Otolith Membrane Herniation, not Semicircular Canal Duct Dilation, Is Associated with Decreased Caloric Responses in Ménière's Disease
© 2022. The Author(s) under exclusive licence to Association for Research in Otolaryngology..
Ménière's disease (MD) is a debilitating disorder with unclear pathophysiology whose diagnosis often relies on clinical judgment rather than objective testing. To complicate matters further, a dissociation has emerged between two vestibular function tests commonly used in patients with MD to examine the same end-organ (the semicircular canals): the caloric test and video head impulse testing (vHIT). Caloric responses are often abnormal, while vHIT results remain normal. Explaining this dissociation could reveal novel insights into MD pathophysiology. Here, we conduct a histopathological study using temporal bone specimens (N = 58, 21 MD-affected ears and 37 age-matched controls) and their clinical testing data to examine current hypotheses aimed at this dissociation. We find otolith membrane herniation into the horizontal semicircular canal in 69% of MD ears, with 90% of these ears demonstrating a diminished caloric response. No ears with a normal response had this herniation. Moreover, we evaluated the semicircular canals for endolymphatic hydrops, which had been hypothesized to contribute to the dissociation, and found no evidence of duct dilation/hydrops. We did, however, note a potentially novel morphologic finding-smaller bony labyrinth cross-sectional diameters/areas in some MD ear canals compared to controls, suggesting relative size of the membranous duct to the bony canal rather than absolute size may be of importance. Taken together, this study refines hypotheses on the vestibular test dissociation in MD, holding diagnostic implications and expanding our understanding of the mechanisms underlying this enigmatic disease.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
|---|---|
| Enthalten in: |
Journal of the Association for Research in Otolaryngology : JARO - 24(2023), 1 vom: 01. Feb., Seite 95-106 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Shen, Leo L [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Caloric |
|---|
| Anmerkungen: |
Date Completed 01.03.2023 Date Revised 02.02.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s10162-022-00883-x |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM350512957 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM350512957 | ||
| 003 | DE-627 | ||
| 005 | 20240202231913.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s10162-022-00883-x |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1278.xml |
| 035 | |a (DE-627)NLM350512957 | ||
| 035 | |a (NLM)36539657 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Shen, Leo L |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Otolith Membrane Herniation, not Semicircular Canal Duct Dilation, Is Associated with Decreased Caloric Responses in Ménière's Disease |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 01.03.2023 | ||
| 500 | |a Date Revised 02.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s) under exclusive licence to Association for Research in Otolaryngology. | ||
| 520 | |a Ménière's disease (MD) is a debilitating disorder with unclear pathophysiology whose diagnosis often relies on clinical judgment rather than objective testing. To complicate matters further, a dissociation has emerged between two vestibular function tests commonly used in patients with MD to examine the same end-organ (the semicircular canals): the caloric test and video head impulse testing (vHIT). Caloric responses are often abnormal, while vHIT results remain normal. Explaining this dissociation could reveal novel insights into MD pathophysiology. Here, we conduct a histopathological study using temporal bone specimens (N = 58, 21 MD-affected ears and 37 age-matched controls) and their clinical testing data to examine current hypotheses aimed at this dissociation. We find otolith membrane herniation into the horizontal semicircular canal in 69% of MD ears, with 90% of these ears demonstrating a diminished caloric response. No ears with a normal response had this herniation. Moreover, we evaluated the semicircular canals for endolymphatic hydrops, which had been hypothesized to contribute to the dissociation, and found no evidence of duct dilation/hydrops. We did, however, note a potentially novel morphologic finding-smaller bony labyrinth cross-sectional diameters/areas in some MD ear canals compared to controls, suggesting relative size of the membranous duct to the bony canal rather than absolute size may be of importance. Taken together, this study refines hypotheses on the vestibular test dissociation in MD, holding diagnostic implications and expanding our understanding of the mechanisms underlying this enigmatic disease | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Caloric | |
| 650 | 4 | |a Herniation | |
| 650 | 4 | |a Ménière | |
| 650 | 4 | |a Ménière’s disease | |
| 650 | 4 | |a Otolith | |
| 650 | 4 | |a Semicircular canal | |
| 700 | 1 | |a Andresen, Nicholas S |e verfasserin |4 aut | |
| 700 | 1 | |a Chari, Divya A |e verfasserin |4 aut | |
| 700 | 1 | |a Pogson, Jacob M |e verfasserin |4 aut | |
| 700 | 1 | |a Lauer, Amanda M |e verfasserin |4 aut | |
| 700 | 1 | |a Rabbitt, Richard D |e verfasserin |4 aut | |
| 700 | 1 | |a Carey, John P |e verfasserin |4 aut | |
| 700 | 1 | |a Santos, Felipe |e verfasserin |4 aut | |
| 700 | 1 | |a Ward, Bryan K |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of the Association for Research in Otolaryngology : JARO |d 2000 |g 24(2023), 1 vom: 01. Feb., Seite 95-106 |w (DE-627)NLM114429790 |x 1438-7573 |7 nnns |
| 773 | 1 | 8 | |g volume:24 |g year:2023 |g number:1 |g day:01 |g month:02 |g pages:95-106 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s10162-022-00883-x |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 24 |j 2023 |e 1 |b 01 |c 02 |h 95-106 | ||