Endolymphatic Hydrops
Meniere Disease
Hydrops Fetalis
Endolymph
Endolymphatic Duct
Perilymph
Endolymphatic Sac
Audiometry, Evoked Response
Cochlea
Gadolinium DTPA
Neuroma, Acoustic
Ear, Inner
Imaging, Three-Dimensional
Changes in Ca2+-ATPase in a guinea pig endolymphatic hydrops model. (1/32)
OBJECTIVE: To investigate the localization of Ca(2+)-ATPase (Ca(2+) pump) in the cochlear and its change after endolymphatic hydrops, and to study the relationship between compound action potential (CAP) threshold and the Ca(2+)-ATPase activety. METHODS: The left endolymphatic sac was ablated to induce endolymphatic hydrops in fourteen healthy guinea pigs with normal action potential thresholds measured after a sliver ball electrode placed on the round window. Ca(2+)-ATPase activity was studied cytochemically using a lead citrate reaction in control and hydropic ears. The reaction product was lead phosphate particles as an expression of Ca(2+)-ATPase activity, observed with an eletron microscope. RESULTS: Ca(2+)-ATPase activity is mainly found on the endolymphatic surface of Reis sner's membrane, the stereocilia and cuticular plate of inner and outer hair cells, and along the infolded plasma membrane of strial marginal cells. CAP thresholds of filtered click are increased and Ca(2+)-ATPase activity significantly decreased after endolymphatic hydrops in the mentioned locations. CONCLUSIONS: CAP thresholds are increased and Ca(2+)-ATPase activity are significantly decreased in the cochlea after endolymphatic hydrops. These results suggest that there is a negative correlation between them. (+info)Acute endolymphatic hydrops generated by exposure of the ear to nontraumatic low-frequency tones. (2/32)
Low-frequency sounds presented at high nontraumatizing levels induce temporary hyperacusis in humans and animals. One explanation of this finding is that the basilar membrane operating point may be disturbed by an endolymph volume change. This possibility was investigated using volume and flow markers iontophoresed into the endolymphatic space of guinea pigs. Marker concentrations were measured with ion-selective microelectrodes placed apically and basally to the iontophoresis site during exposure of the ear to low-frequency tones. Concentration changes were interpreted quantitatively using a finite-element model of the endolymphatic space that allowed changes of endolymph cross-sectional area and flow to be derived. Stimulation with a 200 Hz tone at 115 dB SPL for 3 min produced marker concentration changes consistent with the induction of transient endolymphatic hydrops and a basally directed displacement of endolymph. Endocochlear potentials were greater than normal after the exposure when hydrops was present. During identical tone exposures of animals without marker, we found that action potential (AP) threshold changes and endolymph potassium changes associated with the hydropic state were small. Marker concentration changes were compared with changes in endocochlear potential and AP thresholds for a range of exposure frequencies and levels. AP hypersensitivity occurred with 200 Hz exposure levels below those inducing endolymph volume disturbances. Endolymph volume changes are thought to be the result of, rather than the cause of, changes in operating point of the cochlear transducer. The observations that auditory threshold and endolymph potassium changes are minimal under conditions where substantial endolymphatic hydrops is present is relevant to our understanding of the hearing loss in patients with Meniere's disease. (+info)Vestibular evoked myogenic potentials (VEMP) can detect asymptomatic saccular hydrops. (3/32)
OBJECTIVE: The objective of this study was to explore the useful of vestibular evoked myogenic potential (VEMP) testing for detecting endolymphatic hydrops, especially in the second ear of patients with unilateral Meniere disease (MD). METHODS: This study was performed at a tertiary care academic medical center. Part I consisted of postmortem temporal bone specimens from the temporal bone collection of the Massachusetts Eye & Ear Infirmary; part II consisted of consecutive consenting adult patients (n = 82) with unilateral MD by American Academy of Otolaryngology-Head and Neck Surgery criteria case histories. Outcome measures consisted of VEMP thresholds in patients and histologic saccular endolymphatic hydrops in postmortem temporal bones. RESULTS: Saccular hydrops was observed in the asymptomatic ear in six of 17 (35%) of temporal bones from donors with unilateral MD. Clinic patients with unilateral MD showed