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Xia K, Lei P, Liu Y, Li J, Wang M, Leng Y, Liu B. Comparison of radiological abnormalities between the jugular bulb and the vestibular aqueduct in patients with Ménière's disease. Front Neurol 2023; 14:1184232. [PMID: 37251218 PMCID: PMC10213226 DOI: 10.3389/fneur.2023.1184232] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/11/2023] [Indexed: 05/31/2023] Open
Abstract
Objective Anatomical variations of the inner ear may contribute to the development of Ménière's disease (MD), which is a complex inner ear disorder histopathologically characterized by idiopathic endolymphatic hydrops (ELH). Abnormalities of the vestibular aqueduct (VA) and the jugular bulb (JB) have been suggested as predisposing factors. Yet, few studies have investigated the correlation between JB abnormalities and VA variations as well as its clinical relevance in these patients. In this retrospective study, we investigated the differences in the incidence of radiological abnormalities of the VA and JB in patients with definite MD. Methods Anatomical variations of JB and VA were evaluated based on high-resolution CT (HRCT) in a series of 103 patients with MD (93 unilateral cases and 10 bilateral cases). JB-related indices included JB anteroposterior and mediolateral diameter, JB height, JB type regarding to Manjila classification system, and incidences of JB diverticulum (JBD), JB related inner ear dehiscence (JBID), and inner ear adjacent JB (IAJB). VA-related indices included CT-VA visibility, CT-VA morphology (funnel, tubular, filiform, hollow, and obliterated-shaped type), and peri-VA pneumatization. Radiological indices were compared between MD ears and control ears. Results Radiological JB abnormalities were comparable between MD ears and control ears. As for VA-related indices, the CT-VA visibility was lower in MD ears than in control ears (p = 0.004). The distribution of CT-VA morphology was significantly different between MD and control ears (p = 0.013), with a higher proportion of obliterated-shaped type in MD ears (22.1%) than in control ears (6.6%). Conclusion Compared with JB abnormalities, the anatomical variations of VA are more likely to be an anatomically predisposing factor for MD.
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Affiliation(s)
- Kaijun Xia
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Lei
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingzhao Liu
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Miao Wang
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yangming Leng
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Liu
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zhong S, Zhang B, Qin L, Wang Q, Luo X. Aldosterone inhibits Dot1l expression in guinea pig cochlea. Eur J Med Res 2023; 28:26. [PMID: 36639782 PMCID: PMC9838020 DOI: 10.1186/s40001-023-00994-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/04/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Aldosterone relieves transcriptional repression of epithelial sodium channel (ENaC) by inhibiting Dot1a and Af9 expression and their interaction with ENaC promoter in various tissues. Expressions of ENaC and Af9 in inner ear have been identified. However, it is not known how Dot1l is regulated by aldosterone in inner ear. METHODS Twenty-eight adult guinea pigs were randomly divided into the control group and treatment group. Aldosterone 1 mg/kg/d was injected intraperitoneally in the treatment group and saline in the control group for 7 days. Animals were killed 1 month later following auditory brainstem response examination. Histomorphology of cochlea was detected with hematoxylin-eosin staining, and Dot1l expression was examined with immunohistochemistry and Western blot. RESULTS There was no significant difference in ABR thresholds before and after injection of aldosterone or saline in either group. Endolymphatic hydrops was found in 75% of animals in the treatment group. Dot1l was found in both groups in the stria vascularis, Reissner's membrane, spiral limbus, organ of Corti and spiral ligament. Dot1l expression in the treatment group was decreased by aldosterone. CONCLUSIONS Dot1l in guinea pig cochlea is inhibited by aldosterone with induction of endolymphatic hydrops. Dot1l may be closely related to endolymph regulation by aldosterone and to pathogenesis of Meniere's disease.
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Affiliation(s)
- Shixun Zhong
- grid.452206.70000 0004 1758 417XDepartment of Otolaryngology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016 China
| | - Biyun Zhang
- grid.452206.70000 0004 1758 417XDepartment of Otolaryngology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016 China
| | - Li Qin
- grid.490255.f0000 0004 7594 4364 Department of Otolaryngology, Mianyang Central Hospital, Mianyang, China
| | - Qianying Wang
- grid.452206.70000 0004 1758 417XDepartment of Otolaryngology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016 China
| | - Xiaoli Luo
- Department of Otolaryngology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
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3
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Zhang N, Li N, Wang S, Xu W, Liu J, Lyu Y, Li X, Song Y, Kong L, Liu Y, Guo J, Fan Z, Zhang D, Wang H. Protective effect of anakinra on audiovestibular function in a murine model of endolymphatic hydrops. Front Cell Neurosci 2022; 16:1088099. [PMID: 36589291 PMCID: PMC9798291 DOI: 10.3389/fncel.2022.1088099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Ménière's disease (MD), a common disease in the inner ear, is characterized by an increase in endolymph in the cochlear duct and vestibular labyrinth. The pathophysiology of the condition appears to be the immune response. Studies have shown that basal levels of the IL-1β increased in some MD patients. Methods Here, we used a murine model of endolymphatic hydrops (EH) to study the effect of anakinra on auditory and vestibular function. Mice were intraperitoneal injected with anakinra or saline before LPS by postauricular injection. Weight and disease severity were measured, histologic changes in auditory were assessed, and inflammation state was evaluated. Results We found that anakinra therapy reduced LPS-induced EH, alleviated LPS-induced hearing loss and vestibular dysfunction, and inhibited the expression of the inflammatory cytokines and macrophage infiltration in the cochlea of mice. We further demonstrated that anakinra ameliorated the disorganization and degeneration of myelin sheath, and reduced the neuron damage in cochlea of EH mice. Discussion Consequently, anakinra contributes to a promising therapeutic approach to MD, by restricting EH, alleviating auditory and vestibular function, inhibiting inflammation of the inner ear and protecting the cochlear nerve. Further investigations are needed to assess the potential therapeutic benefits of anakinra in patients with MD.
