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Smith CM, David R, Almécija S, Laitman JT, Hammond AS. First evolutionary insights into the human otolithic system. Commun Biol 2024; 7:1244. [PMID: 39358583 PMCID: PMC11447226 DOI: 10.1038/s42003-024-06966-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Accepted: 09/25/2024] [Indexed: 10/04/2024] Open
Abstract
The human otolithic system (utricle and saccule), housed within the bony vestibule of the inner ear, establishes our sense of balance in conjunction with the semicircular canals. Yet, while the morphological evolution of the semicircular canals is actively explored, comparative morphological analyses of the otolithic system are lacking. This is regrettable because functional links with head orientation suggest the otolithic system could be used to track postural change throughout human evolution and across primates more broadly. In this context, we present the first analysis of the evolution of the human otolithic system within an anthropoid primate setting. Using the vestibule as a morphological proxy for the utricle and saccule, we compare humans to 13 other extant anthropoid species, and use phylogenetically-informed methods to find correlations with body size, endocranial flexion, and head-neck posture. Our results, obtained through micro-CT of 136 inner ears, reveal two major evolutionary transitions in hominoids, leading to distinctive vestibular morphology in humans, characterized by otolithic morphology resembling squirrel monkeys (possibly due to reversal), with a pronounced supraovalic fossa. Finally, we find a positional signal embedded in the anthropoid bony vestibule, providing the foundation to further explore the evolution of human head-neck posture using inner ear morphology.
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Affiliation(s)
- Christopher M Smith
- Division of Anthropology, American Museum of Natural History, New York, NY, USA.
- New York Consortium in Evolutionary Primatology, New York, NY, USA.
| | - Romain David
- Centre for Human Evolution Research, Natural History Museum, London, UK
| | - Sergio Almécija
- Division of Anthropology, American Museum of Natural History, New York, NY, USA
- New York Consortium in Evolutionary Primatology, New York, NY, USA
- Institut Català de Paleontologia Miquel Crusafont (ICP-CERCA), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jeffrey T Laitman
- New York Consortium in Evolutionary Primatology, New York, NY, USA
- Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ashley S Hammond
- Division of Anthropology, American Museum of Natural History, New York, NY, USA
- New York Consortium in Evolutionary Primatology, New York, NY, USA
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Jiang W, Li X, Mu Y, Zhang H, Konduru N, Qiao Y, Zhao F, Liu W. Predictive accuracy of wideband absorbance in children with large vestibular aqueduct syndrome: A single-center retrospective study. Heliyon 2024; 10:e33776. [PMID: 39040356 PMCID: PMC11261878 DOI: 10.1016/j.heliyon.2024.e33776] [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: 03/28/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/24/2024] Open
Abstract
Objectives This study aimed to assess the clinical significance of Wideband Absorbance (WBA) in children with Large Vestibular Aqueduct Syndrome (LVAS), which could potentially serve as diagnostic and predictive markers for LVAS in children. Design This was a single-center retrospective case-control study. Audiological measurements and Wideband Acoustic Immittance (WAI) were performed. Propensity score matching (PSM) was considered to treat group imbalance. The Receiver Operating Characteristic (ROC) curves and area under the ROC curve (AUC) were used to evaluate the sensitivity and specificity of WBA. Study sample Participants included 42 children with LVAS and 163 normal children aged 6 months -11 years recruited from clinical audiology settings between 2019 and 2021. Results The WBA at Tympanometric Peak Pressure (WBATPP) and Ambient Pressure (WBAA) in the LVAS group were significantly lower than those of the control group at 1259-2000 Hz but higher at 4000-6349 Hz (p < 0.05, power >0.8). The WBAA (1587 Hz) AUC value was 0.805, identifying a score ≤0.565 as indicative of a LVAS risk. Conclusions WBA holds promise in distinguishing LVAS from the normal condition and warrants further exploration as a tool to examine the influence of inner ear pressure on acoustic energy transmission in the middle ear.