elevated mean VEMP thresholds and altered VEMP tuning in their symptomatic ears and, to a lesser degree, in their asymptomatic ears. Specific VEMP frequency and tuning criteria were used to define a "Meniere-like" response. This "Meniere-like" response was seen in 27% of asymptomatic ears of our patients with unilateral MD. CONCLUSIONS: Bilateral involvement is seen in approximately one third of MD cases. Saccular hydrops appears to precede symptoms in bilateral MD. Changes in VEMP threshold and tuning appear to be sensitive to these structural changes in the saccule. If so, then VEMP may be useful as a detector of asymptomatic saccular hydrops and as a predictor of evolving bilateral MD. (+info)Experimental endolymphatic hydrops under action of a type II nitric oxide synthase inhibitor: otoacoustic emissions evaluation and electrocochleography. (4/32)
In experimental endolymphatic hydrops distortion-products otoacoustic emission (dpoae) amplitudes decrease and there is elevation on electrocochleographic thresholds. Some authors found type ii nitric oxide synthase (nos ii) expression in hydropic cochleas and they suggest nitric oxide (no) may be involved in endolymphatic hydrops pathogenesis. The aim of this study was to evaluate the action of a nos ii inhibitor on dpoae and electrocochleography in experimental endolymphatic hydrops. MATERIAL E METHODS: endolymphatic hydrops was induced in 16 guinea pigs by obliterating the endolymphatic duct and sac in the right ear. They were divided in two groups: eigth guinea pigs under the action of aminoguanidine, a nos ii inhibitor and eigth control guinea pigs. We compared dpoae amplitudes at geometric means of frequencies 1062, 2187, 4375 and 7000 hz, compound action potential threshold at 1000, 2000, 4000 and 6000 hz and summating potential to action potential (sp/ap) ratio between the groups during the postoperative observation period of 16 weeks. RESULTS: there were no significant changes in the dpoae amplitudes and in the sp/ap ratio. The group that received aminoguanidine had a lower degree of threshold increase at 2000 (p<0.05) And 6000 hz (p<0.05) In 12th postoperative week and at 1000 (p<0.05), 2000 (P<0.001), 4000 (P<0.001) And 6000 hz (p<0.001) At 16th postoperative week. CONCLUSIONS: nos ii inhibitor decreased the electrocochleography threshold elevation on experimental endolymphatic hydrops. (+info)Imaging of endolymphatic and perilymphatic fluid at 3T after intratympanic administration of gadolinium-diethylene-triamine pentaacetic acid. (5/32)
(+info)Imaging endolymphatic hydrops at 3 tesla using 3D-FLAIR with intratympanic Gd-DTPA administration. (6/32)
PURPOSE: Visualization of endolymphatic hydrops by 3-dimensional fluid-attenuated inversion recovery-FLAIR using conventional turbo-spin-echo (3D-FLAIR-CONV) after intratympanic injection of Gd-DTPA has been reported in patients with Meniere's disease. Compared to 3D-FLAIR-CONV used in previous studies, the addition of a variable flip-angle technique (3D-FLAIR-VFL) enables very long echo trains and, therefore, shorter scan times. We evaluated whether 3D-FLAIR-VFL could replace 3D-FLAIR-CONV in detecting endolymphatic hydrops after intratympanic Gd-DTPA administration. METHODS: Eleven patients were included in this study. Twenty-four hours after Gd-DTPA injection, we performed 3D-FLAIR-CONV and 3D-FLAIR-VFL imaging at 3T. We compared the contrast-to-noise ratio (CNR) between cochlear fluid and the cerebellum between the 2 FLAIR sequences. We subjectively scored the size of the endolymphatic space in the cochlea and vestibule for each patient and correlated the scores with the clinical diagnoses. RESULTS: The CNR of 3D-FLAIR-CONV was significantly higher than that of 3D-FLAIR-VFL. Scores for the size of endolymphatic space in the vestibule were identical between the 2 sequences; however, those in the cochlea disagreed in 3 cases. 3D-FLAIR-CONV correlated better with the clinical diagnoses. CONCLUSIONS: Currently, we may not be able to replace 3D-FLAIR-CONV with 3D-FLAIR-VFL, at least not with the scanning parameters used in the present study. (+info)Displacements of the organ of Corti by gel injections into the cochlear apex. (7/32)
(+info)Vestibular evoked myogenic potentials in normal mice and Phex mice with spontaneous endolymphatic hydrops. (8/32)
(+info)Endolymphatic hydrops is a term used to describe the abnormal accumulation of fluid (endolymph) within the inner ear. This condition is most commonly associated with Meniere's disease, but can also be seen in other disorders that affect the inner ear.