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Affiliation(s)
- Na Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Na Li
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China,Center of Clinical Laboratory, Shandong Second Provincial General Hospital, Jinan, Shandong, China
| | - Siyue Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Wandi Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Jiahui Liu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Yafeng Lyu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Xiaofei Li
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Yongdong Song
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Ligang Kong
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Yalan Liu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Jia Guo
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Zhaomin Fan
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China
| | - Daogong Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China,*Correspondence: Daogong Zhang,
| | - Haibo Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, Shandong, China,Shandong Provincial Vertigo and Dizziness Medical Center, Jinan, Shandong, China,Laboratory of Vertigo Disease, Shandong Second Provincial General Hospital, Shandong Institute of Otorhinolaryngology, Jinan, Shandong, China,Haibo Wang,
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Spironolactone Ameliorates Cochlear Implant Induced Endolymphatic Hydrops. Otol Neurotol 2022; 43:685-693. [DOI: 10.1097/mao.0000000000003517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Si L, Shen B, Li Y, Ling X, Li K, Yang X. Clinical Characteristics of Patients with Persistent Apogeotropic and Persistent Geotropic Direction-Changing Positional Nystagmus. J Clin Neurol 2021; 17:443-454. [PMID: 34184453 PMCID: PMC8242324 DOI: 10.3988/jcn.2021.17.3.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 10/12/2020] [Accepted: 10/12/2020] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose This study aimed to determine the clinical features, diagnosis, and treatment of patients with persistent geotropic (pG) and persistent apogeotropic (pAG) direction-changing positional nystagmus (DCPN). Methods This retrospective study included 30 patients with pG-DCPN and 44 patients with pAG-DCPN. All patients underwent neurological and neurotological examinations, including an evaluation of gaze-evoked nystagmus, eye-movement tests, and assessments of limb ataxia and balance, as well as magnetic resonance imaging to exclude central causes. The characteristics of positional nystagmus were detected using the supine roll test (SRT) and bow-and-lean test (BLT). The null point (NP) at which the nystagmus disappeared was determined. All patients were treated with the barbecue maneuver, and treatment efficacy was evaluated immediately, 1 week, and 1 month after treatment. Results The history of diseases associated with atherosclerosis, peripheral vestibular disorders, otological disease, and migraine differed significantly between patients with pG-DCPN and pAG-DCPN. The affected sides of persistent horizontal DCPN can be determined using the SRT and the BLT, while determining the second NP and vestibular function as well as performing an audiological evaluation can be used to assist in identifying the affected side. The efficacy rates immediately and 1 week after treatment with the barbecue maneuver were higher in patients with pAG-DCPN than in patients with pG-DCPN. Conclusions pAG-DCPN was more compatible with the characteristics of cupulolithiasis, and pG-DCPN was more likely to be associated with a light cupula rather than canalolithiasis. pAG-DCPN was more likely to be accompanied by a disease associated with atherosclerosis, while pG-DCPN was often accompanied by autoimmune-related diseases and a history of migraine. The associations between pAG-DCPN, pG-DCPN, and the above-mentioned diseases need to be clarified further. The canalith-repositioning maneuver was effective in patients with pAG-DCPN and ineffective in patients with pG-DCPN, but most cases of pG-DCPN are self-limiting.
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Affiliation(s)
- Lihong Si
- Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Bo Shen
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuanzhe Li
- Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Xia Ling
- Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Kangzhi Li
- Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Xu Yang
- Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
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Oh EH, Shin JH, Kim HS, Cho JW, Choi SY, Choi KD, Rhee JK, Lee S, Lee C, Choi JH. Rare Variants of Putative Candidate Genes Associated With Sporadic Meniere's Disease in East Asian Population. Front Neurol 2020; 10:1424. [PMID: 32038468 PMCID: PMC6987317 DOI: 10.3389/fneur.2019.01424] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/31/2019] [Indexed: 12/13/2022] Open
Abstract
Objectives: The cause of Meniere's disease (MD) is unclear but likely involves genetic and environmental factors. The aim of this study was to investigate the genetic basis underlying MD by screening putative candidate genes for MD. Methods: Sixty-eight patients who met the diagnostic criteria for MD of the Barany Society were included. We performed targeted gene sequencing using next generation sequencing (NGS) panel composed of 45 MD-associated genes. We identified the rare variants causing non-synonymous amino acid changes, stop codons, and insertions/deletions in the coding regions, and excluded the common variants with minor allele frequency >0.01 in public databases. The pathogenicity of the identified variants was analyzed by various predictive tools and protein structural modeling. Results: The average read depth for the targeted regions was 1446.3-fold, and 99.4% of the targeted regions were covered by 20 or more reads, achieving the high quality of the sequencing. After variant filtering, annotation, and interpretation, we identified a total of 15 rare heterozygous variants in 12 (17.6%) sporadic patients. Among them, four variants were detected in familial MD genes (DTNA, FAM136A, DPT), and the remaining 11 in MD-associated genes (PTPN22, NFKB1, CXCL10, TLR2, MTHFR, SLC44A2, NOS3, NOTCH2). Three patients had the variants in two or more genes. All variants were not detected in our healthy controls (n = 100). No significant differences were observed between patients with and without a genetic variant in terms of sex, mean age of onset, bilaterality, the type of MD, and hearing threshold at diagnosis. Conclusions: Our study identified rare variants of putative candidate genes in some of MD patients. The genes were related to the formation of inner ear structures, the immune-associated process, or systemic hemostasis derangement, suggesting the multiple genetic predispositions in the development of MD.
