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Published on: December 9, 2022
Lymphatic and Glymphatic Alterations in Auditory Disorders: A Rapid Review-Informed Systematic Review and
Andrea Frosolini1, Paolo Gennaro1
1Maxillofacial Surgery Unit, Department of Medical Biotechnology, S. Maria alle Scotte University Hospital of Siena, 53100 Siena, Italy.
Medicina (Kaunas, Lithuania)
|May 27, 2026
Summary
Human studies suggest altered central glymphatic function in auditory disorders, linking inner ear health to brain function. Further research is needed to confirm these auditory-glymphatic interactions and their therapeutic potential.
Area of Science:
- Neuroscience
- Otolaryngology
- Radiology
Background:
- The inner ear was traditionally viewed as isolated, but neuro-lymphatic interactions are increasingly studied.
- Glymphatic and lymphatic mechanisms may play a role in auditory pathology and cognitive dysfunction.
Purpose of the Study:
- To systematically review human evidence on glymphatic mechanisms in the inner ear and audiological pathologies.
- To evaluate anatomical, imaging, and clinical correlates and biomarkers of these interactions.
Main Methods:
- Systematic literature search of PubMed, Scopus, and Cochrane databases.
- Inclusion of human studies on inner ear glymphatic assessments (anatomical, histopathological, MRI).
- Meta-analysis of diffusion tensor image analysis along the perivascular space (DTI-ALPS) indices.
Main Results:
- Histopathology showed lymphatic capillaries in Ménière disease.
- MRI studies revealed reduced ALPS indices and enlarged perivascular spaces in various auditory disorders.
- Meta-analysis confirmed significantly reduced ALPS index in auditory disorders (SMD = -0.73).
Conclusions:
- Human evidence supports altered central glymphatic function in auditory disorders.
- Findings strengthen the biological plausibility of auditory-glymphatic interactions.
- Prospective longitudinal studies are needed to establish causality and therapeutic implications.
