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Weitgasser L, Ferstl F, O'Sullivan A, Rösch S. Autoimmune inner ear disease in a young patient – an unsolvable challenge? ACTA OTO-LARYNGOLOGICA CASE REPORTS 2023. [DOI: 10.1080/23772484.2023.2176309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Affiliation(s)
- Lennart Weitgasser
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg, Austria
| | - Florentina Ferstl
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg, Austria
| | - Anna O'Sullivan
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg, Austria
- Institute of Pathology, Paracelsus Medical University Salzburg, Austria
- Institute of Experimental Neuroregeneration, Paracelsus Medical University, Salzburg, Austria
| | - Sebastian Rösch
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg, Austria
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Salah M, Moyaert J, Vanderveken O, Schepers S, Termote B, Van Rompaey V, Janssens de Varebeke S. Does Vestibulo-Ocular Reflex (VOR) Gain Correlate With Radiological Findings in the Semi-Circular Canals in Patients Carrying the p.Pro51Ser (P51S) COCH Variant Causing DFNA9? Relationship Between the Three-Dimensional Video Head Impulse Test (vHIT) and MR/CT Imaging. Otol Neurotol 2022; 43:e348-e354. [PMID: 35020687 DOI: 10.1097/mao.0000000000003434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The primary aim was to determine whether 3D video-head-impulse-test vestibulo-ocular reflex (vHIT VOR)-gains correlate with computed tomography (CT) and magnetic resonance (MR) lesions in a series of carriers of the p.(Pro51Ser)-variant (P51S) in the COCH-gene (DFNA9). Secondary aim was to compare routine imaging with second peer review radiologic lecture. STUDY DESIGN Analytical cross-sectional study. SETTING Secondary referral center. PATIENTS Twenty-four p.P51S carriers with MR and CT images. Eighteen carriers were selected of whom both 3D-vHIT and imaging data were available within a time interval of 24 months. INTERVENTIONS All imaging data were reassessed by two independent neuroradiologists. vHIT VOR-gains were correlated with semi-circular canal (SCC) lesions. MAIN OUTCOME MEASURES Correlation between vHIT VOR-gains and SCC lesions, and additional lesions detected during scientific lecture of imaging data. RESULTS The average gain of the ipsilateral labyrinth was significantly lower when positive CT (0.3215; p = 0.0122) and MR results (0.3215; p = 0.0134).92% of ears presented MR lesions on at least one SCC, whereas this was 75% on CT. The posterior SCC is the most frequently affected on MR and CT. Second lecture led to nine additional MR and 16 CT lesions. CONCLUSIONS Significant correlation was observed between radiological lesions at any SCC and lower average gain of the three ipsilateral SCC. The substantially larger number of lesions during scientific assessment stresses the need to fully inform radiologists concerning differential diagnosis to facilitate accurate diagnosis when planning imaging. Focal sclerosis and narrowing of SCC in DFNA9 represent a possible biomarker of advanced stages of otovestibular deterioration.
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Affiliation(s)
- Mahadi Salah
- Department of Otorhinolaryngology & Head and Neck Surgery, Jessa Hospital, Hasselt
- Faculty of Medicine and Health Sciences, University of Antwerp
- Department of Otorhinolaryngology & Head and Neck Surgery, Antwerp University Hospital, Antwerp
| | - Julie Moyaert
- Department of Otorhinolaryngology & Head and Neck Surgery, Antwerp University Hospital, Antwerp
| | - Olivier Vanderveken
- Faculty of Medicine and Health Sciences, University of Antwerp
- Department of Otorhinolaryngology & Head and Neck Surgery, Antwerp University Hospital, Antwerp
| | | | - Bruno Termote
- Department of Radiology, Jessa Hospital, Hasselt, Belgium
| | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp
- Department of Otorhinolaryngology & Head and Neck Surgery, Antwerp University Hospital, Antwerp
| | - Sebastien Janssens de Varebeke
- Department of Otorhinolaryngology & Head and Neck Surgery, Jessa Hospital, Hasselt
- Faculty of Medicine and Health Sciences, University of Antwerp
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Levie C, Moyaert J, Janssens de Varebeke S, Verdoodt D, Vanderveken OM, Topsakal V, Van Wijk E, de Vrieze E, Pennings R, Van de Berg R, Van Camp G, Ponsaerts P, Van Rompaey V. Attitudes of Potential Participants Towards Potential Gene Therapy Trials in Autosomal Dominant Progressive Sensorineural Hearing Loss. Otol Neurotol 2021; 42:384-389. [PMID: 33555744 DOI: 10.1097/mao.0000000000002981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Advances in gene therapeutic approaches to treat sensorineural hearing loss (SNHL) confront us with future challenges of translating these animal studies into clinical trials. Little is known on patient attitudes towards future innovative therapies. OBJECTIVE We aimed to better understand the willingness of patients with progressive SNHL and vestibular function loss of autosomal dominant (AD) inheritance to participate in potential gene therapy trials to prevent, stabilize, or slow down hearing loss. METHODS A survey was performed in carriers of the P51S and G88E