Value of CT and three-dimensional reconstruction revealing specific radiological signs for screening causative high jugular bulb in patients with Meniere’s disease

Hu, Junjiao; Peng, Anquan; Deng, Kai; Huang, Chao; Wang, Qin; Pan, Xin-Bin; Liu, Wei; Zhang, Zhiwen; Jiang, Wenqi; Chen, Yichao

doi:10.1186/s12880-020-00504-0

Cited by 11 publications

(10 citation statements)

References 29 publications

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“…Future research could use more adequate frequency stimuli to ensure better diffusion of perilymph waves to the presumed VA-IJV interface with lower compliance. Moreover, Hu et al proposed to associate HRCT slices with reconstructions to study the relationship between these two structures ( 42 ). These authors proposed a three-stage classification: no contact, contact without VA obstruction, and VA obstruction.…”

Section: Discussionmentioning

confidence: 99%

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%

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

et al. 2022

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“…MRI was performed using intratympanic and intravenous application of gadopentetate dimeglumine (IT-Gd +IV-Gd) as previously described ( 21 ). In brief, MRI was performed using a single-dose (0.2 ml/kg) intravenous administration of contrast media (Magnevist®, Bayer AG) 4 h before the MRI scan, as well as intratympanic administration of 8-fold-diluted Gd in both ears 24 h prior to the MRI scan.…”

Section: Methodsmentioning

confidence: 99%

Dynamics in Endolymphatic Hydrops & Symptoms in Meniere's Disease After Endolymphatic Duct Blockage, Preliminary Results

Peng

et al. 2021

Front. Neurol.

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Objective: The purpose of the present study was to evaluate the dynamics of endolymphatic hydrops (EH) and symptoms in a group of patients who underwent endolymphatic duct blockage (EDB) for treatment of intractable Meniere's Disease (MD), and to explore a metric for verifying the effectiveness of EDB procedure.Methods: A total of 22 patients with intractable MD patients who underwent EDB participated in the present study. EH was visualized using locally enhanced inner ear magnetic resonance imaging (MRI) prior to and following surgery. The vestibular hydrops ratio (VHR) in the second MRI examination was compared with the pre-surgery recordings.Results: Following EDB, 6 patients exhibited complete or partial reversal of EH, complete control of vertigo spells and reported improvement in hearing; 13 patients showed no changes in EH or hearing, but 5 of these patients exhibited complete control of vertigo attacks, and the other 8 patients exhibited improved control of vertigo attacks. The final 3 patients showed an increase in EH, but symptomatic worsening in 2 patients, and symptomatic improvement in 1 patient. There was a significant difference in the average VHR prior to and following EDB. Postoperative VHR was positively correlated with the frequency of vertigo spells in the latest 6 months of follow-up and improvement of postoperative average hearing threshold.Conclusion: The decreased EH accompanying the reduction in vertigo attacks and hearing preservation may provide a metric for verifying the effectiveness of EDB treatment in patients with MD.

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“…MRI was performed as previously described [ 11 , 12 ]. In brief, when a single-dose (0.2 ml/kg) gadolinium-based contrast agent (Magnevist®, Bayer AG) was administrated intravenously 4 h before the MRI scan (IV-Gd) and a eightfold-diluted Gd was injected intratympanically in both ears 24 h prior to the MRI scan (IT-Gd), the MRI scan was performed with a three-dimensional real inversion recovery (3D-real IR) sequence on a 3 T MR unit (Magnetom Verio; Siemens AG) using a 12-channel head coil, as previously described [ 11 , 12 ]. For the second and third Gd-MRI, the intratympanic administration of contrast agent might be used in the ear undergoing surgery alone when patients were reluctant to receive intratympanic injections in their healthy ear.…”

Section: Methodsmentioning

confidence: 99%

A comparison of endolymphatic duct blockage, endolymphatic sac drainage and endolymphatic sac decompression surgery in reversing endolymphatic hydrops in Meniere's disease

Peng

Wang

et al. 2021

Journal of Otolaryngology - Head & Neck Surgery

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Background To explore the differences between endolymphatic duct blockage, endolymphatic sac drainage and endolymphatic sac decompression surgery in the reversal of endolymphatic hydrops (EH) in patients with intractable Meniere’s disease (MD). Methods A total of 27 MD patients receiving endolymphatic duct blockage surgery (n = 10), endolymphatic sac drainage surgery (n = 9) and endolymphatic sac decompression surgery (n = 8) underwent gadolinium-enhanced inner ear magnetic resonance imaging (MRI) scans prior to, 2 weeks after and at > 12 months following surgery. Results In the group with endolymphatic duct blockage, the second MRI revealed no changes in EH, whereas the third MRI revealed a reversal of vestibular EH in 3 patients and a downgrading of cochlear hydrops in 2 of these 3 patients, who presented with an improvement in their hearing and complete control of vertigo. In the group with endolymphatic sac drainage, the second MRI showed a reversal of EH in 4 patients, and no changes in EH in the remaining 5 patients, whereas the third MRI showed that those 4 patients who presented with a reversal of EH at the second MRI stage remained unchanged except a recurrence of vestibular hydrops in 1 patient. All 4 patients exhibited a complete control of vertigo, but hearing improved in 1, worsened in 1 and remained unchanged in 2. In the group with endolymphatic sac decompression, both the second and third MRI examination revealed no reversal of EH. Conclusions The present study has shown that both endolymphatic duct blockage surgery and endolymphatic sac drainage surgery have the potential to reduce EH in certain MD patients, but none of the patients receiving endolymphatic sac decompression surgery showed reversal of their EH. Graphical Abstract

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Value of CT and three-dimensional reconstruction revealing specific radiological signs for screening causative high jugular bulb in patients with Meniere’s disease

Cited by 11 publications

References 29 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

Dynamics in Endolymphatic Hydrops & Symptoms in Meniere's Disease After Endolymphatic Duct Blockage, Preliminary Results

A comparison of endolymphatic duct blockage, endolymphatic sac drainage and endolymphatic sac decompression surgery in reversing endolymphatic hydrops in Meniere's disease

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