Johannes Gerb, Emilie Kierig, Valerie Kirsch, Sandra Becker-Bense, Rainer Boegle, Thomas Brandt, Marianne Dieterich
{"title":"Contrast Agent Uptake in Endolymphatic Sac and Duct: Inverse Relation to Endolymphatic Hydrops.","authors":"Johannes Gerb, Emilie Kierig, Valerie Kirsch, Sandra Becker-Bense, Rainer Boegle, Thomas Brandt, Marianne Dieterich","doi":"10.1002/lary.32127","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Ménière's disease (MD) and vestibular migraine (VM) can be associated with endolymphatic hydrops (ELH). The differential role of the endolymphatic sac and duct (ES/ED) system for the development of ELH is poorly understood.</p><p><strong>Methods: </strong>On 251 delayed, contrast-enhanced inner ear MRI (iMRI) datasets from neurotological patients and healthy control participants, we evaluated (1) the visibility of the ES/ED system using a novel semi-quantitative scale, and (2) the dimensions of ELH, calculated using volumetric local thresholding (VOLT). Afterwards, statistical analysis of ES/ED radiologic visibility in relation to the grade of ELH, the degree of clinical symptoms, and audiometric findings was performed.</p><p><strong>Results: </strong>Patients were divided into an MD cohort (n = 68, 34 females, mean age 54.5 ± 14.8 years) and a VM cohort (n = 67, 42 females, 45.9 ± 15.5 years). The remaining datasets did not fulfill diagnostic criteria for definite diagnoses (n = 64, 27 females, mean age 51.3 ± 16.6) or were from healthy controls (HC; n = 52, 27 females, 49.0 ± 18.1 years). MD patients showed the lowest ES/ED-visibility scores on the affected side (ANOVA F(172,2): 20.60, p < 0.001), while the ES/ED-visibility on the non-affected side in MD patients was still significantly lower than in VM and HC (ANOVA F(172,2): 6.80, p 1.44 × 10<sup>-3</sup>). The ES/ED-visibility score and ELH volume (determined by VOLT, in mm<sup>3</sup>) correlated inversely (Spearman's rho: -0.32, Fisher's z -0.34, p < 0.001).</p><p><strong>Conclusion: </strong>ES/ED radiologic visibility in iMRI is inversely associated with ELH volumes. Patients with MD show substantially decreased ES/ED visibility on the affected ear and (less pronounced) on the unaffected ear, while VM and HC exhibit normal ES/ED visibility.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.32127","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Ménière's disease (MD) and vestibular migraine (VM) can be associated with endolymphatic hydrops (ELH). The differential role of the endolymphatic sac and duct (ES/ED) system for the development of ELH is poorly understood.
Methods: On 251 delayed, contrast-enhanced inner ear MRI (iMRI) datasets from neurotological patients and healthy control participants, we evaluated (1) the visibility of the ES/ED system using a novel semi-quantitative scale, and (2) the dimensions of ELH, calculated using volumetric local thresholding (VOLT). Afterwards, statistical analysis of ES/ED radiologic visibility in relation to the grade of ELH, the degree of clinical symptoms, and audiometric findings was performed.
Results: Patients were divided into an MD cohort (n = 68, 34 females, mean age 54.5 ± 14.8 years) and a VM cohort (n = 67, 42 females, 45.9 ± 15.5 years). The remaining datasets did not fulfill diagnostic criteria for definite diagnoses (n = 64, 27 females, mean age 51.3 ± 16.6) or were from healthy controls (HC; n = 52, 27 females, 49.0 ± 18.1 years). MD patients showed the lowest ES/ED-visibility scores on the affected side (ANOVA F(172,2): 20.60, p < 0.001), while the ES/ED-visibility on the non-affected side in MD patients was still significantly lower than in VM and HC (ANOVA F(172,2): 6.80, p 1.44 × 10-3). The ES/ED-visibility score and ELH volume (determined by VOLT, in mm3) correlated inversely (Spearman's rho: -0.32, Fisher's z -0.34, p < 0.001).
Conclusion: ES/ED radiologic visibility in iMRI is inversely associated with ELH volumes. Patients with MD show substantially decreased ES/ED visibility on the affected ear and (less pronounced) on the unaffected ear, while VM and HC exhibit normal ES/ED visibility.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