pathogenic variant in the COCH gene (DFNA9). Various hypothetical scenarios were presented while using a Likert scale. RESULTS Fifty three participants were included, incl. 49 symptomatic patients, one presymptomatic patient, and three participants at risk. Their attitude towards potential trials studying innovative therapies was overall affirmative, even if the treatment would only slow down the decline of hearing and vestibular function, rather than cure the disease. Among the different potential scenarios, the less invasive and less frequent treatments increased the likelihood to enroll. Daily oral medication and annual intravenous infusion were awarded the highest scores. The more invasive, more frequent, and more at-risk treatments were still likely to be accepted but decreased the willingness to participate. The presence of a placebo arm was met with the lowest scores of willingness to participate. CONCLUSIONS Overall, most symptomatic DFNA9 patients would likely consider participation in future innovative inner ear therapy trials, even if it would only slow down the decline of hearing and vestibular function.
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Affiliation(s)
- Camille Levie
- Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem
| | - Julie Moyaert
- Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem
| | - Sebastien Janssens de Varebeke
- Department of Otorhinolaryngology and Head & Neck Surgery, Jessa Hospital, Hasselt
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences
| | - Dorien Verdoodt
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences
| | - Olivier M Vanderveken
- Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences
| | - Vedat Topsakal
- Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences
| | - Erwin Van Wijk
- Department of Otorhinolaryngology
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen
| | - Erik de Vrieze
- Department of Otorhinolaryngology
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen
| | - Ronald Pennings
- Department of Otorhinolaryngology
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen
| | - Raymond Van de Berg
- Division of Balance Disorders, Department of ENT, Maastricht University Medical Centre, Maastricht, The Netherlands
- Faculty of Physics, Tomsk State University, Tomsk, Russia
| | - Guy Van Camp
- Centre of Medical Genetics, University of Antwerp and Antwerp University Hospital
| | - Peter Ponsaerts
- Laboratory of Experimental Hematology, Faculty of Medicine and Health Sciences, Vaccine and Infectious Disease Institute (VaxInfectio), University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences
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Castellucci A, Pepponi E, Bertellini A, Senesi C, Bettini M, Botti C, Martellucci S, Malara P, Delmonte S, Crocetta FM, Fornaciari M, Lusetti F, Bianchin G, Ghidini A. Case Report: Filling Defect in Posterior Semicircular Canal on MRI With Balanced Steady-State Gradient-Echo Sequences After Labyrinthine Ischemia in the Common Cochlear Artery Territory as an Early Sign of Fibrosis. Front Neurol 2021; 11:608838. [PMID: 33519688 PMCID: PMC7838557 DOI: 10.3389/fneur.2020.608838] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022] Open
Abstract
We describe a rare case of posterior semicircular canal (PSC) fibrosis following acute labyrinthine ischemia in the territory supplied by the common cochlear artery (CCA) and review the relevant literature. A 71-year-old man with multiple vascular risk factors presented 12 days after the onset of acute vertigo and profound left-sided hearing loss. Right-beating spontaneous nystagmus with downbeat components elicited by mastoid vibrations and headshaking was detected. The video head impulse test (vHIT) revealed an isolated hypofunction of the left PSC, whereas vestibular evoked myogenic potentials (VEMPs) showed ipsilateral saccular loss. The clinical presentation and instrumental picture were consistent with acute ischemia in the territory supplied by left CCA. Compared to previous imaging, a new MRI of the brain with 3D-FIESTA sequences highlighted a filling defect in the left PSC, consistent with fibrosis. Hearing function exhibited mild improvement after steroid therapy and hyperbaric oxygen sessions, whereas vHIT abnormalities persisted over time. To the best of our knowledge, this is the only case in the literature reporting a filling defect on MRI, consistent with semicircular canal fibrosis following acute labyrinthine ischemia. Moreover, PSC fibrosis was related with poor functional outcome. We therefore suggest using balanced steady-state gradient-echo sequences a few weeks following an acute lesion of inner ear sensors to detect signal loss within membranous labyrinth consistent with post-ischemic fibrosis. Besides addressing the underlying etiology, signal loss might also offer clues on the functional behavior of the involved sensor over time. In cases of acute loss of inner ear function, a careful bedside examination supplemented by instrumental assessments, including vHIT and VEMPs, of vestibular receptors and afferents may be completed by MRI with balanced steady-state gradient-echo sequences at a later time to confirm the diagnosis and address both etiology and functional outcome.
