Ductus Reuniens and Its Possible Role in Menière's Disease

Hornibrook, Jeremy; Mudry, Albert; Curthoys, Ian S.; Smith, Christopher M.

doi:10.1097/mao.0000000000003352

Cited by 11 publications

(5 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nishioka et al reported that aldosterone-induced up-regulation of the AQP3 water channel in the stria vascularis is likely to take some part in the formation of hydrops. 37 Moreover, the blockages of the ductus reuniens have been postulated to be saccular otoconia either causing or aggravating hydrops in MD, 38,39 indicating a high degree of interindividual variability exists in the etiology of MD. 40 The limitation of the present study is the small number of subjects.…”

Section: Discussionmentioning

confidence: 99%

Meniere's Disease Patients with Distinct Sac Pathoanatomic Findings React Differently to Endolymphatic Duct Blockage

Wang

et al. 2022

The Laryngoscope

View full text Add to dashboard Cite

ObjectivesTo explore the possible difference in response to endolymphatic duct blockage (EDB) treatment in patients with Meniere's disease (MD) with distinct pathoanatomic characteristics of the sac.MethodsIn a total of 24 patients with MD receiving EDB treatment, the dynamics of the vertigo attack, hearing, vestibular function, and endolymph hydrops (EH) before surgery and 40 months following surgery in patients with normoplastic extraosseous portion of endolymphatic sac (eES) were compared with that in patients with atrophic eES.ResultsA higher prevalence of complete vertigo control, better cochlear and vestibular function, and lower endolymph to vestibule‐volume ratio were found in patients with normoplastic eES than in those with atrophic eES. Moreover, the reversal of EH was found in a total of six patients in normoplastic eES group, but no reversal of EH was detected in the atrophic eES group after surgery.ConclusionsA difference in response to EDB treatment was shown in the MD patients with normoplastic eES and those with atrophic eES; the reversal of EH was found in the normoplastic eES group, but not in the atrophic eES group after surgery, suggesting two distinct pathologies in the eESs may underlie the pathogenesis of EH in two subgroups of MD patients.Level of Evidence4 Laryngoscope, 133:2761–2769, 2023

show abstract

Section: Discussionmentioning

confidence: 99%

Meniere's Disease Patients with Distinct Sac Pathoanatomic Findings React Differently to Endolymphatic Duct Blockage

Wang

et al. 2022

The Laryngoscope

View full text Add to dashboard Cite

show abstract

“…A possible explanation for the link between EH and saccular dysfunction is provided by the recent hypothesis that dislodged otoconia from the saccule might obstruct the ductus reuniens (a tubular connection between the caudal end of the saccule and the scala media of the basal cochlear turn) resulting in cochlear EH (52,53). This hypothesis is strengthened by several lines of evidence from the following: 1) animal studies with obliteration of the ductus reuniens in guinea pigs (54), 2) postmortem human temporal bone studies (55–58), and 3) VEMP measurements in patients with MD showing earlier onset and higher frequency of saccular as compared to utricular dysfunction (59,60).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Endolymphatic Hydrops in Cochlear Implant Candidates with Idiopathic Profound Sensorineural Hearing Loss

et al. 2022

View full text Add to dashboard Cite

ObjectiveTo determine the prevalence of endolymphatic hydrops (EH) in cochlear implant (CI) candidates with idiopathic profound sensorineural hearing loss (SNHL) and its influence on the preservation of audiovestibular function after cochlear implantation.Study DesignProspective case series.SettingTertiary referral center.PatientsCI candidates with idiopathic progressive SNHL, but without classic EH-associated symptoms.InterventionsDelayed intravenous gadolinium-enhanced inner ear fluid-attenuated inversion recovery magnetic resonance imaging as well as pure-tone audiograms, video head impulse tests, and vestibular evoked myogenic potentials before and 4 weeks after cochlear implantation.Main Outcome MeasuresPrevalence of EH before cochlear implantation, audiovestibular function before and after surgery in hydropic and nonhydropic ears.ResultsThirty-two ears in 16 CI candidates were included. Nine ears (28%) with EH were detected. Although preoperative hearing thresholds, utricular function, and semicircular canal function were not different between the two groups, saccular function was reduced in hydropic ears. Ten subjects received a unilateral CI. Of these, 3 (30%) showed EH on the implanted side. There was no difference regarding postoperative hearing loss between the two groups, but the results point toward a higher vulnerability of hydropic ears with respect to loss of otolith function after cochlear implantation.ConclusionsThis is the first study showing that EH can be assumed in about one third of CI candidates with idiopathic profound SNHL, but no classic EH-associated symptoms. Preliminary results suggest that EH has no influence on the preservation of cochlear function but could be a risk factor for loss of otolith function after cochlear implantation.