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Affiliation(s)
- Eun Hye Oh
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jin-Hong Shin
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Hyang-Sook Kim
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jae Wook Cho
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Seo Young Choi
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea
| | - Kwang-Dong Choi
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea
| | - Je-Keun Rhee
- School of Systems Biomedical Science, Soongsil University, Seoul, South Korea
| | - Seowhang Lee
- Department of Biological Sciences, School of Life Sciences, Ulsan National Institute of Sciences and Technology, Ulsan, South Korea
| | - Changwook Lee
- Department of Biological Sciences, School of Life Sciences, Ulsan National Institute of Sciences and Technology, Ulsan, South Korea
| | - Jae-Hwan Choi
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
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Takeda T, Takeda S, Kakigi A. A possible mechanism of the formation of endolymphatic hydrops and its associated inner ear disorders. Auris Nasus Larynx 2019; 47:25-41. [PMID: 31623941 DOI: 10.1016/j.anl.2019.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 08/29/2019] [Accepted: 09/12/2019] [Indexed: 12/19/2022]
Abstract
The pathology of Meniere's disease (MD) is well established to be endolymphatic hydrops. However, the mechanism underlying deafness and vertigo of MD or idiopathic endolymphatic hydrops is still unknown. In order to evaluate the pathogenesis of deafness and vertigo in MD, it seems to be rational to investigate the interrelationship between hydrops and inner ear disorders using animals with experimentally-induced endolymphatic hydrops. In spite of intense efforts by many researchers, the mechanism of vertiginous attack has been unexplained, because animals with experimental hydrops usually did not show vertiginous attack. Recently, there are two reports to succeed to evoke vertiginous attack in animals with experimental hydrops. In the present paper were first surveyed past proposals about underlying mechanism of the development of hydrops and inner ear disorders associated with hydrops, and were discussed the pathogenetic mechanism of vertiginous attack in hydrops. In conclusion, abrupt development of hydrops was thought to play a pivotal role in the onset of vertiginous seizure.
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Affiliation(s)
- Taizo Takeda
- Department of Otolaryngology, Kochi Medical School, Nankoku, Kochi, Japan
| | | | - Akinobu Kakigi
- Department of Otolaryngology-Head & Neck Surgery, Kobe University, Graduate School of Medicine, Hyogo, Japan.
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Brown DJ, Sokolic L, Fung A, Pastras CJ. Response of the inner ear to lipopolysaccharide introduced directly into scala media. Hear Res 2018; 370:105-112. [PMID: 30366193 DOI: 10.1016/j.heares.2018.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/03/2018] [Accepted: 10/14/2018] [Indexed: 12/18/2022]
Abstract
In an attempt to develop an animal model of immune mediated Meniere's disease, we have injected lipopolysaccharide (LPS) directly into scala media of guinea pigs and monitored functional and morphological changes over a period of 6 weeks. Depending on the concentration of LPS, changes ranged from moderate-to-severe hearing loss and endolymphatic hydrops with minimal cellular infiltrate or fibrosis, to dense cellular infiltration that filled the scalae. Interestingly, higher concentrations of LPS not only induced severe cellular infiltration, hydrops, and hearing loss, but also a substantial enlargement of the endolymphatic duct and sac. Moreover, LPS injections into perilymph failed to induce hydrops, yet still resulted in cellular infiltration and fibrosis in the cochlea. This suggests that chronic hydrops resulting from an immune challenge of the cochlea may not be due to blockage of the endolymphatic duct and sac, restricting fluid absorption. Furthermore, injecting antigen into endolymph may produce chronic immune-mediated hydrops, and provide a more promising animal model of Meniere's, although animals did not display signs of vestibular dysfunction, and the hearing loss was relatively severe.
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Affiliation(s)
| | - Ljiljana Sokolic
- The University of Sydney, Meniere's Research Laboratory, Australia
| | - Albert Fung
- The University of Sydney, Meniere's Research Laboratory, Australia
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Wang Y, Diao T, Han L, Tao Y, Yu L. Association of Meniere's disease and retinal vascular calibre: a prospective observational study in China. BMJ Open 2018; 8:e022069. [PMID: 30282681 PMCID: PMC6169750 DOI: 10.1136/bmjopen-2018-022069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE It is believed that Meniere's disease (MD) is associated with vascular disorders, but few studies have reported the relationship between retinal vascular disorders and MD. We evaluated and compared the retinal vascular calibres in patients with MD with healthy subjects matched for age, sex and vascular risk factors using retinal photographs to explore the association between MD and retinal vascular calibre. STUDY DESIGN A prospective study. SETTING Tertiary referral centre. PARTICIPANTS Sixty patients with MD and 62 healthy subjects matched for age, sex and vascular risk factors were enrolled in this study. Twenty-four patients with MD had migraines, and 36 patients with MD did not have migraines. MAIN OUTCOME MEASURE Retinal vascular calibres were calculated and compared not only between patients with MD and healthy subjects but also between subgroups of patients with MD. RESULTS Compared with healthy subjects, patients with MD had a slightly larger retinal artery calibre (126.30±10.45vs 119.61±15.86, p=0.006) and a higher retinal artery/vein ratio (0.79±0.09vs 0.75±0.10, p=0.005). Among patients with MD, those with migraines had a larger retinal artery calibre (130.73±11.55vs 123.35±8.61, p=0.006) than those without migraines. Moreover, the presence of migraines and the high frequency of vertigo attacks appeared to increase the retinal artery calibre. CONCLUSIONS Our study suggests that a relationship exists between retinal vascular calibre and MD. Although the pathophysiological relationship between migraine and MD remains unclear, the presence of migraine attacks may aggravate endolymphatic hydrops (EH) and accelerate the outflow of EH in patients with MD. More extensive studies are required to explore the association between retinal vascular calibre and MD.
