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Xia K, Lei P, Liu Y, Li J, Wang M, Leng Y, Liu B. Comparison of radiological abnormalities between the jugular bulb and the vestibular aqueduct in patients with Ménière's disease. Front Neurol 2023; 14:1184232. [PMID: 37251218 PMCID: PMC10213226 DOI: 10.3389/fneur.2023.1184232] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/11/2023] [Indexed: 05/31/2023] Open
Abstract
Objective Anatomical variations of the inner ear may contribute to the development of Ménière's disease (MD), which is a complex inner ear disorder histopathologically characterized by idiopathic endolymphatic hydrops (ELH). Abnormalities of the vestibular aqueduct (VA) and the jugular bulb (JB) have been suggested as predisposing factors. Yet, few studies have investigated the correlation between JB abnormalities and VA variations as well as its clinical relevance in these patients. In this retrospective study, we investigated the differences in the incidence of radiological abnormalities of the VA and JB in patients with definite MD. Methods Anatomical variations of JB and VA were evaluated based on high-resolution CT (HRCT) in a series of 103 patients with MD (93 unilateral cases and 10 bilateral cases). JB-related indices included JB anteroposterior and mediolateral diameter, JB height, JB type regarding to Manjila classification system, and incidences of JB diverticulum (JBD), JB related inner ear dehiscence (JBID), and inner ear adjacent JB (IAJB). VA-related indices included CT-VA visibility, CT-VA morphology (funnel, tubular, filiform, hollow, and obliterated-shaped type), and peri-VA pneumatization. Radiological indices were compared between MD ears and control ears. Results Radiological JB abnormalities were comparable between MD ears and control ears. As for VA-related indices, the CT-VA visibility was lower in MD ears than in control ears (p = 0.004). The distribution of CT-VA morphology was significantly different between MD and control ears (p = 0.013), with a higher proportion of obliterated-shaped type in MD ears (22.1%) than in control ears (6.6%). Conclusion Compared with JB abnormalities, the anatomical variations of VA are more likely to be an anatomically predisposing factor for MD.
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Affiliation(s)
- Kaijun Xia
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Lei
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingzhao Liu
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Miao Wang
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yangming Leng
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Liu
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Aladeyelu OS, Olojede SO, Lawal SK, Mbatha WBE, Sibiya AL, Rennie CO. Influence of pneumatization on morphology of temporal bone-related vasculatures and their morphometric relationship with ear regions: a computed tomography study. Sci Rep 2023; 13:1996. [PMID: 36737493 PMCID: PMC9898243 DOI: 10.1038/s41598-023-29295-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
Anatomical variations in the location and position of temporal bone-related vasculature are routinely encountered in clinical practice, contributing to clinical syndromes and complexities in ear-related and neurological surgeries. Pneumatization of the temporal bone (TB) is one of several factors that have been hypothesized to influence the variabilities and variations of these vessels. This study aimed to investigate the association between the degree of pneumatization and the morphologies of some TB-related vessels, as well as their morphometrical relationship with ear regions. Observational retrospective chart review of 496 TBs computed tomographic scans were examined. Different degrees of pneumatization were observed, with hyper-pneumatization being the most common and hypo-pneumatization being the least. Various anatomical variants of the sigmoid sinus (SS), jugular bulb (JB), and internal carotid artery (ICA) were observed. Distances of SS and JB to ear regions were observed to have significant differences (p < 0.05) in laterality. These distances increased relative to increased air cells, showing a significant association (p < 0.05). A significant association (p < 0.001) was also observed between the degree of pneumatization and variants of JB and ICA. High JB, JB dehiscence, and ICA dehiscence were significantly associated with increased pneumatization, while flat JB was significantly associated with decreasing pneumatization. However, no significant association (p = 0.070, p = 0.645) was observed between the degree of pneumatization and morphologies of SS. This study concludes that the degree of pneumatization influences only the jugular bulb variants and ICA dehiscence, as well as the distances of SS and JB to ear regions.