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Affiliation(s)
- Wen Jiang
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Xuanyi Li
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Yi Mu
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Huiying Zhang
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Naveena Konduru
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Yuehua Qiao
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Fei Zhao
- Centre for SLT and Hearing Sciences, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, CF5 2YB, UK, Wales
| | - Wen Liu
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
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Smith CM, Curthoys IS, Laitman JT. A morphometric comparison of the ductus reuniens in humans and guinea pigs, with a note on its evolutionary importance. Anat Rec (Hoboken) 2024. [PMID: 38965777 DOI: 10.1002/ar.25534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024]
Abstract
The mammalian inner ear contains the sensory organs responsible for balance (semicircular canals, utricle, and saccule) and hearing (cochlea). While these organs are functionally distinct, there exists a critical structural connection between the two: the ductus reuniens (DR). Despite its functional importance, comparative descriptions of DR morphology are limited, hindering our understanding of the evolutionary diversification of hearing and balance systems among mammals. Using virtual 3D models derived from micro-CT, we examine the morphology of the DR and its relationship to the bony labyrinth in humans compared to that in a commonly used animal model, the guinea pig. Anatomical reconstructions and univariate measurements were carried out in the software 3D Slicer. Data indicate similarities in DR morphology between humans and guinea pigs in terms of overall shape. However, there are considerable differences in relative DR length and width between humans and guinea pigs. Humans possess a relatively shorter and narrower DR but with wider openings to the saccule and cochlear duct. This results in a relatively more constricted DR lumen in humans which may differentially limit fluid transfer between the saccule and cochlea. Our results reveal previously hidden morphological diversity in the communication between the hearing and balance systems of the mammalian inner ear which may indicate alternative strategies for isolating the Organ of Corti from the peripheral vestibular system throughout mammalian evolution.
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Affiliation(s)
- Christopher M Smith
- Division of Anthropology, American Museum of Natural History, New York City, New York, USA
- New York Consortium in Evolutionary Primatology, New York, USA
| | - Ian S Curthoys
- Vestibular Research Laboratory, School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Jeffrey T Laitman
- New York Consortium in Evolutionary Primatology, New York, USA
- Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, USA
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Mohseni-Dargah M, Falahati Z, Pastras C, Khajeh K, Mukherjee P, Razmjou A, Stefani S, Asadnia M. Meniere's disease: Pathogenesis, treatments, and emerging approaches for an idiopathic bioenvironmental disorder. ENVIRONMENTAL RESEARCH 2023; 238:116972. [PMID: 37648189 DOI: 10.1016/j.envres.2023.116972] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/10/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023]
Abstract
Meniere's disease (MD) is a severe inner ear condition known by debilitating symptoms, including spontaneous vertigo, fluctuating and progressive hearing loss, tinnitus, and aural fullness or pressure within the affected ear. Prosper Meniere first described the origins of MD in the 1860s, but its underlying mechanisms remain largely elusive today. Nevertheless, researchers have identified a key histopathological feature called Endolymphatic Hydrops (ELH), which refers to the excessive buildup of endolymph fluid in the membranous labyrinth of the inner ear. The exact root of ELH is not fully understood. Still, it is believed to involve several biological and bioenvironmental etiological factors such as genetics, autoimmunity, infection, trauma, allergy, and new theories, such as saccular otoconia blocking the endolymphatic duct and sac. Regarding treatment, there are no reliable and definitive cures for MD. Most therapies focus on managing symptoms and improving the overall quality of patients' life. To make significant advancements in addressing MD, it is crucial to gain a fundamental understanding of the disease process, laying the groundwork for more effective therapeutic approaches. This paper provides a comprehensive review of the pathophysiology of MD with a focus on old and recent theories. Current treatment strategies and future translational approaches (with low-level evidence but promising results) related to MD are also discussed, including patents, drug delivery, and nanotechnology, that may provide future benefits to patients suffering from MD.
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Affiliation(s)
- Masoud Mohseni-Dargah
- School of Engineering, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109, Australia; Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zahra Falahati
- Department of Biological Sciences, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan, Iran
| | - Christopher Pastras
- School of Engineering, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109, Australia; The Meniere's Laboratory, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Khosro Khajeh
- Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Payal Mukherjee
- RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Amir Razmjou
- Centre for Technology in Water and Wastewater, University of Technology Sydney, New South Wales 2007, Australia
| | - Sebastian Stefani
- School of Engineering, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109, Australia
| | - Mohsen Asadnia
- School of Engineering, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109, Australia.
