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De Ravin E, Quimby AE, Bartellas M, Swanson S, Hwa TP, Bigelow DC, Brant JA, Ruckenstein MJ. An Update on the Epidemiology and Clinicodemographic Features of Meniere's Disease. Laryngoscope 2024; 134:3310-3315. [PMID: 38238895 DOI: 10.1002/lary.31282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/27/2023] [Accepted: 12/22/2023] [Indexed: 06/18/2024]
Abstract
OBJECTIVE To characterize the estimated prevalence and clinicodemographic features of Ménière's disease (MD) using current diagnostic criteria. METHODS A cross-sectional study was undertaken at our tertiary academic referral center. All patients seen in Otolaryngology clinic with ICD-10 diagnoses of MD, from January 1, 2013 to July 31, 2022 were identified. Chart review was undertaken to determine the estimated prevalence of MD meeting AAO-HNS diagnostic criteria. Clinicodemographic features were evaluated against a comparator group without MD seen in our health system. RESULTS Of 806 ICD-10 diagnoses of MD, we identified 480 MD cases meeting diagnostic criteria (168 definite). Mean age at presentation for MD cases was 49 years. Forty-seven percent of cases were male. A significantly higher proportion of MD cases than comparators were white (76% vs. 66%, p < 0.001). Mean time since MD symptom onset was 6.7 years, with a mean attack duration of 4.6 h; 7.5% of MD cases reported a positive family history, and 7% had bilateral disease. The odds of reporting migraine were significantly greater among MD patients than comparators (OR 1.74 [1.26-2.42]); the odds of having autoimmune conditions were lower (OR 0.45 [0.28-0.74]); and the odds of reporting allergies were no different (OR 0.96 [0.74-1.25]) versus comparator patients after controlling for demographic characteristics. CONCLUSIONS Among MD diagnoses, there is a low estimated prevalence of MD meeting diagnostic criteria, and an even lower prevalence of definite MD. Compared to a comparator group of patients seen for any disorder, patients with MD are more likely to be white, male, and have a history of migraine. LEVEL OF EVIDENCE 4 Laryngoscope, 134:3310-3315, 2024.
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Affiliation(s)
- Emma De Ravin
- Department of Otolaryngology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Alexandra E Quimby
- Department of Otolaryngology and Communication, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Michael Bartellas
- Department of Otolarynology - Head & Neck Surgery, University of Ottawa, Ottawa, Ontario, USA
| | - Sydnie Swanson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tiffany P Hwa
- Department of Otorhinolarynoglogy - Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Douglas C Bigelow
- Department of Otorhinolarynoglogy - Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jason A Brant
- Department of Otorhinolarynoglogy - Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Michael J Ruckenstein
- Department of Otorhinolarynoglogy - Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Suárez-Vega V, Manrique-Huarte R, Dominguez P, Blanco M, Alonso-Burgos A, Pérez-Fernández N. Magnetic Resonance Volumetric Quantification of Vestibular Endolymphatic Hydrops in Patients with Unilateral Definite Meniere's Disease Using 3D Inversion Recovery with Real Reconstruction (3D-REAL-IR) Sequence. J Clin Med 2023; 12:5965. [PMID: 37762906 PMCID: PMC10532400 DOI: 10.3390/jcm12185965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The 3D-REAL-IR MRI sequence allows for an in vivo visualization of endolymphatic hydrops. Qualitative assessment methods of the severity of vestibular and cochlear hydrops are the most commonly used. METHODS A quantitative volumetric measurement of vestibular EH in patients with definite unilateral Ménière's disease using the 3D-REAL-IR sequence and the calculation of the endolymphatic ratio (ELR) was intended. RESULTS Volumetric calculations of the vestibules, vestibular endolymph and vestibular ELR are performed in 96 patients with unilateral Ménière's disease and correlated with classic qualitative grading scales. CONCLUSIONS Quantitative volumetric measurement of vestibular hydrops using the 3D-REAL-IR sequence is feasible and reproducible in daily clinical practice. Vestibular ELR values exceeding 60% defined radiologically significant vestibular hydrops, while values below 30% defined radiologically non-significant vestibular hydrops.