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Affiliation(s)
- Okikioluwa Stephen Aladeyelu
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa.
| | - Samuel Oluwaseun Olojede
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
| | - Sodiq Kolawole Lawal
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
| | - Wonder-Boy Eumane Mbatha
- Radiology Department, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
- Lake, Smit & Partners Inc, Durban, South Africa
| | - Andile Lindokuhle Sibiya
- Discipline of Otorhinolaryngology- Head and Neck Surgery, School of Clinical Medicine, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
- ENT Department, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Carmen Olivia Rennie
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
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Abdalkader M, Nguyen TN, Norbash AM, Raz E, Shapiro M, Lenck S, Brinjikji W, Weber P, Sakai O. State of the Art: Venous Causes of Pulsatile Tinnitus and Diagnostic Considerations Guiding Endovascular Therapy. Radiology 2021; 300:2-16. [PMID: 34032509 DOI: 10.1148/radiol.2021202584] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Venous variants and pathologic abnormalities are the most common causes of pulsatile tinnitus. These conditions include causes of turbulence within normally located veins and sinuses, and abnormally enlarged or abnormally located veins in close transmissive proximity to the conductive auditory pathway. Such disorders include pathologic abnormalities of the lateral sinus (transverse sinus stenosis and sigmoid sinus wall anomalies), abnormalities and variants of the emissary veins, and anomalies of the jugular bulb and jugular vein. Despite being the most common causes for pulsatile tinnitus, venous variants and pathologic abnormalities are often overlooked in the workup of pulsatile tinnitus. Such oversights can result in delayed patient care and prolonged patient discomfort. Advances in both cerebrovascular imaging and endovascular techniques allow for improved diagnostic accuracy and an increasing range of endovascular therapeutic options to address pulsatile tinnitus. This review illustrates the venous causes of pulsatile tinnitus and demonstrates the associated endovascular treatment. © RSNA, 2021.
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Affiliation(s)
- Mohamad Abdalkader
- From the Departments of Radiology (M.A., T.N.N., O.S.), Neurology (T.N.N.), Neurosurgery (T.N.N.), Otolaryngology-Head and Neck Surgery (P.W., O.S.), and Radiation Oncology (O.S.), Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118; Department of Radiology, University of California San Diego School of Medicine, UC San Diego Health, San Diego, Calif (A.M.N.); Departments of Radiology (E.R., M.S.) and Neurology (M.S.), NYU Langone Health, New York, NY; Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Sorbonne University, Paris, France (S.L.); and Departments of Radiology and Neurosurgery, Mayo Clinic Rochester, Rochester, Minn (W.B.)
| | - Thanh N Nguyen
- From the Departments of Radiology (M.A., T.N.N., O.S.), Neurology (T.N.N.), Neurosurgery (T.N.N.), Otolaryngology-Head and Neck Surgery (P.W., O.S.), and Radiation Oncology (O.S.), Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118; Department of Radiology, University of California San Diego School of Medicine, UC San Diego Health, San Diego, Calif (A.M.N.); Departments of Radiology (E.R., M.S.) and Neurology (M.S.), NYU Langone Health, New York, NY; Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Sorbonne University, Paris, France (S.L.); and Departments of Radiology and Neurosurgery, Mayo Clinic Rochester, Rochester, Minn (W.B.)
| | - Alexander M Norbash
- From the Departments of Radiology (M.A., T.N.N., O.S.), Neurology (T.N.N.), Neurosurgery (T.N.N.), Otolaryngology-Head and Neck Surgery (P.W., O.S.), and Radiation Oncology (O.S.), Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118; Department of Radiology, University of California San Diego School of Medicine, UC San Diego Health, San Diego, Calif (A.M.N.); Departments of Radiology (E.R., M.S.) and Neurology (M.S.), NYU Langone Health, New York, NY; Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Sorbonne University, Paris, France (S.L.); and Departments of Radiology and Neurosurgery, Mayo Clinic Rochester, Rochester, Minn (W.B.)