show abstract

“…The total scores of endolymphatic hydrops was negatively correlated with the low-, mid- and high-frequency hearing thresholds, suggesting that the severity of hearing loss may indirectly reflect the severity of endolymphatic hydrops. We hypothesize that because endolymphatic hydrops often start in the cochlea and progresses to the saccule, the lesion worsens when the saccule compliance decreases, shedding the saccule otolith and causing obstruction of ductus reuniens ( 15 ). As the degree of endolymphatic hydrops increases, it affects the function of inner and outer hair cells as well as the ionic concentration of endolymphatic fluid.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging of endolymphatic hydrops in Ménière's disease: A comparison of the diagnostic value of multiple scoring methods

et al. 2022

View full text Add to dashboard Cite

ObjectivesTo compare three methods of scoring endolymphatic hydrops in patients with Ménière's disease in order to assess the correlation between endolymphatic hydrops and auditory characteristics.MethodsA retrospective study of 97 patients with unilateral definite Ménière's disease (DMD) who underwent contrast-enhanced three-dimensional fluid attenuated inversion recovery (3D FLAIR) MRI. Each patient was scored by the Inner Ear Structural Assignment Method (IESAM), the Saccule to utricle area ratio (SURI), and the Four Stage Vestibular Hydrops Grading (FSVH), according to their corresponding axial images. Cohen's Kappa and intra-class correlation coefficient were used for consistency testing, combined with binary logistic regression analysis, to compare the sensitivity and specificity of the three methods. The degree of hydrops in different stages of MD was compared. The correlation between endolymphatic hydrops in the inner ear sub-units and hearing thresholds was further analyzed.ResultsThe intra- and inter-reader reliability for the scoring of endolymphatic hydrops were excellent. The IESAM had a high diagnostic value for identifying definite Meniere's disease (sensitivity: 86.6%, specificity: 97.9%). The hearing thresholds were correlated with the degree of endolymphatic hydrops. Stages 3 and 4 were more significant for the severity of hydrops than stage 1. Within the subgroups of the Meniere's disease patients, compared with the non-hydrops group and the pure vestibular hydrops (V group), the cochlear combined vestibular hydrops group (CV group) had significantly higher auditory thresholds. The amplitude ratio of electrocochleogram was significantly higher in the affected ear than in the healthy ear.ConclusionThe IESAM is a more sensitive and specific diagnostic scoring method for the diagnosis of DMD. Diagnostic imaging may improve the detection of inner ear hydrops which is correlated with severity of hearing loss. A comprehensive evaluation of the inner ear sub-unit structures maybe necessary.

show abstract

Ductus Reuniens and Its Possible Role in Menière's Disease

Abstract: Supplemental Digital Content is available in the text

Cited by 11 publications

References 51 publications

Meniere's Disease Patients with Distinct Sac Pathoanatomic Findings React Differently to Endolymphatic Duct Blockage

Meniere's Disease Patients with Distinct Sac Pathoanatomic Findings React Differently to Endolymphatic Duct Blockage

Prevalence of Endolymphatic Hydrops in Cochlear Implant Candidates with Idiopathic Profound Sensorineural Hearing Loss

Magnetic resonance imaging of endolymphatic hydrops in Ménière's disease: A comparison of the diagnostic value of multiple scoring methods

Contact Info

Product

Resources

About