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Affiliation(s)
- Víctor Suárez-Vega
- Department of Radiology, Clinica Universidad de Navarra, 28027 Madrid, Spain;
| | - Raquel Manrique-Huarte
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, 31008 Pamplona, Spain;
| | - Pablo Dominguez
- Department of Radiology, Clinica Universidad de Navarra, 31008 Pamplona, Spain;
| | - Melissa Blanco
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, 28027 Madrid, Spain; (M.B.); (N.P.-F.)
| | | | - Nicolás Pérez-Fernández
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, 28027 Madrid, Spain; (M.B.); (N.P.-F.)
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Wang B, Li Y, Zhang Q, Sun J, Tian Y, Ma D, Leng H. A bibliometric and visualization study of Meniere's disease: Current status and global hotspots and emerging trends. Medicine (Baltimore) 2023; 102:e33156. [PMID: 36897693 PMCID: PMC9997775 DOI: 10.1097/md.0000000000033156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/10/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Meniere's disease (MD) is a clinical condition characterized by endolymphatic hydrops. Persistent symptoms negatively affect patients mood, and the underlying etiology remains unclear. It is necessary to comprehensively understand the relevant publications, review the history and current status of research, and analyze hotspots and frontiers of research on MD. METHODS We retrieved literature on Meniere's disease from 2003 to 2022 from the Web of Science database and extracted the data. Data visualization and analysis was conducted using Cite Space, VOS viewer, an online web tool, and Microsoft Office Power Point 2019. RESULTS In total, 2847 publications were analyzed. The number of annual publications was relatively stable, with an accelerated upward trend over the past 5 years. The country with the most publications was USA (751, 26.38%), while the University of Munich contributed more publications than any other institution (117, 4.11%). The article titled "Diagnostic criteria for Meniere's disease" by Lopez-Escamez J et al in 2015 was the most cited and co-cited publication, and also had the top co-cited references with the strongest citation bursts. Naganawa S was the author with the most publications (85, 2.99%). The top 3 journals and co-cited journals were Otology Neurotology, Acta Oto Laryngologica, and Laryngoscope. Recently, the key theme words were "sensorineural hearing loss," "therapy," "intratympanic injection method," "vestibular-evoked myogenic potentials," "vestibular migraine," "magnetic resonance imaging," and "meniere's disease." CONCLUSIONS The US has the largest number of publications and research institutions, many European countries have high-quality journals, and Japan has the highest number of scholars. The international opinion on Meniere's disease is relatively uniform. The stepped-therapy for MD is scientific and clear. Intratympanic injection of steroids and intratympanic injection of gentamicin are commonly used, but steroids are considered safer. Saccular dysfunction may be more common in patients with MD than in those with utricular dysfunctions. It is worth paying attention to study the relationship between MD and vestibular migraine through headache. Progress in magnetic resonance imaging technology is still required for the imaging diagnosis of MD.
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Affiliation(s)
- Boshen Wang
- Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Yuan Li
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Qi Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Jiawei Sun
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Yu Tian
- Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Dan Ma
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hui Leng
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
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Effects of endolymphatic space volume on discrepancy of results between caloric test and video head impulse test. Auris Nasus Larynx 2022:S0385-8146(22)00220-6. [DOI: 10.1016/j.anl.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/07/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022]
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Kashizadeh A, Pastras C, Rabiee N, Mohseni-Dargah M, Mukherjee P, Asadnia M. Potential nanotechnology-based diagnostic and therapeutic approaches for Meniere's disease. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2022; 46:102599. [PMID: 36064032 DOI: 10.1016/j.nano.2022.102599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
Meniere's disease (MD) is a progressive inner ear disorder involving recurrent and prolonged episodes or attacks of vertigo with associated symptoms, resulting in a significantly reduced quality of life for sufferers. In most cases, MD starts in one ear; however, in one-third of patients, the disorder progresses to the other ear. Unfortunately, the etiology of the disease is unknown, making the development of effective treatments difficult. Nanomaterials, including nanoparticles (NPs) and nanocarriers, offer an array of novel diagnostic and therapeutic applications related to MD. NPs have specific features such as biocompatibility, biochemical stability, targetability, and enhanced visualization using imaging tools. This paper provides a comprehensive and critical review of recent advancements in nanotechnology-based diagnostic and therapeutic approaches for MD. Furthermore, the crucial challenges adversely affecting the use of nanoparticles to treat middle ear disorders are investigated. Finally, this paper provides recommendations and future directions for improving the performances of nanomaterials on theragnostic applications of MD.
