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In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears
Published on: February 21, 2018
Radiological feature heterogeneity supports etiological diversity among patient groups in Meniere's disease
David Bächinger1,2, Noemi Filidoro2, Marc Naville2
1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Abstract:
We aimed to determine the prevalence of radiological temporal bone features that in previous studies showed only a weak or an inconsistent association with the clinical diagnosis of Meniere's disease (MD), in two groups of MD patients (n = 71) with previously established distinct endolymphatic sac pathologies; i.e. the group MD-dg (ES degeneration) and the group MD-hp (ES hypoplasia). Delayed gadolinium-enhanced MRI and high-resolution CT data were used to determine and compare between and within (affected vs. non-affected side) groups geometric temporal bone features (lengths, widths, contours), air cell tract volume, height of the jugular bulb, sigmoid sinus width, and MRI signal intensity alterations of the ES. Temporal bone features with significant intergroup differences were the retrolabyrinthine bone thickness (1.04 ± 0.69 mm, MD-hp; 3.1 ± 1.9 mm, MD-dg; p < 0.0001); posterior contour tortuosity (mean arch-to-chord ratio 1.019 ± 0.013, MD-hp; 1.096 ± 0.038, MD-dg; p < 0.0001); and the pneumatized volume (1.37 [0.86] cm3, MD-hp; 5.25 [3.45] cm3, MD-dg; p = 0.03). Features with differences between the affected and non-affected sides within the MD-dg group were the sigmoid sinus width (6.5 ± 1.7 mm, affected; 7.6 ± 2.1 mm, non-affected; p = 0.04) and the MRI signal intensity of the endolymphatic sac (median signal intensity, affected vs. unaffected side, 0.59 [IQR 0.31-0.89]). Radiological temporal bone features known to be only weakly or inconsistently associated with the clinical diagnosis MD, are highly prevalent in either of two MD patient groups. These results support the existence of diverse-developmental and degenerative-disease etiologies manifesting with distinct radiological temporal bone abnormalities.
Insights
Radiological features in the temporal bone are common in Meniere
Area of Science:
- Otolaryngology
- Radiology
- Medical Imaging
Background:
- Meniere's disease (MD) diagnosis can be challenging.
- Previous studies showed weak or inconsistent associations between temporal bone features and MD.
- Distinct endolymphatic sac pathologies exist in MD patients.
Purpose of the Study:
- To determine the prevalence of specific radiological temporal bone features in two distinct Meniere's disease patient groups.
- To compare these features between groups with endolymphatic sac degeneration (MD-dg) and endolymphatic sac hypoplasia (MD-hp).
- To investigate differences between affected and non-affected sides within the MD-dg group.
Main Methods:
- Utilized delayed gadolinium-enhanced MRI and high-resolution CT data from 71 MD patients.
- Analyzed geometric temporal bone features, air cell tract volume, jugular bulb height, sigmoid sinus width, and endolymphatic sac MRI signal intensity.
- Compared features between MD-dg and MD-hp groups, and between affected and non-affected sides within the MD-dg group.
Main Results:
- Significant intergroup differences found in retrolabyrinthine bone thickness, posterior contour tortuosity, and pneumatized volume.
- The MD-dg group showed greater retrolabyrinthine bone thickness, posterior contour tortuosity, and pneumatized volume compared to the MD-hp group.
- Within the MD-dg group, affected sides had narrower sigmoid sinus width and altered endolymphatic sac MRI signal intensity compared to non-affected sides.
Conclusions:
- Radiological temporal bone features, previously considered weakly associated with MD, are prevalent in distinct MD patient subgroups.
- Findings support diverse etiologies for Meniere's disease, including developmental and degenerative processes.
- These distinct radiological abnormalities correlate with specific endolymphatic sac pathologies in Meniere's disease.
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