The inner ear is made up of two main parts: the cochlea, which is responsible for hearing, and the vestibular system, which helps to control balance. Both of these systems are filled with fluid, including endolymph, which is a watery fluid that bathes the sensory hair cells in these structures.
In endolymphatic hydrops, there is an overproduction or decreased absorption of endolymph, leading to an abnormal buildup of fluid within the inner ear. This can cause a variety of symptoms, including vertigo (a spinning sensation), tinnitus (ringing in the ears), hearing loss, and a feeling of fullness or pressure in the affected ear.
The exact cause of endolymphatic hydrops is not fully understood, but it is thought to be related to changes in the inner ear's fluid balance. Treatment options may include medications to help control symptoms, as well as surgical procedures to relieve pressure on the inner ear.
Menière disease is an inner ear disorder that is characterized by episodes of vertigo (a spinning sensation), tinnitus (ringing or buzzing in the ear), hearing loss, and aural fullness (a feeling of pressure or blockage in the ear). It is caused by an abnormal accumulation of endolymphatic fluid in the inner ear, which can lead to damage of the vestibular system and cochlea. The exact cause of this fluid buildup is not known, but it may be related to genetics, allergies, or autoimmune disorders. Menière disease is typically a chronic condition, with symptoms that can vary in frequency and severity over time. Treatment options include dietary modifications, diuretics, vestibular rehabilitation therapy, and, in some cases, surgery.
Hydrops Fetalis is a serious condition characterized by the accumulation of excessive fluid in two or more fetal compartments, including the abdomen (ascites), around the heart (pericardial effusion), and/or within the lungs (pleural effusion). This accumulation can also affect the skin, causing it to become edematous. Hydrops Fetalis is often associated with various underlying causes, such as chromosomal abnormalities, congenital infections, genetic disorders, and structural defects that impair the fetus's ability to maintain fluid balance. In some cases, the cause may remain unknown. The prognosis for Hydrops Fetalis is generally poor, with a high mortality rate, although early detection and appropriate management can improve outcomes in certain situations.
Endolymph is a specific type of fluid that is found within the inner ear, more specifically in the membranous labyrinth of the inner ear. This fluid plays a crucial role in maintaining balance and hearing functions. It helps in the stimulation of hair cells present in the inner ear which then transmit signals to the brain, enabling us to hear and maintain our balance. Any disturbance or changes in the composition or flow of endolymph can lead to various vestibular disorders and hearing problems.
The endolymphatic duct is a narrow canal in the inner ear that is part of the membranous labyrinth. It connects the utricle and saccule (two sensory structures in the vestibular system responsible for detecting changes in head position and movement) to the endolymphatic sac (a dilated portion of the duct that helps regulate the volume and pressure of endolymph, a fluid found within the membranous labyrinth).
The endolymphatic duct plays a crucial role in maintaining the balance and homeostasis of the inner ear by allowing the absorption and circulation of endolymph. Disorders or abnormalities in this region can lead to various vestibular and hearing dysfunctions, such as Meniere's disease, endolymphatic hydrops, and other inner ear disorders.
Perilymph is a type of fluid found in the inner ear, more specifically within the bony labyrinth of the inner ear. It fills the space between the membranous labyrinth and the bony labyrinth in the cochlea and vestibular system. Perilymph is similar in composition to cerebrospinal fluid (CSF) and contains sodium, chloride, and protein ions. Its main function is to protect the inner ear from damage, maintain hydrostatic pressure, and facilitate the transmission of sound waves to the hair cells in the cochlea for hearing.