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Büki B, Ward BK, Santos F. Differential Volume Increase of Endolymphatic Compartments in Ménière's Disease Is Inversely Associated With Membrane Thickness. Otol Neurotol 2023; 44:e588-e595. [PMID: 37464462 PMCID: PMC10529428 DOI: 10.1097/mao.0000000000003960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Our aim in this study was to characterize the morphology of the endolymphatic compartment on histopathology in individuals with Ménière's disease (MD) and to determine why hydrops of the saccule is more pronounced than that of other compartments of the inner ear in MD. METHODS Temporal bones from 9 patients with idiopathic MD and from 10 individuals without MD/endolymphatic hydrops were examined. The inner ear fluid compartments in normal ears, and ears with MD were three-dimensionally reconstructed and their volume was calculated. The thickness of the membranes of the labyrinth was measured, and both ruptures of the membranes and patency of the utriculoendolymphatic (UEV; Bast's) valve were assessed. RESULTS In ears with MD, the saccule and the cochlear duct were most frequently hydropic; the utricle was involved approximately half as frequently. In ears without MD, the Reissner's membrane and the membranous wall of the saccule were thinner than that of the utricle and of the lateral semicircular canal ( p < 0.01). The lateral semicircular canal did not show signs of hydrops. In all ears with MD in which the utricle exceeded the average volume of normals (6 of 12), the UEV was open or there was a rupture in the utricle. CONCLUSION Increases in endolymphatic pressure may cause a primary swelling of the apical cochlear duct and saccule, both of which have relatively thin membranes. Hydrops in the utricle may occur less frequently because of a thicker wall, because of a functioning UEV, and when the saccule has already occupied most of the vestibular perilymphatic space.
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Affiliation(s)
- Béla Büki
- Department of Otolaryngology, Karl Landsteiner University Hospital Krems, Krems an der Donau, Austria
| | - Bryan K Ward
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Felipe Santos
- Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
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Inui H, Sakamoto T, Ueda K, Ito T, Kitahara T. Volume ratio and distribution rate in patients with orthostatic vertigo/dizziness using MR imaging: a comparison with vertiginous diseases. Acta Otolaryngol 2023; 143:631-635. [PMID: 37537926 DOI: 10.1080/00016489.2023.2238760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/11/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Orthostatic dizziness/vertigo (ODV) is characterized by lightheadedness owing to postural changes. AIMS/OBJECTIVES To measure the endolymphatic space (ELS)/total fluid space (TFS) volume ratio and the distribution rate of endolymphatic fluid (ELF) of patients with ODV and compare them with those of control subjects (CS). MATERIALS AND METHODS This study included 22 patients (44 ears) with ODV and 52 controls (104 ears, CS). The ELS/TFS volume ratio (%) and distribution rate (%) of the inner ear components were measured using 3-dimensional magnetic resonance imaging. RESULTS In the ODV group, the mean ELS/TFS volume ratios of the cochlea, vestibule, and semi-circular canals (SCCs) were 12.1%, 18.6%, and 18.1%, respectively; the mean ELS distribution rates for the cochlea, vestibule, and SCCs were 27.3%, 26.2%, and 46.6%, respectively. The ELS distribution rate of the vestibule was significantly lower (p < .01) and the ELS distribution rate of the SCCs was significantly higher in the ODV than in the CS group (p < .01). CONCLUSIONS AND SIGNIFICANCE The ELS distribution rate in the vestibule + SCCs among patients with ODV did not differ from that in the CS; ELF in the vestibule moved to the SCCs, and a large amount of ELF was distributed only in the SCCs.
