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Fujita H, Ueda K, Kageyama H, Shiozaki T, Inui H, Kitahara T. Relationship between stress levels and endolymphatic space volume in Meniere's disease. Auris Nasus Larynx 2023; 50:866-873. [PMID: 37037749 DOI: 10.1016/j.anl.2023.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVES Since the first report by Hallpike and Yamakawa in 1938, many more patients with Meniere's disease (MD) with endolymphatic hydrops (EHs) have been described. Mental/physical stress and a subsequent increase in the release of the anti-diuretic hormone (ADH) supposedly triggers MD. In the present study, to assess the relationship between stress and EHs, we conducted a series of stress-related questionnaires as well as a 3D endolymphatic space (ELS) analysis in patients with unilateral MD. METHODS We enrolled 76 patients with unilateral MD (uMD) as the active group and 75 patients with unilateral benign paroxysmal positional vertigo (uBPPV) as the control group; both underwent examinations between June 2014 and November 2019. All patients underwent 3-T magnetic resonance imaging (MRI) 4 h after intravenous gadolinium injection. We used the total fluid space (TFS), ELS, and ELS rate (ELS/TFS × 100), which is the percentage of the volume of the ELS relative to that of the TFS, for a precise evaluation of the ELS and EHs in MD. Stress was evaluated using the Self-Rating Depression Scale (SDS), the psychological Stress Response Scale (SRS), and the modified Dizziness Handicap Inventory (mDHI). Stress scores and blood ADH levels were compared across patient groups. RESULTS In patients with uMD, ELS rates significantly correlated with SRS scores on both the affected and the healthy side and with mDHI scores on the affected side, while the SDS and ADH showed no significant correlation with the ELS rates. Correlations were much stronger in the group with severe SDS and one with low ADH levels. CONCLUSIONS The present results indicate that stress may be involved in EHs development in uMD, not only in the ipsilateral but also the contralateral ear. They also suggest that patients with neuropsychiatric tendencies may develop EHs and MD in response to a stressful lifestyle.
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Affiliation(s)
- Hiroto Fujita
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara-city, Nara, Japan
| | - Keita Ueda
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara-city, Nara, Japan
| | - Hajime Kageyama
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara-city, Nara, Japan
| | - Tomoyuki Shiozaki
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara-city, Nara, Japan
| | - Hiroshi Inui
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara-city, Nara, Japan
| | - Tadashi Kitahara
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara-city, Nara, Japan.
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2
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Suárez-Vega V, Manrique-Huarte R, Dominguez P, Blanco M, Alonso-Burgos A, Pérez-Fernández N. Magnetic Resonance Volumetric Quantification of Vestibular Endolymphatic Hydrops in Patients with Unilateral Definite Meniere's Disease Using 3D Inversion Recovery with Real Reconstruction (3D-REAL-IR) Sequence. J Clin Med 2023; 12:5965. [PMID: 37762906 PMCID: PMC10532400 DOI: 10.3390/jcm12185965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The 3D-REAL-IR MRI sequence allows for an in vivo visualization of endolymphatic hydrops. Qualitative assessment methods of the severity of vestibular and cochlear hydrops are the most commonly used. METHODS A quantitative volumetric measurement of vestibular EH in patients with definite unilateral Ménière's disease using the 3D-REAL-IR sequence and the calculation of the endolymphatic ratio (ELR) was intended. RESULTS Volumetric calculations of the vestibules, vestibular endolymph and vestibular ELR are performed in 96 patients with unilateral Ménière's disease and correlated with classic qualitative grading scales. CONCLUSIONS Quantitative volumetric measurement of vestibular hydrops using the 3D-REAL-IR sequence is feasible and reproducible in daily clinical practice. Vestibular ELR values exceeding 60% defined radiologically significant vestibular hydrops, while values below 30% defined radiologically non-significant vestibular hydrops.
