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Visualization and clinical relevance of the endolymphatic duct and sac in Ménière's disease

BACKGROUND: Ménière's disease (MD) is a chronic inner ear disorder with a multifactorial etiology. Decreased visualization of the endolymphatic duct (ED) and sac (ES) is thought to be associated with MD, although controversy exists about whether this finding is specific to MD. Recent literature...

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Autores principales: de Pont, Lisa M. H., Houben, Maartje T. P. M., Verhagen, Thijs O., Verbist, Berit M., van Buchem, Mark A., Bommeljé, Claire C., Blom, Henk M., Hammer, Sebastiaan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501721/
https://www.ncbi.nlm.nih.gov/pubmed/37719762
http://dx.doi.org/10.3389/fneur.2023.1239422
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author de Pont, Lisa M. H.
Houben, Maartje T. P. M.
Verhagen, Thijs O.
Verbist, Berit M.
van Buchem, Mark A.
Bommeljé, Claire C.
Blom, Henk M.
Hammer, Sebastiaan
author_facet de Pont, Lisa M. H.
Houben, Maartje T. P. M.
Verhagen, Thijs O.
Verbist, Berit M.
van Buchem, Mark A.
Bommeljé, Claire C.
Blom, Henk M.
Hammer, Sebastiaan
author_sort de Pont, Lisa M. H.
collection PubMed
description BACKGROUND: Ménière's disease (MD) is a chronic inner ear disorder with a multifactorial etiology. Decreased visualization of the endolymphatic duct (ED) and sac (ES) is thought to be associated with MD, although controversy exists about whether this finding is specific to MD. Recent literature has revealed that two distinct ES pathologies, developmental hypoplasia and epithelial degeneration, can be distinguished in MD using the angular trajectory of the vestibular aqueduct (ATVA) or ED-ES system as a radiographic surrogate marker. It has been suggested that these two subtypes are associated with distinct phenotypical features. However, the clinical differences between the ATVA subtypes require further validation. RESEARCH OBJECTIVE: The objective of this study is to investigate whether (1) non-visualization of the ED-ES system is a discriminative radiological feature for MD in a cohort of vertigo-associated pathologies (VAPs) and whether (2) different angular trajectories of the ED-ES system in MD are associated with distinguishable clinical features. SETTING: The study was conducted in the Vertigo Referral Center (Haga Teaching Hospital, The Hague, the Netherlands). METHODS: We retrospectively assessed 301 patients (187 definite MD and 114 other VAPs) that underwent 4h-delayed 3D FLAIR MRI. We evaluated (1) the visibility of the ED-ES system between MD and other VAP patients and (2) measured the angular trajectory of the ED-ES system. MD patients were stratified based on the angular measurements into α(exit) ≤ 120° (MD-120), α(exit) 120°-140° (MD-intermediate), or α(exit) ≥ 140° (MD-140). Correlations between ATVA subgroups and clinical parameters were evaluated. RESULTS: Non-visualization of the ED-ES system was more common in definite MD patients compared with other VAPs (P < 0.001). Among definite MD patients, the MD-140 subtype demonstrated a longer history of vertigo (P = 0.006), a higher prevalence of bilateral clinical disease (P = 0.005), and a trend toward a male preponderance (p = 0.053). No significant differences were found between ATVA subgroups regarding the presence or severity of auditory symptoms, or the frequency of vertigo attacks. CONCLUSION: Non-visualization of the ED-ES system is significantly associated with MD. Among MD patients with a visible ED-ES system, we demonstrated that the MD-140 subtype is associated with a longer disease duration, a higher prevalence of bilateral MD, and a trend toward a male preponderance.
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spelling pubmed-105017212023-09-15 Visualization and clinical relevance of the endolymphatic duct and sac in Ménière's disease de Pont, Lisa M. H. Houben, Maartje T. P. M. Verhagen, Thijs O. Verbist, Berit M. van Buchem, Mark A. Bommeljé, Claire C. Blom, Henk M. Hammer, Sebastiaan Front Neurol Neurology BACKGROUND: Ménière's disease (MD) is a chronic inner ear disorder with a multifactorial etiology. Decreased visualization of the endolymphatic duct (ED) and sac (ES) is thought to be associated with MD, although controversy exists about whether this finding is specific to MD. Recent literature has revealed that two distinct ES pathologies, developmental hypoplasia and epithelial degeneration, can be distinguished in MD using the angular trajectory of the vestibular aqueduct (ATVA) or ED-ES system as a radiographic surrogate marker. It has been suggested that these two subtypes are associated with distinct phenotypical features. However, the clinical differences between the ATVA subtypes require further validation. RESEARCH OBJECTIVE: The objective of this study is to investigate whether (1) non-visualization of the ED-ES system is a discriminative radiological feature for MD in a cohort of vertigo-associated pathologies (VAPs) and whether (2) different angular trajectories of the ED-ES system in MD are associated with distinguishable clinical features. SETTING: The study was conducted in the Vertigo Referral Center (Haga Teaching Hospital, The Hague, the Netherlands). METHODS: We retrospectively assessed 301 patients (187 definite MD and 114 other VAPs) that underwent 4h-delayed 3D FLAIR MRI. We evaluated (1) the visibility of the ED-ES system between MD and other VAP patients and (2) measured the angular trajectory of the ED-ES system. MD patients were stratified based on the angular measurements into α(exit) ≤ 120° (MD-120), α(exit) 120°-140° (MD-intermediate), or α(exit) ≥ 140° (MD-140). Correlations between ATVA subgroups and clinical parameters were evaluated. RESULTS: Non-visualization of the ED-ES system was more common in definite MD patients compared with other VAPs (P < 0.001). Among definite MD patients, the MD-140 subtype demonstrated a longer history of vertigo (P = 0.006), a higher prevalence of bilateral clinical disease (P = 0.005), and a trend toward a male preponderance (p = 0.053). No significant differences were found between ATVA subgroups regarding the presence or severity of auditory symptoms, or the frequency of vertigo attacks. CONCLUSION: Non-visualization of the ED-ES system is significantly associated with MD. Among MD patients with a visible ED-ES system, we demonstrated that the MD-140 subtype is associated with a longer disease duration, a higher prevalence of bilateral MD, and a trend toward a male preponderance. Frontiers Media S.A. 2023-08-31 /pmc/articles/PMC10501721/ /pubmed/37719762 http://dx.doi.org/10.3389/fneur.2023.1239422 Text en Copyright © 2023 de Pont, Houben, Verhagen, Verbist, Buchem, Bommeljé, Blom and Hammer. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
de Pont, Lisa M. H.
Houben, Maartje T. P. M.
Verhagen, Thijs O.
Verbist, Berit M.
van Buchem, Mark A.
Bommeljé, Claire C.
Blom, Henk M.
Hammer, Sebastiaan
Visualization and clinical relevance of the endolymphatic duct and sac in Ménière's disease
title Visualization and clinical relevance of the endolymphatic duct and sac in Ménière's disease
title_full Visualization and clinical relevance of the endolymphatic duct and sac in Ménière's disease
title_fullStr Visualization and clinical relevance of the endolymphatic duct and sac in Ménière's disease
title_full_unstemmed Visualization and clinical relevance of the endolymphatic duct and sac in Ménière's disease
title_short Visualization and clinical relevance of the endolymphatic duct and sac in Ménière's disease
title_sort visualization and clinical relevance of the endolymphatic duct and sac in ménière's disease
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501721/
https://www.ncbi.nlm.nih.gov/pubmed/37719762
http://dx.doi.org/10.3389/fneur.2023.1239422
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