Stenting the Superior Petrosal Sinus in a Patient With Symptomatic Superior Semicircular Canal Dehiscence

Ionescu, E.; Coudert, Aurélie; Reynard, Pierre Claude; Truy, Éric; Thai‐Van, Hung; Ltaief-Boudrigua, A.; Turjman, Francis

doi:10.3389/fneur.2018.00689

Cited by 11 publications

(14 citation statements)

References 19 publications

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“…The implementation of this classification could also bring a potential addition to develop other treatment methods in the future. As an example, in case of a type II (vestibular-vascular) OCD showing a mass effect on the membranous labyrinth highlighted by 3D MRI, performing an endovascular procedure rather than performing a plugging-type surgery was simplest and with no expected vestibular or auditory impairments (24)(25)(26). So far, it appears to be difficult to propose a correlation between symptoms or signs and each type or subtype of OCD, since there is a wide spectrum of clinical presentations that cannot be necessarily systematized (13,14,20).…”

Section: Discussionmentioning

confidence: 99%

“…As for the dehiscence's involving the IJV bulb and labyrinthic membranous structures (VA and the PSC), Thenint et al had already proposed in a limited series stenting of the IJV to limit the transmission of vascular vibrations to the labyrinth with good results ( 24 ). We proposed a similar approach in one of our patients with SSCD by SPS; a significant improvement was observed after the endovascular procedure, which consisted in stenting the SPS ( 25 ). Recently, a similar, although slightly modified, approach was used by another otologic group, since the SPS was just occluded ( 26 ) with a very good result.…”

Section: Discussionmentioning

confidence: 99%

“…Due to this progressive increase in new variants of OCD reported, the characterization of the anatomical structures involved, as well as the size and location of the TW on the otic capsule, has become essential for a better understanding of the various (or just slightly different) mechanisms associated with this pathology. This allows not only to systematize the different known variants and facilitate the diagnosis of "mysterious" conductive deafness (20)(21)(22), but also to propose new, potentially less invasive or more pathophysiological therapeutic strategies (23)(24)(25)(26). The purpose of this article is: (1) to propose an anatomoradiological classification of different OCD abnormalities and (2) to discuss the alleged pathomechanism of certain variants.…”

Section: Introduction History Of the Third Window Hypothesismentioning

confidence: 99%

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Proposal for a Unitary Anatomo-Clinical and Radiological Classification of Third Mobile Window Abnormalities

et al. 2022

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Introduction: An increased number of otic capsule dehiscence (OCD) variants relying on the third window pathomechanism have been reported lately. Therefore, a characterization of the anatomical structures involved and an accurate radiological description of the third window (TW) interface location have become essential for improving the diagnosis and appropriate therapeutic modalities. The purpose of this article is to propose a classification based on clinical, anatomical, and radiological data of third mobile window abnormalities (TMWA) and to discuss the alleged pathomechanism in lesser-known clinical variants.Materials and Methods: The imaging records of 259 patients who underwent, over the last 6 years, a high-resolution CT (HRCT) of the petrosal bone for conductive hearing loss were analyzed retrospectively. Patients with degenerative, traumatic, or chronic infectious petrosal bone pathology were excluded. As cases with a clinical presentation similar to those of a TW syndrome have recently been described in the literature but without these being confirmed radiologically, we thought it necessary to be integrated in a separated branch of this classification as “CT - TMWA.” The same goes for certain intralabyrinthine pathologies also recently reported in the literature, which mimic to some extent the symptoms of a TW pathology. Therefore, we suggest to call them intralabyrinthine TW-like abnormalities.Results: Temporal bone HRCT and, in some cases, 3T MRI of 97 patients presenting symptomatic or pauci-symptomatic, single or multiple, unilateral or bilateral OCD were used to develop this classification. According to the topography and anatomical structures involved at the site of the interface of the TW, a third-type classification of OCD is proposed.Conclusions: A classification reuniting all types of TMWA as the one proposed in this article would allow for a better systematization and understanding of this complex pathology and possibly paves the way for innovative therapeutic approaches. To encompass all clinical and radiological variants of TMWA reported in the literature so far, TMWAs have been conventionally divided into two major subgroups: Extralabyrinthine (or “true” OCD with three subtypes) and Intralabyrinthine (in which an additional mobile window-like mechanism is highly suspected) or TMWA-like subtype. Along these subgroups, clinical forms of OCD with multiple localization (multiple OCD) and those that, despite the fact that they have obvious characteristics of OCD have a negative CT scan (or CT – TMWA), were also included.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introduction History Of the Third Window Hypothesismentioning

confidence: 99%

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Proposal for a Unitary Anatomo-Clinical and Radiological Classification of Third Mobile Window Abnormalities

et al. 2022

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“…35 Another report showed that stenting of the SPS significantly decreased the symptoms of superior semicircular canal dehiscence by the SPS. 36 The CSA of the SPS is relatively easy to examine compared to the degree of EH. If we can efficiently predict the future development of EH in patients from small SPS CSA values, we may be able to prevent the onset of MD by early lifestyle changes.…”