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Affiliation(s)
- Víctor Suárez-Vega
- Department of Radiology, Clinica Universidad de Navarra, 28027 Madrid, Spain;
| | - Raquel Manrique-Huarte
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, 31008 Pamplona, Spain;
| | - Pablo Dominguez
- Department of Radiology, Clinica Universidad de Navarra, 31008 Pamplona, Spain;
| | - Melissa Blanco
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, 28027 Madrid, Spain; (M.B.); (N.P.-F.)
| | | | - Nicolás Pérez-Fernández
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, 28027 Madrid, Spain; (M.B.); (N.P.-F.)
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Coon A, Setzen G, Musah RA. Mass Spectrometric Interrogation of Earwax: Toward the Detection of Ménière's Disease. ACS OMEGA 2023; 8:27010-27023. [PMID: 37546591 PMCID: PMC10399190 DOI: 10.1021/acsomega.3c01943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/16/2023] [Indexed: 08/08/2023]
Abstract
Many diseases remain difficult to identify because the occurrence of characteristic biomarkers within traditional matrices such as blood and urine remain unknown. Disease diagnosis could, therefore, benefit from the analysis of readily accessible, non-traditional matrices that have a high chemical content and contain distinguishing biomarkers. One such matrix is cerumen (i.e., earwax), whose chemical complexity can pose challenges when analyzed by conventional methods. A combination of cerumen chemical profiles analyzed by gas chromatography-mass spectrometry (GC-MS) and direct analysis in real time-high-resolution mass spectrometry (DART-HRMS) were investigated to ascertain the possible presence of the rare otolaryngological disorder Ménière's disease. This illness is currently identified via "diagnosis by exclusion" in which the disease is distinguished from others with overlapping symptoms by the process of elimination. GC-MS revealed a chemical profile difference between those with and without a Ménière's disease diagnosis by a visually apparent diminution of the compounds present in the Ménière's disease samples. DART-HRMS revealed that the two classes could be differentiated using three fatty acids: cis-9-hexadecenoic acid, cis-10-heptadecenoic acid, and cis-9-octadecenoic acid. These compounds were subsequently quantified by GC-MS and overall, the amounts of these fatty acids were decreased in Ménière's disease patients. The average levels for non-Ménière's disease samples were 7.89 μg/mg for cis-9-hexadecenoic acid, 0.87 μg/mg for cis-10-heptadecenoic acid, and 4.94 μg/mg for cis-9-octadecenoic acid. The average levels for Ménière's disease samples were 1.70 μg/mg for cis-9-hexadecenoic acid, 0.13 μg/mg for cis-10-heptadecenoic acid, and 2.07 μg/mg for cis-9-octadecenoic acid. The confidence levels for cis-9-hexadecenoic acid, cis-10-heptadecenoic acid, and cis-9-octadecenoic acid were 98.7%, 99.9%, and 95.4%, respectively. The results suggest that assessment of the concentrations of these fatty acids could be a useful clinical tool for the more rapid and accurate detection of Ménière's disease.
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Affiliation(s)
- Allix
Marie Coon
- Department
of Chemistry, University at Albany, State
University of New York, 1400 Washington Avenue, Albany, New York 12222, United States
| | - Gavin Setzen
- Albany
ENT and Allergy Services, 123 Everett Rd, Albany, New York 12205, United States
| | - Rabi Ann Musah
- Department
of Chemistry, University at Albany, State
University of New York, 1400 Washington Avenue, Albany, New York 12222, United States
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Xiao H, Lin J, Lin C, Guo X, Cai H, Lin X, Ye S. The value of
3D
quantitative scoring of endolymphatic hydrops in the diagnosis and differential diagnosis of Ménière's disease. Laryngoscope Investig Otolaryngol 2023; 8:568-576. [PMID: 37090865 PMCID: PMC10116982 DOI: 10.1002/lio2.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/09/2023] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
Objective We aimed to explore the application of three-dimensional (3D) quantitative scoring of endolymphatic hydrops (EH) based on gadolinium-contrast MRI in both the diagnosis and differential diagnosis of Ménière's disease (MD). Methods Local threshold method based on signal intensities was used to quantitatively measure volumes, and the degree of EH was scored by 3D quantitative scoring. The receiver-operating characteristic (ROC) curve was used to compare the diagnostic efficacy of this method against conventional evaluation methods. The scores of MD, sudden sensorineural hearing loss (SSNHL), delayed endolymphatic hydrops (DEH), and vestibular migraine (VM) group were compared and correlated with clinical examination results, including pure tone audiometry (PTA), electrocochleogram, and caloric test. Results The sensitivity and specificity of 3D quantitative scoring were 94.1% and 92.2%, while conventional evaluation methods were 84.3% and 88.2%, respectively. Cochlear score (CR), vestibular score (VR), semicircular canal score (SR), and total scores (TR) in MD group were significantly higher than those in SSNHL group. The rate of diagnosis of MD was significantly higher in the MD group (92.2%) than VM group (27.3%). In MD, PTA was significantly correlated with CR and SR, the ratio of summating potential to action potential (-SP/AP) of electrocochleogram was significantly correlated with CR, VR, and SR, also canal paresis (CP) value of caloric test was significantly correlated with SR. Conclusion 3D quantitative scoring demonstrated better diagnostic efficacy than conventional evaluation methods for Ménière's disease, and it may be an effective clinical tool to distinguish MD from SSNHL and VM. The clinical practicality of inner ear-enhanced MRI was further confirmed. Level of Evidence IV.