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Affiliation(s)
| | | | - Keita Ueda
- Department of Otorhinolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Taeko Ito
- Department of Otorhinolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Tadashi Kitahara
- Department of Otorhinolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara, Japan
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Smith CM, Curthoys IS, Laitman JT. First evidence of the link between internal and external structure of the human inner ear otolith system using 3D morphometric modeling. Sci Rep 2023; 13:4840. [PMID: 36964237 PMCID: PMC10039035 DOI: 10.1038/s41598-023-31235-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/08/2023] [Indexed: 03/26/2023] Open
Abstract
Our sense of balance is among the most central of our sensory systems, particularly in the evolution of human positional behavior. The peripheral vestibular system (PVS) comprises the organs responsible for this sense; the semicircular canals (detecting angular acceleration) and otolith organs (utricle and saccule; detecting linear acceleration, vibration, and head tilt). Reconstructing vestibular evolution in the human lineage, however, is problematic. In contrast to considerable study of the canals, relationships between external bone and internal membranous otolith organs (otolith system) remain largely unexplored. This limits our understanding of vestibular functional morphology. This study combines spherical harmonic modeling and landmark-based shape analyses to model the configuration of the human otolith system. Our approach serves two aims: (1) test the hypothesis that bony form covaries with internal membranous anatomy; and (2) create a 3D morphometric model visualizing bony and membranous structure. Results demonstrate significant associations between bony and membranous tissues of the otolith system. These data provide the first evidence that external structure of the human otolith system is directly related to internal anatomy, suggesting a basic biological relationship. Our results visualize this structural relationship, offering new avenues into vestibular biomechanical modeling and assessing the evolution of the human balance system.
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Affiliation(s)
- Christopher M Smith
- Department of Anthropology, The Graduate Center, City University of New York, New York, NY, 10016, USA.
- Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
- New York Consortium in Evolutionary Primatology, New York, NY, 10016, USA.
| | - Ian S Curthoys
- Vestibular Research Laboratory, School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Jeffrey T Laitman
- Department of Anthropology, The Graduate Center, City University of New York, New York, NY, 10016, USA
- Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- New York Consortium in Evolutionary Primatology, New York, NY, 10016, USA
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
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Kashizadeh A, Pastras C, Rabiee N, Mohseni-Dargah M, Mukherjee P, Asadnia M. Potential nanotechnology-based diagnostic and therapeutic approaches for Meniere's disease. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2022; 46:102599. [PMID: 36064032 DOI: 10.1016/j.nano.2022.102599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
Meniere's disease (MD) is a progressive inner ear disorder involving recurrent and prolonged episodes or attacks of vertigo with associated symptoms, resulting in a significantly reduced quality of life for sufferers. In most cases, MD starts in one ear; however, in one-third of patients, the disorder progresses to the other ear. Unfortunately, the etiology of the disease is unknown, making the development of effective treatments difficult. Nanomaterials, including nanoparticles (NPs) and nanocarriers, offer an array of novel diagnostic and therapeutic applications related to MD. NPs have specific features such as biocompatibility, biochemical stability, targetability, and enhanced visualization using imaging tools. This paper provides a comprehensive and critical review of recent advancements in nanotechnology-based diagnostic and therapeutic approaches for MD. Furthermore, the crucial challenges adversely affecting the use of nanoparticles to treat middle ear disorders are investigated. Finally, this paper provides recommendations and future directions for improving the performances of nanomaterials on theragnostic applications of MD.
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Affiliation(s)
- Afsaneh Kashizadeh
- School of Electrical and Computer Engineering, Shahid Beheshti University, Tehran 1983969411, Iran
| | - Christopher Pastras
- School of Engineering, Macquarie University, Sydney, NSW 2109, Australia; The Menière's Laboratory, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Navid Rabiee
- School of Engineering, Macquarie University, Sydney, NSW 2109, Australia
| | - Masoud Mohseni-Dargah
- School of Engineering, Macquarie University, Sydney, NSW 2109, Australia; Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Payal Mukherjee
- RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Mohsen Asadnia
- School of Engineering, Macquarie University, Sydney, NSW 2109, Australia.
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Smith CM, Curthoys IS, Plontke SK, Menzel M, Mukherjee P, Wong C, Laitman JT. Insights into Inner Ear Function and Disease Through Novel Visualization of the Ductus Reuniens, a Seminal Communication Between Hearing and Balance Mechanisms. J Assoc Res Otolaryngol 2022; 23:633-645. [PMID: 35804276 PMCID: PMC9613819 DOI: 10.1007/s10162-022-00858-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 06/29/2022] [Indexed: 11/27/2022] Open
Abstract
The sensory end-organs responsible for hearing and balance in the mammalian inner ear are connected via a small membranous duct known as the ductus reuniens (also known as the reuniting duct (DR)). The DR serves as a vital nexus linking the hearing and balance systems by providing the only endolymphatic connection between the cochlea and vestibular labyrinth. Recent studies have hypothesized new roles of the DR in inner ear function and disease, but a lack of knowledge regarding its 3D morphology and spatial configuration precludes testing of such hypotheses. We reconstructed the 3D morphology of the DR and surrounding anatomy using osmium tetroxide micro-computed tomography and digital visualizations of three human inner ear specimens. This provides a detailed, quantitative description of the DR's morphology, spatial relationships to surrounding structures, and an estimation of its orientation relative to head position. Univariate measurements of the DR, inner ear, and cranial planes were taken using the software packages 3D Slicer and Zbrush. The DR forms a narrow, curved, flattened tube varying in lumen size, shape, and wall thickness, with its middle third being the narrowest. The DR runs in a shallow bony sulcus superior to the osseus spiral lamina and adjacent to a ridge of bone that we term the "crista reuniens" oriented posteromedially within the cranium. The DR's morphology and structural configuration relative to surrounding anatomy has important implications for understanding aspects of inner ear function and disease, particularly after surgical alteration of the labyrinth and potential causative factors for Ménière's disease.
