease

Magnetic Resonance Imaging of Endolymphatic Sac in Acute Low-Tone Sensorineural Hearing Loss without Vertigo

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