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Affiliation(s)
- Afsaneh Kashizadeh
- School of Electrical and Computer Engineering, Shahid Beheshti University, Tehran 1983969411, Iran
| | - Christopher Pastras
- School of Engineering, Macquarie University, Sydney, NSW 2109, Australia; The Menière's Laboratory, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Navid Rabiee
- School of Engineering, Macquarie University, Sydney, NSW 2109, Australia
| | - Masoud Mohseni-Dargah
- School of Engineering, Macquarie University, Sydney, NSW 2109, Australia; Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Payal Mukherjee
- RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Mohsen Asadnia
- School of Engineering, Macquarie University, Sydney, NSW 2109, Australia.
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Inui H, Sakamoto T, Ito T, Kitahara T. Magnetic resonance imaging of endolymphatic hydrops in patients with unilateral Meniere's disease: volume ratio and distribution rate of the endolymphatic space. Acta Otolaryngol 2021; 141:1033-1037. [PMID: 34807797 DOI: 10.1080/00016489.2021.1968488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Endolymphatic hydrops (ELH), which is a pathological feature of Meniere's disease (MD), is characterized by an extended endolymphatic space (ELS). AIMS/OBJECTIVES We aimed to perform a quantitative volumetric analysis of inner-ear ELH in patients with unilateral MD (uMD). MATERIAL AND METHODS This study included 97 patients with definite uMD and 49 control subjects (CS). The ELS/total fluid space (TFS) volume ratio (%) and the distribution rate of the inner-ear components in the ELS (%) were measured using 3D magnetic resonance imaging and compared between patients with uMD and CS. RESULTS Compared to CS, patients with uMD had significantly higher mean ELS/TFS volume ratios for inner-ear components. The mean distribution rate of the inner-ear components in the ELS was not significantly different between the two groups. CONCLUSIONS AND SIGNIFICANCE In patients with uMD, ELH was noted to be spread throughout the entire inner ear and the endolymph was evenly distributed in the total ELS. These findings should be useful as a standard reference for further research.
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Affiliation(s)
- Hiroshi Inui
- Department of Otorhinolaryngology, Inui ENT Clinic, Nara, Japan
| | | | - Taeko Ito
- Department of Otorhinolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan
| | - Tadashi Kitahara
- Department of Otorhinolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan
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7
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Noh TS, Park MK, Lee JH, Oh SH, Kim JH, Song IC, Suh MW. Three-Dimensional Volumetric Measurement of Endolymphatic Hydrops in Meniere's Disease. Front Neurol 2021; 12:710422. [PMID: 34589046 PMCID: PMC8473889 DOI: 10.3389/fneur.2021.710422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/13/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: We used volumetric three-dimensional (3D) analysis to quantitatively evaluate the extent of endolymphatic hydrops (EH) in the entire inner ear. We tested for correlations between the planimetric and volumetric measurements, to identify their advantages and disadvantages. Methods: HYDROPS2-Mi2 EH images were acquired for 32 ears (16 patients): 16 ipsilateral ears of MD patients (MD-ears) and 16 contralateral ears. Three-T MR unit with a 32-channel phased-array coil/the contrast agent to fill the perilymphatic space and the HYDROPS2-Mi2 sequence. We calculated the EH% [(endolymph)/(endolymph+perilymph)] ratio and analyzed the entire inner ear in terms of the volumetric EH% value, but only single cochlear and vestibular slices were subjected to planimetric EH% evaluation. The EH% values were compared between MD ears and non-MD ears, to evaluate the diagnostic accuracy of the two methods. Results: The volumetric EH% was significantly higher for MD vestibules (50.76 ± 13.78%) than non-MD vestibules (39.50 ± 8.99%). The planimetric EH% was also significantly higher for MD vestibules (61.98 ± 20.65%) than non-MD vestibules (37.22 ± 12.95%). The vestibular and cochlear volumetric EH% values correlated significantly with the planimetric EH% values of the MD ear. Conclusion: Volumetric and planimetric EH measurements facilitate diagnosis of MD ears compared to non-MD ears. Both methods seem to be reliable and consistent; the measurements were significantly correlated in this study. However, the planimetric EH% overestimates the extent of vestibular hydrops by 26.26%. Also, planimetric data may not correlate with volumetric data for non-MD cochleae with normal EH% values.