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Affiliation(s)
- Yixu Wang
- Department of Otolaryngology, Head and Neck Surgery, People’s Hospital, Peking University, Beijing, China
| | - Tongxiang Diao
- Department of Otolaryngology, Head and Neck Surgery, People’s Hospital, Peking University, Beijing, China
| | - Lin Han
- Department of Otolaryngology, Head and Neck Surgery, People’s Hospital, Peking University, Beijing, China
| | - Ye Tao
- Department of Ophthalmology, People’s Hospital, Peking University, Beijing, China
| | - Lisheng Yu
- Department of Otolaryngology, Head and Neck Surgery, People’s Hospital, Peking University, Beijing, China
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Ishiyama G, Wester J, Lopez IA, Beltran-Parrazal L, Ishiyama A. Oxidative Stress in the Blood Labyrinthine Barrier in the Macula Utricle of Meniere's Disease Patients. Front Physiol 2018; 9:1068. [PMID: 30233382 PMCID: PMC6129601 DOI: 10.3389/fphys.2018.01068] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/17/2018] [Indexed: 12/13/2022] Open
Abstract
The blood labyrinthine barrier (BLB) is critical in the maintenance of inner ear ionic and fluid homeostasis. Recent studies using imaging and histopathology demonstrate loss of integrity of the BLB in the affected inner ear of Meniere's disease (MD) patients. We hypothesized that oxidative stress is involved in the pathogenesis of BLB degeneration, and to date there are no studies of oxidative stress proteins in the human BLB. We investigated the ultrastructural and immunohistochemical changes of the BLB in the vestibular endorgan, the macula utricle, from patients with MD (n = 10), acoustic neuroma (AN) (n = 6) and normative autopsy specimens (n = 3) with no inner ear disease. Each subject had a well-documented clinical history and audiovestibular testing. Utricular maculae were studied using light and transmission electron microscopy and double labeling immunofluorescence. Vascular endothelial cells (VECs) were identified using isolectin B4 (IB4) and glucose-transporter-1 (GLUT-1). Pericytes were identified using alpha smooth muscle actin (αSMA) and phalloidin. IB4 staining of VECS was consistently seen in both AN and normative. In contrast, IB4 was nearly undetectable in all MD specimens, consistent with the significant VEC damage confirmed on transmission electron microscopy. GLUT-1 was present in MD, AN, and normative. αSMA and phalloidin were expressed consistently in the BLB pericytes in normative, AN specimen, and Meniere's specimens. Endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), and nitrotyrosine were used as markers of oxidative stress. The VECs of the BLB in Meniere's had significantly higher levels of expression of iNOS and nitrotyrosine compared with normative and AN specimen. eNOS-IF staining showed similar patterns in normative and Meniere's specimens. Microarray-based gene expression profiling confirmed upregulation of iNOS mRNA from the macula utricle of Meniere's patients compared with AN. Nitrotyrosine, a marker recognized as a hallmark of inflammation, especially when seen in association with an upregulation of iNOS, was detected in the epithelial and stromal cells in addition to VECs in MD. Immunohistochemical and ultrastructural degenerative changes of the VEC suggest that these cells are the primary targets of oxidative stress, and pericyte pathology including degeneration and migration, likely also plays a role in the loss of integrity of the BLB and triggering of inflammatory pathways in MD. These studies advance our scientific understanding of oxidative stress in the human inner ear BLB and otopathology.
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Affiliation(s)
- Gail Ishiyama
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Jacob Wester
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Ivan A. Lopez
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Luis Beltran-Parrazal
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
- Centro de Investigaciones Cerebrales, Universidad Veracruzana, Xalapa, Mexico
| | - Akira Ishiyama
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
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Abstract
OBJECTIVE To evaluate the effects of intratympanic steroid injection (ITS) in light cupula. METHODS A total of 47 patients showing persistent geotropic direction-changing positional nystagmus with null point (light cupula) were randomly classified into three groups: ITS (n = 15), vestibular suppressant (VS, n = 16) and canalith repositioning procedure (CRP, n = 16). Positional nystagmus and dizziness severity by dizziness handicap inventory (DHI) and visual analogue scale (VAS) were conducted before and 3 d and 1 week after first treatment to compare the effect of each treatment. RESULTS DHI and VAS scores had decreased after each treatment; however, there were no differences among the three groups. A week after the first treatment, 7, 6 and 7 patients showed resolution of direction-changing positional nystagmus (DCPN) in the ITS, CRP and VS groups, respectively. There were no significant differences between the three groups. In the ITS group only, however, reversal of the stronger side on head roll test was observed in 6 patients, and 2 of them showed resolution of DCPN at the third day. CONCLUSIONS ITS was not effective for patients with light cupula at 1-week follow-up. However, some patients in the ITS group showed resolution of DCPN at earlier follow-up.
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Affiliation(s)
- Jin Su Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - So Yean Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Min-Beom Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
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Oberman BS, Patel VA, Cureoglu S, Isildak H. The aetiopathologies of Ménière's disease: a contemporary review. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:250-263. [PMID: 28244505 PMCID: PMC5584095 DOI: 10.14639/0392-100x-793] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 03/26/2016] [Indexed: 11/23/2022]
Abstract
Ménière's disease, a condition first described in the 1800's, has been an advancing area of clinical interest and scientific research in recent decades. Guidelines published by the American Academy of Otolaryngology - Head and Neck Surgery remained nearly static for almost 20 years, although we have certainly expanded our knowledge of the aetiology of the disease since that time. This review of the literature highlights the breadth and detail of the current theories in understanding the pathophysiology of this enigmatic disease. Histopathological specimens providing evidence of many of the aetiologies are presented as well. We aim to provide a centralised and updated resource regarding current and emerging theories for Ménière's disease.
