ObjectiveWe aimed to evaluate the diagnostic performance of some anatomical variables with regard to endolymphatic sac (ES) and duct (ED), measured by non-contrast three-dimensional sampling perfection with application-optimized contrasts using different flip angle evolutions (3D-SPACE) magnetic resonance imaging (MRI), in differentiating vestibular migraine (VM) from unilateral Ménière's disease (MD).MethodsIn this study, 81 patients with VM, 97 patients with unilateral MD, and 50 control subjects were enrolled. The MRI-visualized parameters, such as the distance between the vertical part of the posterior semicircular canal and the posterior fossa (MRI-PP distance) and visibility of vestibular aqueduct (MRI-VA), were measured bilaterally. The diagnostic value of the MRI-PP distance and MRI-VA visibility for differentiating VM from unilateral MD was examined.Results(1) Compared with the VM patients, patients with unilateral MD exhibited shorter MRI-PP distance and poorer MRI-VA visibility. No differences in the MRI-PP distance and MRI-VA visibility were detected between patients with VM and control subjects. (2) No significant interaural difference in the MRI-PP distance and MRI-VA visibility was observed in patients with VM and those with unilateral MD, respectively. (3) Area under the curve (AUC) showed a low diagnostic value for the MRI-PP distance and MRI-VA visibility, respectively, in differentiating between the VM and unilateral MD.ConclusionsBased on non-enhanced MRI-visualized measurement, anatomical variables with regard to the endolymphatic drainage system differed significantly between the patients with VM and those with unilateral MD. Further investigations are needed to improve the diagnostic value of these indices in differentiating VM from unilateral MD.

ObjectiveAnatomical variations of the inner ear may contribute to the development of Ménière’s disease (MD), which is a complex inner ear disorder histopathologically characterized by idiopathic endolymphatic hydrops (ELH). Abnormalities of the vestibular aqueduct (VA) and the jugular bulb (JB) have been suggested as predisposing factors. Yet, few studies have investigated the correlation between JB abnormalities and VA variations as well as its clinical relevance in these patients. In this retrospective study, we investigated the differences in the incidence of radiological abnormalities of the VA and JB in patients with definite MD.MethodsAnatomical variations of JB and VA were evaluated based on high-resolution CT (HRCT) in a series of 103 patients with MD (93 unilateral cases and 10 bilateral cases). JB-related indices included JB anteroposterior and mediolateral diameter, JB height, JB type regarding to Manjila classification system, and incidences of JB diverticulum (JBD), JB related inner ear dehiscence (JBID), and inner ear adjacent JB (IAJB). VA-related indices included CT-VA visibility, CT-VA morphology (funnel, tubular, filiform, hollow, and obliterated-shaped type), and peri-VA pneumatization. Radiological indices were compared between MD ears and control ears.ResultsRadiological JB abnormalities were comparable between MD ears and control ears. As for VA-related indices, the CT-VA visibility was lower in MD ears than in control ears (p = 0.004). The distribution of CT-VA morphology was significantly different between MD and control ears (p = 0.013), with a higher proportion of obliterated-shaped type in MD ears (22.1%) than in control ears (6.6%).ConclusionCompared with JB abnormalities, the anatomical variations of VA are more likely to be an anatomically predisposing factor for MD.

Objective We aimed to investigate the impact of the position, configuration and neurovascular contact of the anterior inferior cerebellar artery (AICA) in cerebellopontine angle (CPA) and internal auditory canal (IAC) on the clinical features of patients with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL). Methods One hundred and thirty‐six patients with unilateral ISSNHL were enrolled. All patients received detailed history inquiry and standard treatments. Pure tone audiometry and magnetic resonance imaging (MRI) of CPA‐IAC were performed. The MRI findings of both ears were evaluated by the Chavda, Gorrie and Kazawa systems. The association between radiological findings and clinical data were analyzed. Results (1) No significant interaural difference in the position, configuration and neurovascular contact of AICA was observed. (2) There was no significant association between the AICA loop and concomitant vertigo or pre‐treatment audiometric configuration in the affected ear. (3) Concomitant tinnitus seemed to be affected by the configuration of AICA categorized by Kazawa system, while the Chavda and Gorrie classification of AICA loop was unassociated with tinnitus. (4) Hearing outcomes were not compromised by the position or configuration of AICA based on the Chavda and Kazawa systems. Patients with Gorrie type B tended to have better hearing recovery than those with type C. Conclusions In patients with ISSNHL, the position, configuration and neurovascular contact of AICA in the CPA‐IAC were unassociated with the side of hearing loss, audiometric configurations, or concomitant vertigo. The neurovascular contact graded by Gorrie system might be associated with hearing outcomes.