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Affiliation(s)
- Tae-Soo Noh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Jun Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Seung Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Ji-Hoon Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - In Chan Song
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Myung-Whan Suh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
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Teggi R, Battista RA, Di Berardino F, Familiari M, Cangiano I, Gatti O, Bussi M. Evaluation of a large cohort of adult patients with Ménière's disease: bedside and clinical history. ACTA ACUST UNITED AC 2021; 40:444-449. [PMID: 33558773 PMCID: PMC7889248 DOI: 10.14639/0392-100x-n0776] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/16/2020] [Indexed: 01/03/2023]
Abstract
Objective The purpose of this study was to assess vestibular findings and clinical history in a large cohort of patients affected by Ménière’s disease. Methods We retrospectively analysed 511 adult patients fulfilling criteria for definite unilateral Ménière’s disease according to Barany Society. Thorough clinical history, audiometric exam, central nervous system MRI, quantification of serum autoantibodies and complete vestibular function test were performed. Results Mean age at clinical record was 55.4 years, while age at onset of the first vertigo attack was 47.4 ± 14.3 years. Ménière’s disease overlapped with migraine in 43.4% of patients. In 31.7% of cases, positivity was found for at least one autoantibody. Forty-nine patients (9.6%) had family history for Ménière’s disease. Bedside examination resulted in 14.7% positivity for video head impulse test, 58.9% for skull vibration-induced nystagmus, 38.7% for the positional test and 23.1% for the post head shaking test. Complete negative examination was reported in 115 cases. Conclusions Ménière’s disease was seen to present a characteristic phenotypic pattern in our cohort, confirming the crucial role of thorough anamnesis and bedside examination in diagnosis.
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Affiliation(s)
- Roberto Teggi
- Department of Otolaryngology Head & Neck Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Rosa Alessia Battista
- Department of Otolaryngology Head & Neck Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Di Berardino
- Audiology Unit, Dept of Clinical Sciences and Community Health and Dept. of Specialistic Surgical Sciences, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Marco Familiari
- Department of Otolaryngology Head & Neck Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | | | - Omar Gatti
- Department of Otolaryngology Head & Neck Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mario Bussi
- Department of Otolaryngology Head & Neck Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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Magnetic resonance imaging and Ménière's disease-unavoidable alliance. Neuroradiology 2021; 63:1749-1763. [PMID: 34142211 DOI: 10.1007/s00234-021-02744-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/31/2021] [Indexed: 12/28/2022]
Abstract
Ménière's disease (MD) is a clinical syndrome characterized by recurrent episodes of spontaneous vertigo, unilateral fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Endolymphatic hydrops is recognized as the pathophysiological substrate of the disease, having been demonstrated in anatomical pathological studies and more recently by magnetic resonance imaging (MRI). The current criteria of the disease, however, remain symptom based and do not include the demonstration of endolymphatic hydrops. The authors review MRI techniques and diagnostic criteria of endolymphatic hydrops and the role of MRI in MD is discussed.
