Association Between Vestibular Aqueduct Morphology and Meniere's Disease

Huang, Yan; Tang, Ruowei; Xu, Ning; Ding, Heyu; Pu, Wei; Xie, Jing; Yang, Zhenghan; Liu, Yuhe; Gong, Shusheng; Wang, Zhenchang; Zhao, Pengfei

doi:10.1002/lary.31339

Cited by 3 publications

(1 citation statement)

References 25 publications

(39 reference statements)

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“…Although the techniques used in these previous studies did not allow labeling of selective immune cell populations nor 3D reconstruction, and therefore bone marrow was not investigated in these studies, comparative measurements of bone properties from these studies suggest that the rat would be the optimal model to study endochondral bone marrow, since endochondral bone vascularization is much higher in rat than in most other animal models ( 41 ). Given that the links between bone marrow, bone metabolism, and inflammation are being elucidated ( 57 ), studying endochondral bone marrow may be crucial in understanding inner ear pathologies that link inflammation to aberrant vascular and bone changes, such as Menière’s disease ( 58 , 59 ) or otosclerosis ( 60 ).…”

Section: Discussionmentioning

confidence: 99%

Temporal bone marrow of the rat and its connections to the inner ear

Perin,

Cossellu,

Vivado

et al. 2024

Front. Neurol.

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Calvarial bone marrow has been found to be central in the brain immune response, being connected to the dura through channels which allow leukocyte trafficking. Temporal bone marrow is thought to play important roles in relation to the inner ear, but is still largely uncharacterized, given this bone complex anatomy. We characterized the geometry and connectivity of rat temporal bone marrow using lightsheet imaging of cleared samples and microCT. Bone marrow was identified in cleared tissue by cellular content (and in particular by the presence of megakaryocytes); since air-filled cavities are absent in rodents, marrow clusters could be recognized in microCT scans by their geometry. In cleared petrosal bone, autofluorescence allowed delineation of the otic capsule layers. Within the endochondral layer, bone marrow was observed in association to the cochlear base and vestibule, and to the cochlear apex. Cochlear apex endochondral marrow (CAEM) was a separated cluster from the remaining endochondral marrow, which was therefore defined as “vestibular endochondral marrow” (VEM). A much larger marrow island (petrosal non-endochondral marrow, PNEM) extended outside the otic capsule surrounding semicircular canal arms. PNEM was mainly connected to the dura, through bone channels similar to those of calvarial bone, and only a few channels were directed toward the canal periosteum. On the contrary, endochondral bone marrow was well connected to the labyrinth through vascular loops (directed to the spiral ligament for CAEM and to the bony labyrinth periosteum for VEM), and to dural sinuses. In addition, CAEM was also connected to the tensor tympani fossa of the middle ear and VEM to the endolymphatic sac. Endochondral marrow was made up of small lobules connected to each other and to other structures by channels lined by elongated macrophages, whereas PNEM displayed larger lobules connected by channels with a sparse macrophage population. Our data suggest that the rat inner ear is surrounded by bone marrow at the junctions with middle ear and brain, most likely with “customs” role, restricting pathogen spread; a second marrow network with different structural features is found within the endochondral bone layer of the otic capsule and may play different functional roles.

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Section: Discussionmentioning

confidence: 99%

Temporal bone marrow of the rat and its connections to the inner ear

Perin,

Cossellu,

Vivado

et al. 2024

Front. Neurol.

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Update on the pathophysiology, diagnosis and management of Ménière's disease

Lopez-Escamez,

Perez-Carpena

2024

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of the review The aim of this work is to summarize the main advances on the pathophysiology, diagnosis, and treatment of Meniere's disease (MD). Recent findings Different immune responses to biotic stimuli may trigger MD, with subgroups identified based on cytokine and genetic profile, suggesting potential benefits from immune therapy, including antiallergic medication. Genetic and epigenetic research, along with imaging studies, reveal the complexity of MD, involving inflammation, immunity, and metabolic processes. Advanced imaging techniques define specific temporal bone features and endolymphatic hydrops, while machine learning models enhance diagnostic accuracy through clinical and laboratory data analysis. Differentiating MD from vestibular migraine remains challenging due to overlapping symptoms, but combining vestibular tests, audiological assessments, and biomarkers like cytokines and chemokines shows promise. Pharmacological treatments such as betahistine or corticosteroids show varying effectiveness and require further research according to immune subgroups. Surgical options like endolymphatic sac decompression, semicircular canal occlusion and labyrinthectomy are restricted to intractable cases. Summary Research into MD aims to improve diagnosis and treatment through genetic, immunological, and advanced imaging studies. Current treatments include pharmacological, intratympanic, and surgical interventions, but current research supports a personalized approach based on clinical and molecular re-definition of patient subgroups.

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Angular Trajectory of the Vestibular Aqueduct in a Cohort of Chinese Patients with Unilateral Ménière’s Disease: Association with Other Imaging Indices and Clinical Profiles

Xia,

Lei,

Liu

et al. 2024

Biomedicines

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Objective: We aimed to investigate the association between the angular trajectory of the vestibular aqueduct (ATVA) with other radiological parameters of temporal bone and clinical characteristics in patients with Ménière’s disease (MD). Methods: A total of 125 unilateral MD patients and 118 controls were enrolled. Computer tomography (CT)-based radiological parameters included ATVA, vestibular aqueduct (VA) visibility, VA morphology, the vertical part of the posterior semicircular canal—the posterior fossa distance (PPD), and peri-VA pneumatization. The clinical characteristics of MD patients included gender, age of diagnosis/onset, disease duration, migraine history, clinical staging, and the results of audio-vestibular tests. The radiological parameters and clinical characteristics in MD patients were compared. Results: Compared with control ears, ATVA ≥ 140° was more prevalent and ATVA ≤ 120° was less frequent in the MD-affected side. For the MD-affected side, MD patients with ATVA ≥ 140° exhibited more severe VA invisibility and obliteration and higher male preponderance than those with ATVA ≤ 120°. Other radio-clinical features did not differ between these two subgroups. Conclusion: In the current study, ATVA ≥ 140°, an indicator of a hypoplastic endolymphatic sac, was found in approximately one-third of the affected and unaffected ears of patients with MD, as well as in a minority of controls. This suggests that the indices may be a predisposing factor rather than a specific marker for the MD ear. The male preponderance in MD patients with hypoplastic ES suggests a gender difference in the anatomical factors for MD pathogenesis.

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Association Between Vestibular Aqueduct Morphology and Meniere's Disease

Cited by 3 publications

References 25 publications

Temporal bone marrow of the rat and its connections to the inner ear

Temporal bone marrow of the rat and its connections to the inner ear

Update on the pathophysiology, diagnosis and management of Ménière's disease

Angular Trajectory of the Vestibular Aqueduct in a Cohort of Chinese Patients with Unilateral Ménière’s Disease: Association with Other Imaging Indices and Clinical Profiles

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