Visualization of Endolymphatic Hydrops in Patients With Meniere's Disease

Nakashima, Tsutomu; Naganawa, Shinji; Sugiura, Makoto; Teranishi, Masaaki; Sone, Michihiko; Hayashi, Hideo; Nakata, Seiichi; Katayama, Naomi; Ishida, Ieda Maria

doi:10.1097/mlg.0b013e31802c300c

Cited by 530 publications

(369 citation statements)

References 15 publications

Supporting

Mentioning

357

Contrasting

Unclassified

Order By: Relevance

“…23 Recent studies using magnetic resonance imaging have also confirmed these histopathologic findings. 24,25 In the Surgery group in Experiment 1, ears that underwent electrocauterization of the ES but without administration of desmopressin developed slight to moderate hydrops, indicating that prolonged ES dysfunction induced by electrocauterization may cause malabsorption of endolymph, and thus development of EH. This assumption is in line with following histopathologic findings related to the ES in patients with MD: poor development of the ES, 26,27 fibrotic changes of the ES, and a hypoplastic vestibular aqueduct.…”

Section: Discussionmentioning

confidence: 99%

Morphological and functional changes in a new animal model of Ménière's disease

Egami

Kakigi

Sakamoto

et al. 2013

Laboratory Investigation

View full text Add to dashboard Cite

The purpose of this study was to clarify the underlying mechanism of vertiginous attacks in Ménière's disease (MD) while obtaining insight into water homeostasis in the inner ear using a new animal model. We conducted both histopathological and functional assessment of the vestibular system in the guinea-pig. In the first experiment, all animals were maintained 1 or 4 weeks after electrocauterization of the endolymphatic sac of the left ear and were given either saline or desmopressin (vasopressin type 2 receptor agonist). The temporal bones from both ears were harvested and the extent of endolymphatic hydrops was quantitatively assessed. In the second experiment, either 1 or 4 weeks after surgery, animals were assessed for balance disorders and nystagmus after the administration of saline or desmopressin. In the first experiment, the proportion of endolymphatic space in the cochlea and the saccule was significantly greater in ears that survived for 4 weeks after surgery and were given desmopressin compared with other groups. In the second experiment, all animals that underwent surgery and were given desmopressin showed spontaneous nystagmus and balance disorder, whereas all animals that had surgery but without desmopressin administration were asymptomatic. Our animal model induced severe endolymphatic hydrops in the cochlea and the saccule, and showed episodes of balance disorder along with spontaneous nystagmus. These findings suggest that administration of desmopressin can exacerbate endolymphatic hydrops because of acute V2 (vasopressin type 2 receptor)-mediated effects, and, when combined with endolymphathic sac dysfunction, can cause temporary vestibular abnormalities that are similar to the vertiginous attacks in patients with MD. Ménière's disease (MD) is a well-known inner ear disorder characterized by symptoms including recurring attacks of vertigo typically lasting for hours, fluctuating sensorineural hearing loss, and tinnitus. Since the milestone findings on the temporal bones of MD patients, 1,2 endolymphatic hydrops (EH) has been considered as the histopathological origin of MD, as characteristic morphological changes were reported to be produced by surgical obstruction of the endolymphatic sac (ES) in guinea-pig. 3 This observation indicates that malabsorption of endolymph in the ES is one of the possible mechanisms underlying the development of EH. This experimentally induced EH has been frequently used as an animal model to investigate the pathogenesis of inner ear disorders associated with EH. In terms of vestibular function, while canal dysfunction and/or spontaneous nystagmus have been occasionally observed in this animal model, 4,5 episodes of vertiginous attack or balance disorder have only rarely been observed. 6 In other words, this model is insufficient for fully representing the common symptoms of MD.Water homeostasis of the inner ear is essential for maintaining the functions of hearing and balance. EH is considered to be the result of disruption of inner ear water homeostasis, which ...

show abstract

Section: Discussionmentioning

confidence: 99%

Morphological and functional changes in a new animal model of Ménière's disease

Egami

Kakigi

Sakamoto

et al. 2013

Laboratory Investigation

View full text Add to dashboard Cite

show abstract

“…18 High sensitivity to subtle T 1 changes in fluid FLAIR is reported to be more sensitive to subtle T 1 changes in fluid than conventional T 1 -weighted images. [21][22][23][24][25][26][27][28][29][30] A FLAIR image allows the detection of subtle subarachnoid hemorrhage in the CSF space, 9 signal increases in CSF after the inhalation of oxygen, 31 and subtle compositional changes of the labyrinthine fluid (Figs. 6 and 7), 26,27,30,[32][33][34] which can be difficult to recognize on T 1 -weighted images.…”