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Boegle R, Gerb J, Kierig E, Becker-Bense S, Ertl-Wagner B, Dieterich M, Kirsch V. Intravenous Delayed Gadolinium-Enhanced MR Imaging of the Endolymphatic Space: A Methodological Comparative Study. Front Neurol 2021; 12:647296. [PMID: 33967941 PMCID: PMC8100585 DOI: 10.3389/fneur.2021.647296] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/24/2021] [Indexed: 12/11/2022] Open
Abstract
In-vivo non-invasive verification of endolymphatic hydrops (ELH) by means of intravenous delayed gadolinium (Gd) enhanced magnetic resonance imaging of the inner ear (iMRI) is rapidly developing into a standard clinical tool to investigate peripheral vestibulo-cochlear syndromes. In this context, methodological comparative studies providing standardization and comparability between labs seem even more important, but so far very few are available. One hundred eight participants [75 patients with Meniere's disease (MD; 55.2 ± 14.9 years) and 33 vestibular healthy controls (HC; 46.4 ± 15.6 years)] were examined. The aim was to understand (i) how variations in acquisition protocols influence endolymphatic space (ELS) MR-signals; (ii) how ELS quantification methods correlate to each other or clinical data; and finally, (iii) how ELS extent influences MR-signals. Diagnostics included neuro-otological assessment, video-oculography during caloric stimulation, head-impulse test, audiometry, and iMRI. Data analysis provided semi-quantitative (SQ) visual grading and automatic algorithmic quantitative segmentation of ELS area [2D, mm2] and volume [3D, mm3] using deep learning-based segmentation and volumetric local thresholding. Within the range of 0.1-0.2 mmol/kg Gd dosage and a 4 h ± 30 min time delay, SQ grading and 2D- or 3D-quantifications were independent of signal intensity (SI) and signal-to-noise ratio (SNR; FWE corrected, p < 0.05). The ELS quantification methods used were highly reproducible across raters or thresholds and correlated strongly (0.3-0.8). However, 3D-quantifications showed the least variability. Asymmetry indices and normalized ELH proved the most useful for predicting quantitative clinical data. ELH size influenced SI (cochlear basal turn p < 0.001), but not SNR. SI could not predict the presence of ELH. In conclusion, (1) Gd dosage of 0.1-0.2 mmol/kg after 4 h ± 30 min time delay suffices for ELS quantification. (2) A consensus is needed on a clinical SQ grading classification including a standardized level of evaluation reconstructed to anatomical fixpoints. (3) 3D-quantification methods of the ELS are best suited for correlations with clinical variables and should include both ears and ELS values reported relative or normalized to size. (4) The presence of ELH increases signal intensity in the basal cochlear turn weakly, but cannot predict the presence of ELH.
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Affiliation(s)
- Rainer Boegle
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFB (Integriertes Forschungs- und Behandlungszentrum), University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität, Munich, Germany
| | - Johannes Gerb
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFB (Integriertes Forschungs- und Behandlungszentrum), University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Emilie Kierig
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFB (Integriertes Forschungs- und Behandlungszentrum), University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Sandra Becker-Bense
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFB (Integriertes Forschungs- und Behandlungszentrum), University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Birgit Ertl-Wagner
- Department of Radiology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Marianne Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFB (Integriertes Forschungs- und Behandlungszentrum), University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Valerie Kirsch
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFB (Integriertes Forschungs- und Behandlungszentrum), University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität, Munich, Germany
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11
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He B, Zhang F, Zheng H, Sun X, Chen J, Chen J, Liu Y, Wang L, Wang W, Li S, Yang J, Duan M. The Correlation of a 2D Volume-Referencing Endolymphatic-Hydrops Grading System With Extra-Tympanic Electrocochleography in Patients With Definite Ménière's Disease. Front Neurol 2021; 11:595038. [PMID: 33551957 PMCID: PMC7856148 DOI: 10.3389/fneur.2020.595038] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/16/2020] [Indexed: 01/18/2023] Open
Abstract
Background: Although magnetic resonance imaging (MRI) of the membranous labyrinth and electrocochleography (ECochG) have been used to diagnose endolymphatic hydrops (ELH) in patients with Ménière's disease (MD), the relationship between imaging and ECochG is not well-documented. Objectives: This study evaluates the ELH using 3D-FLAIR MRI and extra-tympanic ECochG (ET-ECochG) and correlates the results from 3D-FLAIR MRI to those from ET-ECochG. Materials and Methods: 3D-FLAIR MRI images of 50 patients were assessed using a 2D volume-referencing grading system (VR scores, relative scores according to the known volumes of the cochlea, vestibule, and semicircular canals). Forty healthy subjects were included and compared to 51 definite MD ears of 50 patients while analyzing the ET-ECochG, which used a self-made bronze foil electrode. The amplitude ratio of the summating potential (SP) to the action potential (AP) (SP/AP) and the area ratio of SP to AP (Asp/Aap) were collected. Relative ELH grade scores were then correlated to ET-ECochG (SP/AP, Asp/Aap). Results: The VR scores showed a better correlation (r = 0.88) with the pure tone average (PTA), disease duration, and vertigo frequency of MD than the Bernaerts scores (grading the cochlea and vestibule separately) (r = 0.22). The SP/AP and Asp/Aap of the unilateral MD patients were statistically comparable to those measured in contralateral ears and the results between the definite MD ears with healthy ears were statistically comparable (p < 0.05). In a ROC analysis Asp/Aap (area under curve, AUC 0.98) significantly (p = 0.01) outperformed SP/AP (AUC 0.91). The total score of ELH, vestibular ELH, and cochlear ELH were also correlated with SP/AP and Asp/Aap. The strongest correlation was found between the Asp/Aap and cochlear ELH (r = 0.60). Conclusion: The 2D volume-referencing grading system was more meaningful than the Bernaerts scores. A correlation was found between ELH revealed by 3D-FLAIR MRI and the SP/AP of ET-ECochG in evaluating definite MD patients. The Asp/Aap appeared a more sensitive and reliable parameter than SP/AP for diagnosing the ELH of the membranous labyrinth.