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Affiliation(s)
- B S Oberman
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - V A Patel
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - S Cureoglu
- Department of Otolaryngology, Paparella Otopathology Laboratory, University of Minnesota, Minneapolis, MN, USA
| | - H Isildak
- Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
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Liu GS, Kim J, Applegate BE, Oghalai JS. Computer-aided detection and quantification of endolymphatic hydrops within the mouse cochlea in vivo using optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:76002. [PMID: 28687821 DOI: 10.1117/1.jbo.22.7.076002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 06/13/2017] [Indexed: 06/07/2023]
Abstract
Diseases that cause hearing loss and/or vertigo in humans such as Meniere’s disease are often studied using animal models. The volume of endolymph within the inner ear varies with these diseases. Here, we used a mouse model of increased endolymph volume, endolymphatic hydrops, to develop a computer-aided objective approach to measure endolymph volume from images collected <italic<in vivo</italic< using optical coherence tomography. The displacement of Reissner’s membrane from its normal position was measured in cochlear cross sections. We validated our computer-aided measurements with manual measurements and with trained observer labels. This approach allows for computer-aided detection of endolymphatic hydrops in mice, with test performance showing sensitivity of 91% and specificity of 87% using a running average of five measurements. These findings indicate that this approach is accurate and reliable for classifying endolymphatic hydrops and quantifying endolymph volume.
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Affiliation(s)
- George S Liu
- Stanford University, Department of Otolaryngology-Head and Neck Surgery, Stanford, California, United States
| | - Jinkyung Kim
- Stanford University, Department of Otolaryngology-Head and Neck Surgery, Stanford, California, United States
| | - Brian E Applegate
- Texas A&M University, Department of Biomedical Engineering, College Station, Texas, United States
| | - John S Oghalai
- Stanford University, Department of Otolaryngology-Head and Neck Surgery, Stanford, California, United States
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Bello SA, Malavade S, Passaglia CL. Development of a Smart Pump for Monitoring and Controlling Intraocular Pressure. Ann Biomed Eng 2017; 45:990-1002. [PMID: 27679446 PMCID: PMC5364042 DOI: 10.1007/s10439-016-1735-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 09/12/2016] [Indexed: 10/20/2022]
Abstract
Animal models of ocular hypertension are important for glaucoma research but come with experimental costs. Available methods of intraocular pressure (IOP) elevation are not always successful, the amplitude and time course of IOP changes are unpredictable and irreversible, and IOP measurement by tonometry is laborious. Here we present a novel system for monitoring and controlling IOP without these limitations. It consists of a cannula implanted in the anterior chamber of the eye, a pressure sensor that continually measures IOP, and a bidirectional pump driven by control circuitry that can infuse or withdraw fluid to hold IOP at user-desired levels. A portable version was developed for tethered use on rats. We show that rat eyes can be cannulated for months without causing significant anatomical or physiological damage although the animal and its eyes freely move. We show that the system measures IOP with <0.7 mmHg resolution and <0.3 mmHg/month drift and can maintain IOP within a user-specified window of desired levels for any duration necessary. We conclude that the system is ready for cage- or bench-side applications. The results lay the foundation for an implantable version that would give glaucoma researchers unprecedented knowledge and control of IOP in rats and potentially larger animals.
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Affiliation(s)
- Simon A Bello
- Department of Chemical & Biomedical Engineering, University of South Florida, 4202 E Fowler Ave, Tampa, FL, 33620, USA
| | - Sharad Malavade
- Department of Ophthalmology, University of South Florida, Tampa, FL, 33620, USA
| | - Christopher L Passaglia
- Department of Chemical & Biomedical Engineering, University of South Florida, 4202 E Fowler Ave, Tampa, FL, 33620, USA.
- Department of Ophthalmology, University of South Florida, Tampa, FL, 33620, USA.
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Cureoglu S, da Costa Monsanto R, Paparella MM. Histopathology of Meniere's disease. ACTA ACUST UNITED AC 2016; 27:194-204. [PMID: 28286401 DOI: 10.1016/j.otot.2016.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Sebahattin Cureoglu
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Rafael da Costa Monsanto
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA; Department of Otolaryngology and Head and Neck Surgery, Banco de Olhos de Sorocaba Hospital, Sorocaba, Brazil
| | - Michael M Paparella
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA; Paparella Ear Head and Neck Institute, Minneapolis, Minnesota, USA
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16
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Brown DJ, Pastras CJ, Curthoys IS, Southwell CS, Van Roon L. Endolymph movement visualized with light sheet fluorescence microscopy in an acute hydrops model. Hear Res 2016; 339:112-24. [PMID: 27377233 DOI: 10.1016/j.heares.2016.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/30/2016] [Accepted: 06/13/2016] [Indexed: 10/21/2022]
Abstract
There are a variety of techniques available to investigate endolymph dynamics, primarily seeking to understand the cause of endolymphatic hydrops. Here we have taken the novel approach of injecting, via a glass micropipette, fluorescein isothiocyanate-dextran (FITC-dex) and artificial endolymph into scala media of anaesthetized guinea pigs, with subsequent imaging of the inner ear using Light Sheet Fluorescence Microscopy (LSFM) as a means to obtain highly resolved 3D visualization of fluid movements. Our results demonstrate endolymph movement into the utricle, semicircular canals and endolymphatic duct and sac when more than 2.5 μl of fluid had been injected into scala media, with no apparent movement of fluid into the perilymphatic compartments. There was no movement of endolymph into these compartments when less than 2.5 μl was injected. The remarkable uptake of the FITC-dex into the endolymphatic duct, including an absorption into the periductal channels surrounding the endolymphatic duct, highlights the functional role this structure plays in endolymph volume regulation.