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Affiliation(s)
- Heng Xiao
- Department of OtorhinolaryngologyThe First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
- Department of OtorhinolaryngologyNational Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical UniversityFuzhou350212China
- Fujian Institute of Otorhinolaryngology, The First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
| | - Jianwei Lin
- Department of OtorhinolaryngologyThe First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
| | - Chenxin Lin
- Department of OtorhinolaryngologyThe First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
| | - Xiaojing Guo
- Department of OtorhinolaryngologyThe First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
| | - Huimin Cai
- Department of OtorhinolaryngologyThe First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
- Department of OtorhinolaryngologyNational Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical UniversityFuzhou350212China
- Fujian Institute of Otorhinolaryngology, The First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
| | - Xing Lin
- Department of OtorhinolaryngologyThe First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
- Department of OtorhinolaryngologyNational Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical UniversityFuzhou350212China
- Fujian Institute of Otorhinolaryngology, The First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
| | - Shengnan Ye
- Department of OtorhinolaryngologyThe First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
- Department of OtorhinolaryngologyNational Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical UniversityFuzhou350212China
- Fujian Institute of Otorhinolaryngology, The First Affiliated Hospital, Fujian Medical UniversityFuzhou350005China
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Wang B, Li Y, Zhang Q, Sun J, Tian Y, Ma D, Leng H. A bibliometric and visualization study of Meniere's disease: Current status and global hotspots and emerging trends. Medicine (Baltimore) 2023; 102:e33156. [PMID: 36897693 PMCID: PMC9997775 DOI: 10.1097/md.0000000000033156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/10/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Meniere's disease (MD) is a clinical condition characterized by endolymphatic hydrops. Persistent symptoms negatively affect patients mood, and the underlying etiology remains unclear. It is necessary to comprehensively understand the relevant publications, review the history and current status of research, and analyze hotspots and frontiers of research on MD. METHODS We retrieved literature on Meniere's disease from 2003 to 2022 from the Web of Science database and extracted the data. Data visualization and analysis was conducted using Cite Space, VOS viewer, an online web tool, and Microsoft Office Power Point 2019. RESULTS In total, 2847 publications were analyzed. The number of annual publications was relatively stable, with an accelerated upward trend over the past 5 years. The country with the most publications was USA (751, 26.38%), while the University of Munich contributed more publications than any other institution (117, 4.11%). The article titled "Diagnostic criteria for Meniere's disease" by Lopez-Escamez J et al in 2015 was the most cited and co-cited publication, and also had the top co-cited references with the strongest citation bursts. Naganawa S was the author with the most publications (85, 2.99%). The top 3 journals and co-cited journals were Otology Neurotology, Acta Oto Laryngologica, and Laryngoscope. Recently, the key theme words were "sensorineural hearing loss," "therapy," "intratympanic injection method," "vestibular-evoked myogenic potentials," "vestibular migraine," "magnetic resonance imaging," and "meniere's disease." CONCLUSIONS The US has the largest number of publications and research institutions, many European countries have high-quality journals, and Japan has the highest number of scholars. The international opinion on Meniere's disease is relatively uniform. The stepped-therapy for MD is scientific and clear. Intratympanic injection of steroids and intratympanic injection of gentamicin are commonly used, but steroids are considered safer. Saccular dysfunction may be more common in patients with MD than in those with utricular dysfunctions. It is worth paying attention to study the relationship between MD and vestibular migraine through headache. Progress in magnetic resonance imaging technology is still required for the imaging diagnosis of MD.