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Affiliation(s)
- Baihui He
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Fan Zhang
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Hui Zheng
- Department of Radiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiayu Sun
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Junmin Chen
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jianyong Chen
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yupeng Liu
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Lu Wang
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Wei Wang
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Shuna Li
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jun Yang
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Maoli Duan
- Department of Otolaryngology Head and Neck and Neurotology and Audiology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
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12
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Jasińska A, Lachowska M, Wnuk E, Niemczyk K. Magnetic resonance imaging of the inner ear in the diagnostics of Ménière's disease. Otolaryngol Pol 2020; 75:1-8. [PMID: 33949313 DOI: 10.5604/01.3001.0014.6176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Ménière's disease is characterized by sudden episodes of vertigo accompanied by tinnitus and/or feeling of fullness in the ear as well as fluctuating sensorineural hearing loss. Despite numerous studies, the etiology of this disease remains unknown. However, the enlargement of the inner ear's endolymphatic spaces, referred to as endolymphatic hydrops, is considered the underlying condition. Thanks to recent advances in magnetic resonance (MR) technology, it is now possible to obtain in vivo imaging of endolymphatic hydrops in patients presenting with Ménière's disease symptoms. Visualization of the inner ear fluid compartments is achieved after gadolinium contrast is administered into the tympanic cavity or via the intravenous route. Evaluation of endolymphatic hydrops is possible as the contrast agent selectively penetrates the perilymph, and endolymph is visualized as contrast defects. The currently used radiological hydrops grading systems include qualitative, semi-quantitative, and volumetric scales. The methods are subject to ongoing modifications to increase their sensitivity and specificity. Numerous studies describe correlations between clinical symptoms and audiological and otoneurological examination results with the endolymphatic hydrops grade. MRI is also applicable in patients' diagnostics with an incomplete or atypical course of the Ménière's disease. In the course of the treatment, follow-up MRI scans enable assessing individual treatment modalities' efficacy in terms of the severity of lesions and the further course of the disease within the inner ear.
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Affiliation(s)
- Agnieszka Jasińska
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland; Head: Prof. Kazimierz Niemczyk MD PhD
| | - Magdalena Lachowska
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland; Head: Prof. Kazimierz Niemczyk MD PhD
| | - Emilia Wnuk
- Department of Clinical Radiology, Medical University of Warsaw, Poland; Head: Prof. Olgierd Rowiński MD PhD
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland; Head: Prof. Kazimierz Niemczyk MD PhD
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13
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Shiozaki T, Sakagami M, Ito T, Ota I, Wada Y, Kitahara T. What diagnosis should we make for long-lasting vertiginous sensation after acute peripheral vertigo? Acta Otolaryngol 2020; 140:1001-1006. [PMID: 32921200 DOI: 10.1080/00016489.2020.1813327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Differential diagnosis of persistent vertigo/dizziness in patients with a past history of vestibular neuritis (VN) and sudden deafness with vertigo (SDV) could sometimes be difficult for physicians due to variable vertiginous symptoms from rotatory to floating sensation. OBJECTIVES The main purpose of the present study was to examine the associations between the findings of otology/neurotology examinations in patients at the chronic stage after VN and SDV. MATERIAL AND METHODS We encountered 1789 successive vertigo/dizziness patients at the Vertigo/Dizziness Center in Nara Medical University between 2014 and 2018. Eighty-five patients were diagnosed as showing VN and 60 showed SDV according to the diagnostic guideline . The VN and SDV patients included 75 and 45 patients with chronic-stage of persistent vertigo/dizziness, of which 55 and 40 were enrolled into the present study. RESULTS Persistent vertigo/dizziness after VN was attributable to delayed vestibular compensation (dVC: 33/55; 60.0%), secondary benign paroxysmal positional vertigo (sBPPV: 20/55; 36.4%), and secondary endolymphatic hydrops (sEH: 2/55; 3.6%), while that after SDV was attributable to sBPPV (20/40; 50.0%), sEH (16/40; 40.0%), and dVC (4/40; 10.0%). CONCLUSION AND SIGNIFICANCE The present results could allow to simplify differential diagnosis of persistent vertigo/dizziness after VN and SDV such diseases as dVC, sBPPV, or sEH.