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Affiliation(s)
- Andrea Castellucci
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Emanuela Pepponi
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Annalisa Bertellini
- Department of Radiology, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Caterina Senesi
- Department of Neurology, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Margherita Bettini
- Audiology and Ear Surgery Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cecilia Botti
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Pasquale Malara
- Audiology and Vestibology Service, Centromedico Bellinzona, Bellinzona, Switzerland
| | - Silvia Delmonte
- Audiology and Ear Surgery Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Martina Fornaciari
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Lusetti
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Bianchin
- Audiology and Ear Surgery Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Angelo Ghidini
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Van Rompaey V. Making the Case for Research on Disease-Modifying Treatments to Tackle Post-lingual Progressive Sensorineural Hearing Loss. Front Neurol 2020; 11:290. [PMID: 32373054 PMCID: PMC7186466 DOI: 10.3389/fneur.2020.00290] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 03/26/2020] [Indexed: 01/10/2023] Open
Abstract
Hearing loss not only has a significant impact on the quality of life of patients and society, but its correlation with cognitive decline in an aging population will also increase the risk of incident dementia. While current management of hearing loss is focused on hearing rehabilitation (and essentially symptomatic), patients are suffering from the burden of progressive hearing loss before hearing aids or cochlear implants are fitted. Although these devices have a significant effect on speech understanding, they do not always lead to normal speech understanding, especially in noisy environments. A significant number of patients suffer from autosomal dominantly inherited disorders that can produce progressive sensorineural hearing loss. This includes DFNA9, a disorder caused by pathologic variants in the COCH gene that leads to post-lingual profound sensorineural hearing loss and bilateral vestibulopathy. Carriers of a pathogenic variant leading to DFNA9 can be diagnosed at the pre-symptomatic or early symptomatic stage which creates a window of opportunity for treatment. Preventing hearing loss from occurring or stabilizing progression would provide the opportunity to avoid hearing aids or cochlear implants and would be able to reduce the increased incidence of dementia. While innovative therapies for restoration of hearing have been studied for restoration of hearing in case of severe-to-profound sensorineural hearing loss and congenital hearing loss, further research is needed to study how we can modify disease progression in late-onset autosomal dominant hereditary sensorineural hearing loss. Recently, gene editing strategies have been explored in autosomal dominant disorders to disrupt dominant mutations selectively without affecting wild-type alleles.
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Affiliation(s)
- Vincent Van Rompaey
- Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Eliezer M, Hautefort C, Van Nechel C, Duquesne U, Guichard JP, Herman P, Kania R, Houdart E, Attyé A, Toupet M. Electrophysiological and inner ear MRI findings in patients with bilateral vestibulopathy. Eur Arch Otorhinolaryngol 2020; 277:1305-1314. [PMID: 32036409 DOI: 10.1007/s00405-020-05829-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/24/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Bilateral vestibulopathy (BV) is an uncommon disorder and the etiology remained idiopathic in most cases. Delayed 3D-FLAIR sequences have provided new insights into various inner ear diseases, allowing the evaluation of the endolymphatic space and the permeability of the blood-labyrinthine barrier (BLB). The aim of this study was to assess both the morphology of the endolymphatic space and the permeability of the BLB in patients with BV as evaluated by delayed 3D-FLAIR sequences. METHODS In this retrospective study, we performed 3D-FLAIR sequences 4 h after administering contrast media to 42 patients with BV. Two radiologists independently evaluated the morphology of the endolymphatic space (either vestibular atelectasis or endolymphatic hydrops) and the permeability of the BLB. RESULTS Morphologic anomalies of the endolymphatic space and vestibular blood-labyrinthine barrier impairment were observed in 59.6% of patients with BV. Bilateral vestibular atelectasis (VA) was found in 21 patients (50%), involving only the utricle and all three ampullas while the saccule was always observed with no sign of collapse: idiopathic BV (n = 19), aminoglycoside administration (n = 1) and few days following abdominal surgery (n = 1). One patient had bilateral vestibular malformation. BLB impairment was observed in five patients (11.9%): paraneoplastic (n = 1), lymphoma (n = 1), autoimmune (n = 1), and vestibular "neuritis" (n = 2). Seventeen patients (40.4%) had normal MRI with no endolymphatic space anomaly or BLB impairment. CONCLUSION Patients with BV presented with morphologic anomalies of the endolymphatic space or BLB impairment in 59.6% of patients.