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Affiliation(s)
- Christopher M Smith
- Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, Annenberg Building Room 12-90, 1468 Madison Ave, New York, NY, 10029, USA.
- Department of Anthropology, The Graduate Center, City University of New York, New York, NY, USA.
- New York Consortium in Evolutionary Primatology, New York, NY, USA.
| | - Ian S Curthoys
- Vestibular Research Laboratory, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Stefan K Plontke
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Matthias Menzel
- Fraunhofer Institute for Microstructure of Materials and Systems, Halle (Saale), Germany
| | - Payal Mukherjee
- RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Christopher Wong
- Vestibular Research Laboratory, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Jeffrey T Laitman
- Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, Annenberg Building Room 12-90, 1468 Madison Ave, New York, NY, 10029, USA
- Department of Anthropology, The Graduate Center, City University of New York, New York, NY, USA
- New York Consortium in Evolutionary Primatology, New York, NY, USA
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Nagururu NV, Akbar A, Ward BK. Using magnetic resonance imaging to improve diagnosis of peripheral vestibular disorders. J Neurol Sci 2022; 439:120300. [DOI: 10.1016/j.jns.2022.120300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/18/2022] [Accepted: 05/23/2022] [Indexed: 12/01/2022]
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Chen W, Geng Y, Niu Y, Lin M, Lin N, Sha Y. Endolymphatic Hydrops Magnetic Resonance Imaging in Menire's Disease Patients on a Vertigo Attack. Otol Neurotol 2022; 43:489-493. [PMID: 35184071 DOI: 10.1097/mao.0000000000003474] [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 To investigate the characteristics of endolymphatic hydrops (EH) in Menire's disease (MD) patient on a vertigo attack. STUDY DESIGN Prospective study. SETTING Tertiary referral center. PATIENTS Thirty-six MD patients underwent the enhanced magnetic resonance imaging (MRI) examinations of the inner ear on a vertigo attack were enrolled. MAIN OUTCOME MEASURES All patients met the diagnostic criteria for MD and underwent intravenous gadolinium injection 4 hours before the MRI examinations. The MRI examinations were performed in MD patients on a vertigo attack. RESULTS Various degrees of vestibular EH appeared in almost all affected ears (2 ears had no EH, 11 ears had mild EH, 26 ears had significant EH). The positive rate of vestibular EH was 37/39 (94.9%). Cochlear EH occurred in 29 ears among 39 affected ears (17 ears had mild EH, 12 ears had significant EH). CONCLUSION MRI with intravenous gadolinium injection can provide a better assessment of EH in MD patient on a vertigo attack. Vestibular EH seems to be closely related with the vertigo attacks in MD patients, which needs further study.