| | - Eytan Raz
- From the Departments of Radiology (M.A., T.N.N., O.S.), Neurology (T.N.N.), Neurosurgery (T.N.N.), Otolaryngology-Head and Neck Surgery (P.W., O.S.), and Radiation Oncology (O.S.), Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118; Department of Radiology, University of California San Diego School of Medicine, UC San Diego Health, San Diego, Calif (A.M.N.); Departments of Radiology (E.R., M.S.) and Neurology (M.S.), NYU Langone Health, New York, NY; Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Sorbonne University, Paris, France (S.L.); and Departments of Radiology and Neurosurgery, Mayo Clinic Rochester, Rochester, Minn (W.B.)
| | - Maksim Shapiro
- From the Departments of Radiology (M.A., T.N.N., O.S.), Neurology (T.N.N.), Neurosurgery (T.N.N.), Otolaryngology-Head and Neck Surgery (P.W., O.S.), and Radiation Oncology (O.S.), Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118; Department of Radiology, University of California San Diego School of Medicine, UC San Diego Health, San Diego, Calif (A.M.N.); Departments of Radiology (E.R., M.S.) and Neurology (M.S.), NYU Langone Health, New York, NY; Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Sorbonne University, Paris, France (S.L.); and Departments of Radiology and Neurosurgery, Mayo Clinic Rochester, Rochester, Minn (W.B.)
| | - Stéphanie Lenck
- From the Departments of Radiology (M.A., T.N.N., O.S.), Neurology (T.N.N.), Neurosurgery (T.N.N.), Otolaryngology-Head and Neck Surgery (P.W., O.S.), and Radiation Oncology (O.S.), Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118; Department of Radiology, University of California San Diego School of Medicine, UC San Diego Health, San Diego, Calif (A.M.N.); Departments of Radiology (E.R., M.S.) and Neurology (M.S.), NYU Langone Health, New York, NY; Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Sorbonne University, Paris, France (S.L.); and Departments of Radiology and Neurosurgery, Mayo Clinic Rochester, Rochester, Minn (W.B.)
| | - Waleed Brinjikji
- From the Departments of Radiology (M.A., T.N.N., O.S.), Neurology (T.N.N.), Neurosurgery (T.N.N.), Otolaryngology-Head and Neck Surgery (P.W., O.S.), and Radiation Oncology (O.S.), Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118; Department of Radiology, University of California San Diego School of Medicine, UC San Diego Health, San Diego, Calif (A.M.N.); Departments of Radiology (E.R., M.S.) and Neurology (M.S.), NYU Langone Health, New York, NY; Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Sorbonne University, Paris, France (S.L.); and Departments of Radiology and Neurosurgery, Mayo Clinic Rochester, Rochester, Minn (W.B.)
| | - Peter Weber
- From the Departments of Radiology (M.A., T.N.N., O.S.), Neurology (T.N.N.), Neurosurgery (T.N.N.), Otolaryngology-Head and Neck Surgery (P.W., O.S.), and Radiation Oncology (O.S.), Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118; Department of Radiology, University of California San Diego School of Medicine, UC San Diego Health, San Diego, Calif (A.M.N.); Departments of Radiology (E.R., M.S.) and Neurology (M.S.), NYU Langone Health, New York, NY; Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Sorbonne University, Paris, France (S.L.); and Departments of Radiology and Neurosurgery, Mayo Clinic Rochester, Rochester, Minn (W.B.)
| | - Osamu Sakai
- From the Departments of Radiology (M.A., T.N.N., O.S.), Neurology (T.N.N.), Neurosurgery (T.N.N.), Otolaryngology-Head and Neck Surgery (P.W., O.S.), and Radiation Oncology (O.S.), Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118; Department of Radiology, University of California San Diego School of Medicine, UC San Diego Health, San Diego, Calif (A.M.N.); Departments of Radiology (E.R., M.S.) and Neurology (M.S.), NYU Langone Health, New York, NY; Department of Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Sorbonne University, Paris, France (S.L.); and Departments of Radiology and Neurosurgery, Mayo Clinic Rochester, Rochester, Minn (W.B.)
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