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Affiliation(s)
- Daniel J Brown
- Sydney Medical School, The University of Sydney, Sydney, NSW, 2050, Australia.
| | | | - Ian S Curthoys
- Vestibular Research Laboratory, The University of Sydney, School of Psychology, Sydney, NSW, 2050, Australia
| | | | - Lieke Van Roon
- University of Utrecht, Faculty Nature and Technique, Inst. for Life Sciences and Chemistry, Utrecht, 3508 AD, The Netherlands
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Smeds H, Eastwood HT, Hampson AJ, Sale P, Campbell LJ, Arhatari BD, Mansour S, O'Leary SJ. Endolymphatic hydrops is prevalent in the first weeks following cochlear implantation. Hear Res 2015; 327:48-57. [PMID: 25987505 DOI: 10.1016/j.heares.2015.04.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/02/2015] [Accepted: 04/24/2015] [Indexed: 01/15/2023]
Abstract
AIM To explore morphological or electrophysiological evidence for the presence of endolymphatic hydrops (EH) in guinea pig cochleae in the first 3 months after cochlear implantation. METHODS Dummy silastic electrodes were implanted atraumatically into the basal turn of scala tympani via a cochleostomy. Round window electrocochleography (ECochG) was undertaken prior to and after implantation. Animals survived for 1, 7, 28 or 72 days prior to a terminal experiment, when ECochG was repeated. The cochleae were imaged using micro-CT after post-fixing with osmium tetroxide to reveal the inner ear soft tissue structure. EH was assessed by visual inspection at a series of frequency specific places along the length of the cochlea, and the extent to which Reissner's membrane departed from its neutral position was quantified. Tissue response volumes were calculated. Using ECochG, the ratio of the summating potential to the action potential (SP/AP ratio) was calculated in response to frequencies between 2 and 32 kHz. RESULTS There was minimal evidence of electrode trauma from cochlear implantation on micro-CT imaging. Tissue response volumes did not change over time. EH was most prevalent 7 days after surgery in implanted ears, as determined by visual inspection. Scala media areas were increased, as expected in cases of EH, over the first month after cochlear implantation. SP/AP ratios decreased immediately after surgery, but were elevated 1 and 7 days after implantation. CONCLUSIONS EH is prevalent in the first weeks after implant surgery, even in the absence of significant electrode insertion trauma.
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Affiliation(s)
- H Smeds
- Department of Otolaryngology, University of Melbourne, 2nd Floor, Peter Howson Wing, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, Victoria 3002, Australia; Karolinska University Hospital, Stockholm, Sweden.
| | - H T Eastwood
- Department of Otolaryngology, University of Melbourne, 2nd Floor, Peter Howson Wing, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, Victoria 3002, Australia.
| | - A J Hampson
- Department of Otolaryngology, University of Melbourne, 2nd Floor, Peter Howson Wing, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, Victoria 3002, Australia.
| | - P Sale
- Department of Otolaryngology, University of Melbourne, 2nd Floor, Peter Howson Wing, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, Victoria 3002, Australia.
| | - L J Campbell
- Department of Otolaryngology, University of Melbourne, 2nd Floor, Peter Howson Wing, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, Victoria 3002, Australia.
| | - B D Arhatari
- ARC Centre of Excellence for Advanced Molecular Imaging, Department of Physics, La Trobe University, Victoria 3086, Australia.
| | - S Mansour
- Department of Otolaryngology, University of Melbourne, 2nd Floor, Peter Howson Wing, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, Victoria 3002, Australia.
| | - S J O'Leary
- Department of Otolaryngology, University of Melbourne, 2nd Floor, Peter Howson Wing, Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne, Victoria 3002, Australia.
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Cho NH, Lee JW, Cho JH, Kim J, Jang JH, Jung W. Evaluation of the usefulness of three-dimensional optical coherence tomography in a guinea pig model of endolymphatic hydrops induced by surgical obliteration of the endolymphatic duct. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:036009. [PMID: 25764313 DOI: 10.1117/1.jbo.20.3.036009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 02/19/2015] [Indexed: 06/04/2023]
Abstract
Optical coherence tomography (OCT) has advanced significantly over the past two decades and is currently used extensively to monitor the internal structures of organs, particularly in ophthalmology and dermatology. We used ethylenediamine tetra-acetic acid (EDTA) to decalcify the bony walls of the cochlea and investigated the inner structures by deep penetration of light into the cochlear tissue using OCT on a guinea pig model of endolymphatic hydrops (EH), induced by surgical obliteration of the endolymphatic duct. The structural and functional changes associated with EH were identified using OCT and auditory brainstem response tests, respectively. We also evaluated structural alterations in the cochlea using three-dimensional reconstruction of the OCT images, which clearly showed physical changes in the cochlear structures. Furthermore, we found significant anatomical variations in the EH model and conducted graphical analysis by strial atrophy for comparison. The physical changes included damage to and flattening of the organ of Corti—evidence of Reissner's membrane distention—and thinning of the lateral wall. These results indicate that observation of EDTA-decalcified cochlea using OCT is significant in examination of gradual changes in the cochlear structures that are otherwise not depicted by hematoxylin and eosin staining.