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Affiliation(s)
- Wei Chen
- Department of Radiology, Eye & ENT Hospital of Fudan University
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
| | - Yue Geng
- Department of Radiology, Eye & ENT Hospital of Fudan University
| | - Yue Niu
- Department of Radiology, Eye & ENT Hospital of Fudan University
| | - Mengyan Lin
- Department of Radiology, Eye & ENT Hospital of Fudan University
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China
| | - Naier Lin
- Department of Radiology, Eye & ENT Hospital of Fudan University
| | - Yan Sha
- Department of Radiology, Eye & ENT Hospital of Fudan University
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Zhang D, Lv Y, Li X, Song Y, Kong L, Fan Z, Wang H. Efficacy of Resection of Lateral Wall of Endolymphatic Sac for Treatment of Meniere's Disease. Front Neurol 2022; 13:827462. [PMID: 35359640 PMCID: PMC8962735 DOI: 10.3389/fneur.2022.827462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background To explore the long-term efficacy and safety of resection of the lateral wall of the endolymphatic sac for the treatment of intractable Meniere's disease (MD) as an alternative surgical procedure for treating this disorder. Methods Data from 73 patients who were referred to our hospital and diagnosed with unilateral MD between January 2015 and June 2019 were retrospectively analyzed in this study. Seventy-three patients who had frequent vertigo even after receiving standardized conservative treatment for at least half a year underwent resection of the lateral wall of the endolymphatic sac. Vertigo control and auditory function were assessed. Pure tone audiometry, caloric test, and vestibular evoked myogenic potential were performed to evaluate audiological and vestibular functions. The post-operative follow-up duration was more than 2 years. Results Among the 73 patients (male 34 cases, female 39 cases; age 20–69 years, average 51.4), vertigo was controlled effectively for 66 cases (90.4%) after 2 years of follow-up; 45 cases (61.6%) were completely controlled, and 21 cases (28.8%) were substantially controlled in this study. The patients of 16.4% had hearing loss with more than 10 dB change based on the four-tone average (0.5, 1, 2 and 3 kHz). No patient had a facial nerve weakness, cerebrospinal fluid leakage, or other complications. Conclusion Resection of the lateral wall of the endolymphatic sac, which can effectively control vertiginous symptoms in intractable MD patients, represents an effective and safe therapy for this disease. Resection of the lateral wall of the endolymphatic sac is expected to be used as an alternative treatment for MD.
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Vogl C, Neef J, Wichmann C. Methods for multiscale structural and functional analysis of the mammalian cochlea. Mol Cell Neurosci 2022; 120:103720. [DOI: 10.1016/j.mcn.2022.103720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/13/2022] [Accepted: 03/08/2022] [Indexed: 01/11/2023] Open
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Hornibrook J, Mudry A, Curthoys I, Smith CM. Ductus Reuniens and Its Possible Role in Menière's Disease. Otol Neurotol 2021; 42:1585-1593. [PMID: 34766952 DOI: 10.1097/mao.0000000000003352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE After 160 years the true underlying cause of Meniere's disease remains enigmatic. The aim of our study is to discuss the possible implication of an obstruction of the ductus reuniens as a cause in Menière's disease. METHODOLOGY We first conducted an historical study of the description of the ductus reuniens. We then reviewed the literature regarding ductus reuniens obstruction in animal experiments, human post-mortem studies and living ear imaging. We completed its description by modern microCT imaging. Limited knowledge on the fate of dislodged saccular otoconia is summarized. The possible implications for Meniere's attacks are discussed. RESULTS Victor Hensen was the first to describe the ductus reuniens in 1863. He described its length and width and predicted that saccular otoconia might enter the ductus and the cochlea. On microCT the narrowest width of the human ductus reuniens was 0.14 mm. The literature reports cochlear endolymphatic hydrops occurring after animal experimental obstruction of the duct. Human postmortem studies have confirmed saccular otoconial clumps entering the ductus and the cochlea. A postmortem study has shown sites of endolymphatic obstruction, and imaging speculates on blockages in ears with Meniere's disease. Dislodged utricular otoconia can be in clumps of otolithic membranes. CONCLUSION Blockages of the ductus reuniens and at other endolymphatic system sites appear to be a feature in Meniere's disease ears. The blockages have been postulated to be saccular otoconia either causing or aggravating hydrops. This could be consistent with observed nystagmus reversals during attacks as the endolymphatic sac attempts to clear the hydrops and the otoconia.
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Affiliation(s)
- Jeremy Hornibrook
- Department of Otolaryngology - Head Neck Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Albert Mudry
- Department of Otolaryngology - Head and Neck Surgery, Stanford University, School of Medicine, Stanford, California, USA
| | - Ian Curthoys
- Vestibular Research Laboratory, School of Psychology, University of Sydney, New South Wales, Australia
| | - Christopher M Smith
- Department of Anthropology, The Graduate Center, City University of New York, New York, New York, USA
- Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- New York Consortium in Evolutionary Primatology, New York, New York, USA
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