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Affiliation(s)
- Tomoyuki Shiozaki
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Masaharu Sakagami
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Taeko Ito
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Ichiro Ota
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Yoshiro Wada
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Tadashi Kitahara
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
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14
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Ito T, Matsuyama S, Shiozaki T, Nishikawa D, Akioka H, Yamanaka T, Kitahara T. Differences between primary care physicians and specialised neurotologists in the diagnosis of dizziness and vertigo in Japan. J Laryngol Otol 2020; 134:1-5. [PMID: 32940200 DOI: 10.1017/s0022215120001309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Vertigo and dizziness are frequent symptoms in patients at out-patient services. An accurate diagnosis for vertigo or dizziness is essential for symptom relief; however, it is often challenging. This study aimed to identify differences in diagnoses between primary-care physicians and specialised neurotologists. METHOD In total, 217 patients were enrolled. To compare diagnoses, data was collected from the reference letters of primary-care physicians, medical questionnaires completed by patients and medical records. RESULTS In total, 62.2 per cent and 29.5 per cent of the patients were referred by otorhinolaryngologists and internists, respectively. The cause of vertigo or dizziness and diagnosis was missing in 47.0 per cent of the reference letters. In addition, 67.3 per cent of the diagnoses by previous physicians differed from those reported by specialised neurotologists. CONCLUSION To ensure patient satisfaction and high quality of life, an accurate diagnosis for vertigo or dizziness is required; therefore, methods or materials to improve the diagnostic accuracy are needed.
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Affiliation(s)
- T Ito
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - S Matsuyama
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - T Shiozaki
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - D Nishikawa
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - H Akioka
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - T Yamanaka
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
| | - T Kitahara
- Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Japan
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15
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Inui H, Sakamoto T, Ito T, Kitahara T. Magnetic resonance imaging of endolymphatic space in patients with sensorineural hearing loss: comparison between fluctuating and idiopathic sudden sensorineural hearing loss. Acta Otolaryngol 2020; 140:345-350. [PMID: 32027202 DOI: 10.1080/00016489.2020.1720919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Recently, 3-Tesla magnetic resonance imaging (MRI) after an intravenous gadolinium injection has been used to describe the endolymphatic space (ELS).Objectives: This study described the histopathological differences between idiopathic sudden sensorineural hearing loss (ISSNHL) and fluctuating sensorineural hearing loss (FSNHL) by examining the ELS. Additionally, the relationship between the affected cochlear and vestibular ELS/total fluid space (TFS) volume ratio and the duration from the onset to MRI in patients with FSNHL were evaluated.Material and methods: This study included 205 individuals without vertigo: 47 controls, 94 with ISSNHL, and 64 with FSNHL. The TFS and ELS volumes were measured and the ELS/TFS volume ratios (%) were evaluated.Results: The cochlear and vestibular ELS/TFS volume ratios of the affected ear in patients with FSNHL were significantly higher than that in those with ISSNHL. There was no correlation between the duration from FSNHL onset to the MRI scan in the affected cochlea and vestibule.Conclusion and significance: There were differences in the form of hearing fluctuation and the extended ELS volume between ISSNHL and FSNHL. ISSNHL cases with severe ELS extension were likely to change to FSNHL.
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Affiliation(s)
| | | | - Taeko Ito
- Department of Otorhinolaryngology Head and Neck Surgery, Nara Medical University, Nara, Japan
| | - Tadashi Kitahara
- Department of Otorhinolaryngology Head and Neck Surgery, Nara Medical University, Nara, Japan
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