Vestibular Aqueduct Size Correlates With the Degree of Cochlear Hydrops in Patients With and Without Menière's Disease.

To correlate the CT imaging findings of the visibility and size of the vestibular aqueduct (VA) with the degree of the cochlear hydrops determined in MRI late imaging of the hydrops. Study Design: Retrospective study. Setting: Tertiary referral center. Patients: A total of 127 patients (62 women, 65 men, average age 55.6 yrs): 86 of these were diagnosed with Menière's disease (American Academy of Otolaryngology-Head and Neck Surgery [AAO-HNS] criteria; 67 unilateral, 19 bilateral). Temporal bone CT and hydrops MRI were performed in all patients. Visibility/width of the VA in temporal bone CT and grade of cochlear hydrops evaluated by MRI. The width of the VA is significantly smaller in patients diagnosed with Menière's disease (30% non-visible VA), compared with the patients who did not fulfill the diagnostic criteria of Menière's disease (12% non-visible VA) (double sided Spearman correlation, p < 0.001). In all ears of patients diagnosed with Menière's disease the width of the VA was significantly correlated with the degree of the cochlear hydrops (in cases of non-visible VA 65% [34/52] ears presented with hydrops grade 3 or 4; 13% [7/52] ears presented with hydrops grade 1 or 2 and 21% [11/52] ears showed no hydrops) (Spearman correlation p = 0.001/p < 0.01). This is also true for all ears that can be summarized as hydrophic ear disease (symptomatic ears that present with a hydrops in MRI). The results of our study could confirm the importance of the VA in the pathogenesis of the endolymphatic hydrops in vivo.

Grosser D ，Willenborg K ，Dellani P ，Avallone E ，Götz F ，Böthig D ，Warnecke A ，Lanfermann H ，Lenarz T ，Giesemann A ... -  《-》

The vestibular aqueduct ossification on temporal bone CT: an old sign revisited to rule out the presence of endolymphatic hydrops in Menière's disease patients.

Mainnemarre J ，Hautefort C ，Toupet M ，Guichard JP ，Houdart E ，Attyé A ，Eliezer M ... -  《-》

Evaluation of the vestibular aqueduct in Ménière's disease using multiplanar reconstruction images of CT.

Previous studies, in which the vestibular aqueduct (VA) was determined using axial CT, have indicated that the VA sizes in patients with Ménière's disease were smaller than those in the subjects of the control group and that 25-35% of ears with Ménière's disease were "non-visible type." In this study, in addition to obtaining the axial size, we measured the VA size along the vertical plane by using vertical multiplanar reconstruction (MPR) images. The VA size of both ears of patients with unilateral Ménière's disease (n=34) and of subjects of the control group (n=30) was measured by using the vertical MPR and the axial CT images. The VA size was measured along the axial and vertical planes in all subjects. The parameters measured on the axial image of the VA correlated with each other; however, the parameters on the vertical MPR image did not correlate with those on the axial image. Values of parameters in the affected and nonaffected ears with Ménière's disease tended to be smaller than those in the control ear. The external aperture areas of the VA fenestra of the affected and nonaffected ears of patients with Ménière's disease were significantly smaller than that for the control ears. Our findings suggest that the vertical parameters of the VA yield information that is independent of that provided by the axial parameters. In both ears of patients with unilateral Ménière's disease, the VA tended to be thinner than those in the control ear.

Miyashita T ，Toyama Y ，Inamoto R ，Mori N ... -  《-》

External aperture of the vestibular aqueduct in Meniere's disease.

Shea JJ Jr ，Ge X ，Warner RM ，Orchik DJ ... -  《-》

The vestibular aqueduct sign: Magnetic resonance imaging can detect abnormalities in both ears of patients with unilateral Meniere's disease.

In patients with Meniere's disease (MD), saccular hydrops can only be studied by magnetic resonance imaging (MRI) at a late stage when the disease is already responsible for moderate to severe hearing loss. However, these patients may also present vestibular aqueduct (VA) abnormalities. In this prospective study (38RC14.428 for healthy subjects/38RC15.173 for patients), imaging was carried out on a 3T MRI scanner. Twenty healthy subjects (13 women, median age 53.5 [52.2-66.7]) and twenty MD patients (9 women, median age 54.5 [52-66.7]) had MRI scans with 3D-FLAIR sequences without injection, then 4 hours after a single intra-venous dose of contrast agent. Two radiologists independently ranked the morphology of the VA in the healthy subjects and in MD patients, using a three-level score (completely visible, discontinuous and not visible). Each subject was then graded, based on both the VA's appearance and on saccular hydrops presence. Inter-reader agreement tests were performed. In controls and patients, VA modifications were symmetrical without significant difference between the symptomatic and asymptomatic ears. The presence of at least one ear with discontinuous VA showed a correlation with clinical MD (P < 0.001) with a sensitivity of 90%. Ten patients had saccular hydrops, but only in the symptomatic ears. The evaluation of VA did not differ between MRI, both within MRI series or between the two radiologists (kappa without and with contrast agent = 0.9 and 0.92 respectively). Analysis of the vestibular aqueduct by MRI detects abnormalities in both ears of patients with unilateral MD.

Attyé A ，Barma M ，Schmerber S ，Dumas G ，Eliezer M ，Krainik A ... -  《JOURNAL OF NEURORADIOLOGY》