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Affiliation(s)
- Boshen Wang
- Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Yuan Li
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Qi Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Jiawei Sun
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Yu Tian
- Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Dan Ma
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hui Leng
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
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Liu Y, Pyykkö I, Naganawa S, Marques P, Gürkov R, Yang J, Duan M. Consensus on MR Imaging of Endolymphatic Hydrops in Patients With Suspected Hydropic Ear Disease (Meniere). Front Surg 2022; 9:874971. [PMID: 35574547 PMCID: PMC9096015 DOI: 10.3389/fsurg.2022.874971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Endolymphatic hydrops (EH) is considered the histological hallmark of Meniere's disease. Visualization of EH has been achieved by special sequences of inner ear magnetic resonance imaging (MRI) with a gadolinium-based contrast agent via intravenous or intratympanic administration. Although it has been applied for more than 10 years since 2007, a unified view on this technique has not yet been achieved. This paper presents an expert consensus on MRI of endolymphatic hydrops in the following aspects: indications and contra-indications for patient selection, methods of contrast-agent administration (intravenous or intratympanic), MRI sequence selection, the specific scanning parameter settings, and standard image evaluation methods and their advantages and disadvantages. For each part of this consensus, a comment is attached to elucidate the reasons for the recommendation.
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Affiliation(s)
- Yupeng Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, Faculty of Medicine and Health Technology, School of Medicine, Tampere University, Tampere, Finland
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Pedro Marques
- Unit of Otorhinolaryngology, Department of Surgery and Physiology, University of Porto Medical School, Porto, Portugal
| | - Robert Gürkov
- ENT Centre at Red Cross Square, University of Munich, Munich, Germany
| | - Jun Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
- *Correspondence: Jun Yang
| | - Maoli Duan
- Ear Nose and Throat Patient Area, Trauma and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Maoli Duan
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Inui H, Sakamoto T, Ito T, Kitahara T. Magnetic resonance imaging of endolymphatic hydrops in patients with unilateral Meniere's disease: volume ratio and distribution rate of the endolymphatic space. Acta Otolaryngol 2021; 141:1033-1037. [PMID: 34807797 DOI: 10.1080/00016489.2021.1968488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Endolymphatic hydrops (ELH), which is a pathological feature of Meniere's disease (MD), is characterized by an extended endolymphatic space (ELS). AIMS/OBJECTIVES We aimed to perform a quantitative volumetric analysis of inner-ear ELH in patients with unilateral MD (uMD). MATERIAL AND METHODS This study included 97 patients with definite uMD and 49 control subjects (CS). The ELS/total fluid space (TFS) volume ratio (%) and the distribution rate of the inner-ear components in the ELS (%) were measured using 3D magnetic resonance imaging and compared between patients with uMD and CS. RESULTS Compared to CS, patients with uMD had significantly higher mean ELS/TFS volume ratios for inner-ear components. The mean distribution rate of the inner-ear components in the ELS was not significantly different between the two groups. CONCLUSIONS AND SIGNIFICANCE In patients with uMD, ELH was noted to be spread throughout the entire inner ear and the endolymph was evenly distributed in the total ELS. These findings should be useful as a standard reference for further research.
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Affiliation(s)
- Hiroshi Inui
- Department of Otorhinolaryngology, Inui ENT Clinic, Nara, Japan
| | | | - Taeko Ito
- Department of Otorhinolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan
| | - Tadashi Kitahara
- Department of Otorhinolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan
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