Section: T 2 -Selective Inversion Recoverymentioning

confidence: 99%

The Technical and Clinical Features of 3D-FLAIR in Neuroimaging

Naganawa

2015

magn reson med sci

Self Cite

View full text Add to dashboard Cite

In clinical MR neuroimaging, 3D fluid-attenuated inversion recovery (3D-FLAIR) with a variable-flip-angle turbo spin echo sequence is becoming popular. There are more than 100 reports regarding 3D-FLAIR in the PubMed database. In this article, the technical and clinical features of 3D-FLAIR for neuroimaging are reviewed and summarized. 3D-FLAIR allows thinner slices with multi-planar reformation capability, a higher flow sensitivity, high sensitivity to subtle T 1 changes in fluid, images without cerebrospinal fluid (CSF) inflow artifacts, and a 3D dataset compatible with computer-aided analysis. In addition, 3D-FLAIR can be obtained within a clinically reasonable scan time. It is important for radiologists to be familiar with the features of 3D-FLAIR and to provide useful information for patients.

show abstract

“…Patients received a dose of 8-fold diluted gadopentetate dimeglumine (Magnevist, Bayer Co. Ltd., Osaka, Japan) in one ear 24 hours prior to MR scanning according to the procedure previously detailed for IT injection. 9 Our medical ethics committee approved the use of the IT method for GBCM administration, and all patients gave written informed consent. The committee also approved this retrospective analysis of data using the IT and IV methods and waived informed consent.…”

Section: Mr Imagingmentioning

confidence: 99%

“…[7][8][9] A specific size criterion for the diagnosis of endolymphatic hydrops has been proposed for the inner ear without significant morphological anomaly. 10 According to this criterion, endolymph occupying more than half of the total vestibular space is defined as significant endolymphatic hydrops.…”

Section: Introductionmentioning

confidence: 99%

Ratio of Vestibular Endolymph in Patients with Isolated Lateral Semicircular Canal Dysplasia

2015

Self Cite

View full text Add to dashboard Cite

Purpose: Isolated vestibular-lateral semicircular canal dysplasia (LSCCD) is one of the most common anomalies of the inner ear. However, endolymphatic size in LSCCD is unknown. We measured the size of the endolymph in the vestibule of patients with LSCCD and compared it with that measured in patients without LSCCD.Methods: We extracted 1102 magnetic resonance (MR) studies for the evaluation of endolymphatic hydrops (EH) from our database of radiology reports. Among these, we found 15 ears from 11 patients with LSCCD; 4 patients had bilateral abnormalities. Seven of the 15 ears demonstrated aplasia and 8 ears, hypoplasia of the lateral semicircular canal (LSCC). The control group consisted of 26 ears from 13 randomly selected patients without LSCCD. We measured the area of endolymph in the vestibule (ELA), total area of vestibular lymph fluid (TLA), and area of the central bony island (CBI) of the LSCC from axial MR images obtained after intratympanic or intravenous administration of gadolinium-based contrast material. The ratio of endolymphatic area to total lymphatic area (%EL) was defined as %EL = ELA/TLA © 100.We evaluated the correlation between %EL and the area of the CBI and compared age, %EL, degree of cochlear EH, hearing level, and presence of rotating vertigo among the 3 groups (aplasia, hypoplasia, control).Results: The mean %EL was 76.7% in the aplasia group, 50.0% in the hypoplasia group, and 27.8% in the control group (P < 0.001). There was a relatively strong linear correlation between the area of the CBI and %EL (r = ¹0.767). Patient age, mean hearing level, degree of cochlear EH, or presence of vertigo attacks did not differ significantly among the groups (P > 0.05).Conclusion: The size of vestibular endolymph was larger in the groups with aplasia or hypoplasia than the control group. Thus, the current diagnostic cut-off value for significant vestibular EH (>50%) might not be appropriate for ears with LSCCD.

show abstract

Visualization of Endolymphatic Hydrops in Patients With Meniere's Disease

Cited by 530 publications

References 15 publications

Morphological and functional changes in a new animal model of Ménière's disease

Morphological and functional changes in a new animal model of Ménière's disease

The Technical and Clinical Features of 3D-FLAIR in Neuroimaging

Ratio of Vestibular Endolymph in Patients with Isolated Lateral Semicircular Canal Dysplasia

Contact Info

Product

Resources

About