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Affiliation(s)
- Nam Hyun Cho
- Kyungpook National University, School of Electronics Engineering, 1370 Sankyuk 3-dong, Buk-gu, Daegu 702-701, Republic of KoreabInstitute for Basic Science, Center for Soft and Living Matter, Banyeon-ri, Eonyang-eup, Ulju-gun, Ulsan 689-798, Republic of K
| | - Jang Woo Lee
- Kyungpook National University, School of Electronics Engineering, 1370 Sankyuk 3-dong, Buk-gu, Daegu 702-701, Republic of Korea
| | - Jin-ho Cho
- Kyungpook National University, School of Electronics Engineering, 1370 Sankyuk 3-dong, Buk-gu, Daegu 702-701, Republic of Korea
| | - Jeehyun Kim
- Kyungpook National University, School of Electronics Engineering, 1370 Sankyuk 3-dong, Buk-gu, Daegu 702-701, Republic of Korea
| | - Jeong Hun Jang
- Kyungpook National University College of Medicine, Department of Otorhinolaryngology, 680 Gukchaebosang-ro, Jung-gu, Daegu 700-842, Republic of Korea
| | - Woonggyu Jung
- Institute for Basic Science, Center for Soft and Living Matter, Banyeon-ri, Eonyang-eup, Ulju-gun, Ulsan 689-798, Republic of Korea
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Foster C, Breeze R. The Meniere attack: An ischemia/reperfusion disorder of inner ear sensory tissues. Med Hypotheses 2013; 81:1108-15. [DOI: 10.1016/j.mehy.2013.10.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 10/11/2013] [Indexed: 01/12/2023]
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Kim CH, Kim MB, Ban JH. Persistent geotropic direction-changing positional nystagmus with a null plane: the light cupula. Laryngoscope 2013; 124:E15-9. [PMID: 24166487 DOI: 10.1002/lary.24048] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 12/30/2012] [Accepted: 01/17/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS The aim of this study was to characterize the clinical features and typical positional nystagmus in patients with persistent geotropic direction-changing positional nystagmus (DCPN) and address the possible pathophysiology of the disease. Furthermore, the proportion of light cupula among the patients showing geotropic DCPN was investigated to assume the incidence of light cupula in those patients. STUDY DESIGN Prospective case series. METHODS We conducted a prospective case series study in 19 patients with persistent geotropic DCPN. Positional nystagmus during the bow and lean test and the supine head roll test was analyzed using videonystagmography. RESULTS All of the 19 patients showed persistent geotropic DCPN without latency. A null plane in which the nystagmus ceases was identified in all of 19 patients, and the intensity of nystagmus was stronger on one side in13 patients (68%) on supine head roll test. Overall, the affected side could be identified in 18 patients (95%). About 14.2% (19 of 134) of patients with geotropic DCPN could be diagnosed as having light cupula in the horizontal semicircular canal. CONCLUSIONS The patients with light cupula show persistent geotropic DCPN without latency. Affected side(s) can be determined by the direction and intensity of the characteristic positional nystagmus and the side of the null plane. The pathophysiology and treatment of light cupula still remain to be elucidated.
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Affiliation(s)
- Chang-Hee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine
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21
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Kanzaki J, Masuda M. Correlation between stress and acute sensorineural hearing loss: stress and sudden deafness. ACTA ACUST UNITED AC 2013. [DOI: 10.4295/audiology.56.137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kim CH, Kim YC, Choi BY, Lee HS, Oh SH, Kim YH. Expression of osmotic stress protein 94 in murine endolymphatic hydrops model. Acta Otolaryngol 2012; 132 Suppl 1:S118-23. [PMID: 22582773 DOI: 10.3109/00016489.2012.666804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The up-regulation of osmotic stress protein 94 (OSP94) in the murine endolymphatic hydrops (EH) models suggests that OSP94 might be involved in cellular adaptation in response to ionic and osmotic stress in the murine inner ear. OBJECTIVES The purpose of the present study was to investigate the expression of OSP94 in cochlear tissues of the murine EH models and control animals. METHODS Nine adult BALB/c mice were treated with both intratympanic injection of lipopolysaccharide and intraperitoneal administration of aldosterone to induce EH. Nine mice were used as control animals. The expression level of OSP94 in the EH and control groups was compared using immunohistochemistry and real-time RT-PCR. RESULTS Immunohistochemical staining of tissues in the EH group showed an up-regulation of OSP94 expression in the cochlea, especially in the stria vascularis and Reissner's membrane. Quantitative real-time PCR analysis also showed that transcription of the OSP94 gene in the cochlea was significantly up-regulated in the EH group.
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Affiliation(s)
- Chang-Hee Kim
- Department of Physiology, Seoul National University, College of Medicine, Seoul, Korea
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Progression of endolymphatic hydrops in Ménière's disease as evaluated by magnetic resonance imaging. Otol Neurotol 2011; 32:1152-7. [PMID: 21817938 DOI: 10.1097/mao.0b013e31822a1ce2] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the presence and the degree of endolymphatic hydrops (EHs) in patients with unilateral Ménière's disease (MD), as a function of duration of the disease, estimated using a 3-dimensional fluid-attenuated inversion recovery sequence in a 3-Tesla magnetic resonance imaging unit, after intratympanic gadolinium administration. PATIENTS A total of 32 patients (21 male and 11 female subjects, aged 25-78 yr; median, 56 yr) participated in the investigation. The duration of the disease ranged from 2 months to 10 years (median, 3 yr), with a prevalence of vertigo spells in the last 6 months ranging from 0.5 to 8 per month (median, 2.5). INTERVENTION A 0.6-ml solution of gadobutrol (1 mmol/ml) diluted 1:7 in saline was injected in the affected ear through the inferior-posterior quadrant of the tympanic membrane, using a 22-gauge spinal needle. The patient was kept with the head rotated 45 degrees contralaterally for 30 minutes after each injection. Twenty-four hours later, a 3-dimensional fluid-attenuated inversion recovery magnetic resonance imaging was performed. MAIN OUTCOME MEASURE Perilymphatic enhancement was evaluated in different portions of the labyrinth as a function of MD duration. RESULTS Reduced or absence of enhancement of the vestibule occurred precociously and occurred in all subjects at long term. The prevalence of enhancement abnormalities in the cochlea and the semicircular canals was directly proportional to MD duration. At long term, the vestibule and the cochlea showed a more severe hydropic involvement compared with semicircular canals. A statistical significant correlation between enhancement abnormalities and MD duration was observed for most inner ear sites. CONCLUSION The increased prevalence and severity of EH with the duration of MD indicates that hydrops is a progressive degenerative phenomenon. The frequent abnormality in the vestibule and, secondarily, in the cochlea is in line with some histopathologic investigations. It remains to be clarified whether hydropic changes are related to specific signs and symptoms of MD.