Section: Superior Petrosal Sinus and Ehmentioning

confidence: 99%

Cross-sectional Area of the Superior Petrosal Sinus is Reduced in Patients with Significant Endolymphatic Hydrops

Naganawa¹,

Ito²,

Kawai³

et al. 2022

magn reson med sci

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Purpose: To evaluate the relationship between the size of the venous structures related to the inner ear and the degree of endolymphatic hydrops (EH). Methods: Thirty-four patients with a suspicion of EH underwent whole brain MR imaging including the inner ear. Images were obtained pre- and post-administration, and at 4 and 24 hours after the intravenous administration of a gadolinium-based contrast agent (IV-GBCA). The cross-sectional areas (CSA) of the internal jugular vein (IJV), superior petrosal sinus (SPS), and inferior petrosal sinus (IPS) were measured on the magnetization prepared rapid acquisition of gradient echo (MPRAGE) images obtained immediately after the IV-GBCA. The grade of EH was determined on the hybrid of reversed image of positive endolymph signal and native image of positive perilymph signal (HYDROPS) images obtained at 4 hours after IV-GBCA as no, mild, and significant EH according to the previously proposed grading system for the cochlea and vestibule, respectively. The ipsilateral CSA was compared between groups with each level of EH grade. P < 0.05 was considered statistically significant. Results: There were no statistically significant differences between EH grades for the CSA of the IJV or that of the IPS in either the cochlea or the vestibule. The CSA of the SPS in the groups with significant EH was significantly smaller than that in the group with no EH, for both the cochlea ( P < 0.01) and the vestibule ( P < 0.05). In an ROC analysis to predict significant EH, the cut-off CSA value in the SPS was 3.905 mm 2 for the cochlea (AUC: 0.8762, 95% confidence interval [CI]: 0.7952‒0.9572) and 3.805 mm 2 for the vestibule (AUC: 0.7727, 95% CI: 0.6539‒0.8916). Conclusion: In the ears with significant EH in the cochlea or vestibule, the CSA of the ipsilateral SPS was smaller than in the ears without EH.

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“…Because of the fragility, microscopic dimensions and complexity of the inner ear structures, relatively few steps have been taken to date in the specific field of treatments dedicated to the inner ear diseases. In this context, our aim is to develop an artificial vestibular system [4][5][6] that thoroughly represents the physiology of the inner ear in order to sustain or confirm new pathophysiological mechanism theories and to propose new treatment procedures [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Development of a bio-inspired angular acceleration sensor : towards the non-invasive investigation of inner ear pathologies

Puyoo

Vieren

Roiban

et al. 2021

2021 Symposium on Design, Test, Integration &Amp; Packaging of MEMS and MOEMS (DTIP)

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In this paper, we introduce the development of a bio-inspired system that mimics the angular acceleration sensor function provided by the vestibular system. The prototype is made of a Plexiglas piece that presents the pattern of a semicircular canal at scale 10, with a simplified geometry. A flexible piezoresistive cantilever integrated on polyimide substrate is used to model the electro-mechanical transduction of the cupula/hair cells system. The electro-mechanical response of the complete system is analyzed when submitted to both pulse and sine rotational excitations. It is demonstrated that the biomimetic system only responds to one rotational axis, and is also sensitive to the rotational direction. We also validate that the prototype actually responds to the expected medium vestibular frequencies (from 0.16Hz to 0.64Hz).

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Stenting the Superior Petrosal Sinus in a Patient With Symptomatic Superior Semicircular Canal Dehiscence

Cited by 11 publications

References 19 publications

Proposal for a Unitary Anatomo-Clinical and Radiological Classification of Third Mobile Window Abnormalities

Proposal for a Unitary Anatomo-Clinical and Radiological Classification of Third Mobile Window Abnormalities

Cross-sectional Area of the Superior Petrosal Sinus is Reduced in Patients with Significant Endolymphatic Hydrops

Development of a bio-inspired angular acceleration sensor : towards the non-invasive investigation of inner ear pathologies

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