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Affiliation(s)
- Michael Eliezer
- Department of Neuroradiology and MR Unit, Lariboisière University Hospital, 75010, Paris, France.
| | - Charlotte Hautefort
- Department of Head and Neck Surgery, Lariboisiere University Hospital, Paris, France
| | | | | | - Jean-Pierre Guichard
- Department of Neuroradiology and MR Unit, Lariboisière University Hospital, 75010, Paris, France
| | - Philippe Herman
- Department of Head and Neck Surgery, Lariboisiere University Hospital, Paris, France
| | - Romain Kania
- Department of Head and Neck Surgery, Lariboisiere University Hospital, Paris, France
| | - Emmanuel Houdart
- Department of Neuroradiology and MR Unit, Lariboisière University Hospital, 75010, Paris, France
| | - Arnaud Attyé
- Department of Neuroradiology and MRI, SFR RMN Neurosciences, Grenoble Alpes University Hospital, Grenoble, France
| | - Michel Toupet
- Centre d'Explorations Fonctionnelles Otoneurologiques, Paris, France
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7
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Ihtijarevic B, Janssens de Varebeke S, Mertens G, Dekeyzer S, Van de Heyning P, Van Rompaey V. Correlations Between Vestibular Function and Imaging of the Semicircular Canals in DFNA9 Patients. Front Neurol 2020; 10:1341. [PMID: 31998212 PMCID: PMC6965155 DOI: 10.3389/fneur.2019.01341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 12/05/2019] [Indexed: 11/25/2022] Open
Abstract
Background and Purpose: Radiologic abnormalities on computed tomography (CT), including narrowing or sclerosis of the semicircular canals (SCCs), and T2-weighted magnetic resonance imaging (MRI), including signal loss in the SCC, have been reported as potential biomarkers in patients with P51S mutations in the COCH gene (i.e., DFNA9). The aim of our study was to correlate caloric responses through electronystagmography (ENG) data with imaging results in DFNA9 patients. Materials and Methods: A retrospective study was performed in 45 patients; therefore, 90 ears with P51S mutations in the COCH gene were tested. Caloric responses and CT and MRI data were analyzed from June 2003 until May 2014. More than half of patients (54%) were candidates for cochlear implantation. Results: In our population, 91% of tested ears had sclerotic lesions and/or narrowing in one or more SCCs on CT scan. All tested ears had narrowing or signal loss in at least one SCC on T2-weighted MRI. The lateral SCC was affected in 87% on CT scan and 92% on MRI. However, in 83% of tested ears, all three SCCs were affected on MRI. Furthermore, in 77% of tested ears, caloric responses were reduced bilaterally, while 11.5% showed unilateral hypofunction and the other 11.5% had normal caloric responses. CT abnormalities correlated with hypofunction of caloric responses. This statistically significant difference was present if abnormalities were observed in at least one of the SCCs as well as in ipsilateral lateral SCC function loss. MRI abnormalities in at least one of the SCCs correlated with ENG hypofunction, but there was no direct correlation between lateral SCC abnormalities on MRI and caloric responses of the investigated lateral canal. Conclusion: Our retrospective analysis confirms the presence of CT and MRI abnormalities in DFNA9 patients with the P51S mutation in the COCH gene. A correlation between these radiologic features and vestibular function (tested by means of caloric response) was found in this population.