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Salt AN, Plontke SK. Endolymphatic hydrops: pathophysiology and experimental models. Otolaryngol Clin North Am 2010; 43:971-83. [PMID: 20713237 DOI: 10.1016/j.otc.2010.05.007] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
It is well established that endolymphatic hydrops plays a role in Ménière disease, even though the precise role is not fully understood and the presence of hydrops in the ear does not always result in symptoms of the disease. It nevertheless follows that a scientific understanding of how hydrops arises, how it affects the function of the ear, and how it can be manipulated or reversed could contribute to the development of effective treatments for the disease. Measurements in animal models in which endolymphatic hydrops has been induced have given numerous insights into the relationships between hydrops and other pathologic and electrophysiological changes, and how these changes influence the function of the ear. The prominent role of the endolymphatic sac in endolymph volume regulation, and the cascade of histopathological and electrophysiological changes that are associated with chronic endolymphatic hydrops, have now been established. An increasing number of models are now available that allow specific aspects of the interrelationships to be studied. The yclical nature of Ménière symptoms gives hope that treatments can be developed to maintain the ear in permanent state of remission, possibly by controlling endolymphatic hydrops, thereby avoiding the rogressive damage and secondary pathologic changes that may also contribute to the patient's symptoms.
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Affiliation(s)
- Alec N Salt
- Department of Otolaryngology, Washington University School of Medicine, Box 8115, 660 South Euclid Avenue, St Louis, MO 63110, USA.
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Zou J, Zhang W, Poe D, Zhang Y, Ramadan UA, Pyykkö I. Differential passage of gadolinium through the mouse inner ear barriers evaluated with 4.7T MRI. Hear Res 2009; 259:36-43. [PMID: 19818391 DOI: 10.1016/j.heares.2009.09.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 09/28/2009] [Accepted: 09/29/2009] [Indexed: 12/16/2022]
Abstract
Magnetic resonance imaging (MRI), supplemented by contrast agents, is a powerful tool that can be used to visualise the structures of the inner ear in vivo and assess some aspects of physiology, such as the permeability of agents through membranes. The mouse is an excellent animal species for investigating human diseases, including hearing loss but detailed MRI studies with contrast have not been reported. In this work, we aimed to demonstrate the limits of MR imaging resolution of the fine inner ear structures in the mouse and to explore the permeability of the intracochlear barriers to gadolinium-tetra-azacyclo-dodecane-tetra-acetic acid (Gd-DOTA) administered by intravenous injection (IV) or intratympanic (IT) routes. Twenty-three female FVB mice were imaged with a 4.7-T MR scanner using both 2D and high resolution 3D sequences. Inner ear region of interest (ROI) signal intensities and perilymph volumes were evaluated. Finer structures were studied using 3D acquisition and reconstruction techniques and comparisons were made to similarly oriented histological sections that were examined by light microscopy. Gd-DOTA enhancement occurred in the perilymphatic compartment and highlighted the contiguous inner ear structures, but enhancement did not appear within the endolymph. The dynamic uptake of Gd-DOTA in the perilymphatic compartments reached an initial plateau 80min after IV administration and continued to slightly increase to a maximum level by 100min. The perilymph volume demonstrated by Gd-DOTA uptake was statistically significantly larger in the IV group (1.72mm(3)) than in the IT group (1.28mm(3)) (p<0.05).
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology, University of Tampere, Medical School, FM1, 3rd Floor, Biokatu 6, 33520 Tampere, Finland.
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Takumida M, Akagi N, Anniko M. Effect of inner ear blood flow changes in Ménière's model mice. Acta Otolaryngol 2009; 129:244-53. [PMID: 18615328 DOI: 10.1080/00016480802241980] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSIONS The endolymphatic sac (ES) is important for inner ear fluid homeostasis. A dysfunctional ES can cause vertigo attacks following additional stress such as a sudden change in endolymphatic volume and/or pressure, or restricted inner ear blood flow. OBJECTIVE The purpose of this study was to elucidate the mechanism of vertigo attacks in Ménière's disease. MATERIALS AND METHODS Adult CBA/J mice were given an intratympanic injection of lipopolysaccharide and an intraperitoneal injection of aldosterone. These 'model' animals had epinephrine or sodium nitroprusside (SNP) instilled into the middle ear cavity. Cochleae, vestibules, and endolymphatic sacs were studied morphologically by light microscopy. RESULTS The injection of epinephrine into the model animals reduced the endolymphatic hydrops in the cochlea, but also produced mild hydrops in the vestibule, which was never observed in untreated (control) animals. The ES did not react to epinephrine in the normal way. Injection of SNP did not cause any changes.
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