Otolithic Membrane Damage in Patients with Endolymphatic Hydrops and Drop Attacks

Overview

Journal Otol Neurotol

Specialties Neurology
Otorhinolaryngology

Date 2012 Oct 16

PMID 23064391

Citations 16

Authors

Audrey P Calzada

Ivan A Lopez

Gail Ishiyama

Akira Ishiyama

Affiliations

Soon will be listed here.

Abstract

Objectives: 1. Evaluate the otolithic membrane in patients with endolymphatic hydrops (EH) and vestibular drop attacks (VDA) undergoing ablative labyrinthectomy. 2. Correlate intraoperative findings to archival temporal bone specimens of patients with EH.

Study Design: Retrospective case review.

Setting: Tertiary referral center. SPECIMEN SOURCE: 1. Patients undergoing labyrinthectomy for incapacitating Ménière's disease (MD), delayed EH, VDA, or acoustic neuroma (AN) between 2004 and 2011. 2. Archival temporal bone specimens of patients with MD.

Interventions: Ablative labyrinthectomy.

Main Outcome Measures: Examination of the utricular otolithic membrane.

Results: The otolithic membrane of the utricle was evaluated intraoperatively in 28 patients undergoing labyrinthectomy. Seven (25%) had a history of VDA, 6 (21%) had delayed EH, 9 (32%) had MD, and 6 (21%) had AN. All patients with VDA showed evidence of a disrupted utricular otolithic membrane, whereas only 50% and 56% of patients with delayed EH and MD, respectively, demonstrated otolithic membrane disruption (p = 0.051). None of the patients with AN showed otolithic membrane disruption (p = 0.004). The mean thickness of the otolithic membrane in 5 archival temporal bone MD specimens was 11.45 micrometers versus 38 micrometers in normal specimens (p = 0.001).

Conclusion: The otolithic membrane is consistently damaged in patients with VDA. In addition, there is a significantly higher incidence of otolithic membrane injury in patients with MD and delayed EH compared with patients without hydrops, suggesting that the underlying pathophysiology in VDA results from injury to the otolithic membrane of the saccule and utricle, resulting in free-floating otoliths and atrophy.

Citing Articles

Posterior Semicircular Canal Plugging Relieves Tumarkin's Crisis in Ménière's Disease Patients.

Comacchio F, Bordin A, Di Pasquale Fiasca V, Bellemo B, Magnavita P, Fasanaro E Audiol Res. 2024; 14(3):432-441.

PMID: 38804460 PMC: 11130875. DOI: 10.3390/audiolres14030036.

Research advances in cochlear pericytes and hearing loss.

Shi X Hear Res. 2023; 438:108877.

PMID: 37651921 PMC: 10538405. DOI: 10.1016/j.heares.2023.108877.

[Expert consensus on the diagnosis of isolated otolith dysfunction].

Wu Z, Liu B Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023; 37(6):409-414.

PMID: 37253512 PMC: 10495805. DOI: 10.13201/j.issn.2096-7993.2023.06.002.

Vestibular Drop Attacks and Meniere's Disease as Results of Otolithic Membrane Damage-A Numerical Model.

Senofsky N, Faber J, Bozovic D J Assoc Res Otolaryngol. 2022; 24(1):107-115.

PMID: 36517730 PMC: 9971529. DOI: 10.1007/s10162-022-00880-0.

Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment.

de Pont L, van Steekelenburg J, Verhagen T, Houben M, Goeman J, Verbist B Front Surg. 2021; 8:758947.

PMID: 34805261 PMC: 8601159. DOI: 10.3389/fsurg.2021.758947.

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