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Affiliation(s)
- Berina Ihtijarevic
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Sebastien Janssens de Varebeke
- Department of Otorhinolaryngology and Head and Neck Surgery, Jessa Hospital, Hasselt, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Griet Mertens
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Sven Dekeyzer
- Department of Radiology, Antwerp University Hospital, Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Detection of intralabyrinthine abnormalities using post-contrast delayed 3D-FLAIR MRI sequences in patients with acute vestibular syndrome. Eur Radiol 2018; 29:2760-2769. [PMID: 30413960 DOI: 10.1007/s00330-018-5825-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/17/2018] [Accepted: 10/10/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE 3D-FLAIR sequences with delayed acquisition after contrast medium injection have demonstrated new insights into blood-labyrinthine barrier (BLB) abnormalities in various diseases. The aim of this study was to assess the BLB in patients referred with unilateral acute vestibular syndrome (UAVS). MATERIALS AND METHODS In this retrospective multicenter imaging study, we performed 3D-FLAIR and steady-state free precession (SSFP) sequences 4 h after contrast medium administration in 26 healthy volunteers and in 30 patients with UAVS. Two radiologists, blinded to the clinical data, independently assessed the asymmetrical enhancement of the labyrinthine structures and the vestibular nerve on 3D-FLAIR sequences, and the signal of the labyrinthine structures on SSFP sequences. Inter-reader agreement tests were performed. RESULTS An asymmetrical enhancement of the semicircular canals was observed in 26 out of 30 ears (86.6%, p < 0.001) and never observed in healthy subjects. An asymmetrical enhancement of the vestibular nerve was never observed in either patients or healthy subjects. An asymmetrical enhancement of the cochlea was observed on the 3D-FLAIR sequence in 6 out of 30 ears only in the patients' group (20%, p = 0.03) and always associated with an enhancement of at least one semicircular canal. A low signal on SSFP sequences was observed only in 11 out of 30 symptomatic ears (36.7%, p < 0.001), involving the utricle in 7 ears and the superior semicircular canal in 4 ears. CONCLUSION Patients with typical UAVS presented with semicircular canal enhancement on MRI, while an asymmetrical enhancement of the vestibular nerve was not displayed. TRIAL REGISTRATION NCT02529475 KEY POINTS: • Patients with typical vestibular neuronitis presented with semicircular canal enhancement on MRI in 87% of cases. • An enhancement of the vestibular nerve was never displayed.
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De Belder J, Matthysen S, Claes AJ, Mertens G, Van de Heyning P, Van Rompaey V. Does Otovestibular Loss in the Autosomal Dominant Disorder DFNA9 Have an Impact of on Cognition? A Systematic Review. Front Neurosci 2018; 11:735. [PMID: 29375286 PMCID: PMC5767272 DOI: 10.3389/fnins.2017.00735] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 12/18/2017] [Indexed: 12/21/2022] Open
Abstract
Background and Purpose: Cognitive impairment has been observed in patients with bilateral vestibular loss (BVL) and in patients with sensorineural hearing loss (SNHL). DFNA9 is an autosomal dominant disorder that causes a combination of both sensory deficits by the 3rd to 5th decade. We therefore hypothesize a combined detrimental effect on cognition. The aim of this systematic review was to identify studies related to DFNA9 in general and its relationship with cognitive impairment more specifically. Materials and Methods: Several databases including Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, ISI Web of Knowledge, and Web of Science were searched to accumulate information about DFNA9-mutations, including phenotype, genotype, pathophysiology, quality of life (QOL), and imaging in general and cognitive function more specifically. A qualitative analysis was performed on the 55 articles that qualified. Results: The clinical features of DFNA9 are different along the 24 COCH mutations, described up to now. Vestibular symptoms generally present themselves a few years after SNHL onset in mutations associated with the vWFA-domain although they can precede SNHL onset in other mutations associated with the LCCL-domain. QoL has not been studied extensively in DFNA9, although scarce work is available on the positive impact of cochlear implantation to rehabilitate hearing. No studies were found evaluating cognition in DFNA9 patients. Conclusion: Although cognitive impairment has been demonstrated in patients with hearing loss as well as in patients with BVL, no studies have been reported on the combination of both sensory deficits, such as in DFNA9. Further research is warranted to correlate otovestibular status with cognition.
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Affiliation(s)
- Jonas De Belder
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Stijn Matthysen
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Annes J Claes
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Griet Mertens
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Paul Van de Heyning
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
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