The endolymphatic sac is a small, fluid-filled structure that is part of the inner ear. It is located near the vestibular aqueduct and is responsible for maintaining the balance of fluids in the inner ear. The endolymphatic sac also plays a role in the resorption of endolymph, which is the fluid that fills the membranous labyrinth of the inner ear. Disorders of the endolymphatic sac can lead to conditions such as Meniere's disease, which is characterized by vertigo, hearing loss, and tinnitus.
Audiometry, evoked response is a hearing test that measures the brain's response to sound. It is often used to detect hearing loss in infants and young children, as well as in people who are unable to cooperate or communicate during traditional hearing tests.
During the test, electrodes are placed on the scalp to measure the electrical activity produced by the brain in response to sounds presented through earphones. The responses are recorded and analyzed to determine the quietest sounds that can be heard at different frequencies. This information is used to help diagnose and manage hearing disorders.
There are several types of evoked response audiometry, including:
* Auditory Brainstem Response (ABR): measures the electrical activity from the brainstem in response to sound.
* Auditory Steady-State Response (ASSR): measures the brain's response to continuous sounds at different frequencies and loudness levels.
* Auditory Middle Latency Response (AMLR): measures the electrical activity from the auditory cortex in response to sound.
These tests are usually performed in a quiet, sound-treated room and can take several hours to complete.
The cochlea is a part of the inner ear that is responsible for hearing. It is a spiral-shaped structure that looks like a snail shell and is filled with fluid. The cochlea contains hair cells, which are specialized sensory cells that convert sound vibrations into electrical signals that are sent to the brain.
The cochlea has three main parts: the vestibular canal, the tympanic canal, and the cochlear duct. Sound waves enter the inner ear and cause the fluid in the cochlea to move, which in turn causes the hair cells to bend. This bending motion stimulates the hair cells to generate electrical signals that are sent to the brain via the auditory nerve.
The brain then interprets these signals as sound, allowing us to hear and understand speech, music, and other sounds in our environment. Damage to the hair cells or other structures in the cochlea can lead to hearing loss or deafness.
Gadolinium DTPA (Diethylenetriaminepentaacetic acid) is a type of gadolinium-based contrast agent (GBCA) used in medical imaging, particularly magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA). It functions as a paramagnetic substance that enhances the visibility of internal body structures during these imaging techniques.
The compound Gadolinium DTPA is formed when gadolinium ions are bound to diethylenetriaminepentaacetic acid, a chelating agent. This binding helps to make the gadolinium ion safer for use in medical imaging by reducing its toxicity and improving its stability in the body.
Gadolinium DTPA is eliminated from the body primarily through the kidneys, making it important to monitor renal function before administering this contrast agent. In some cases, Gadolinium DTPA may cause adverse reactions, including allergic-like responses and nephrogenic systemic fibrosis (NSF) in patients with impaired kidney function.
An acoustic neuroma, also known as vestibular schwannoma, is not actually a neuroma but rather a benign (noncancerous) tumor that develops on the vestibular nerve. This nerve is one of the two nerves that transmit sound and balance information from the inner ear to the brain. The tumor arises from an overproduction of Schwann cells, which normally provide a protective covering for the nerve fibers. As the tumor grows, it can press against the hearing and balance nerves, causing symptoms such as hearing loss, ringing in the ear (tinnitus), unsteadiness, and disequilibrium. In some cases, acoustic neuromas can become quite large and cause additional symptoms by pressing on nearby cranial nerves. Treatment options include observation, radiation therapy, or surgical removal of the tumor.
The inner ear is the innermost part of the ear that contains the sensory organs for hearing and balance. It consists of a complex system of fluid-filled tubes and sacs called the vestibular system, which is responsible for maintaining balance and spatial orientation, and the cochlea, a spiral-shaped organ that converts sound vibrations into electrical signals that are sent to the brain.
The inner ear is located deep within the temporal bone of the skull and is protected by a bony labyrinth. The vestibular system includes the semicircular canals, which detect rotational movements of the head, and the otolith organs (the saccule and utricle), which detect linear acceleration and gravity.
Damage to the inner ear can result in hearing loss, tinnitus (ringing in the ears), vertigo (a spinning sensation), and balance problems.
Three-dimensional (3D) imaging in medicine refers to the use of technologies and techniques that generate a 3D representation of internal body structures, organs, or tissues. This is achieved by acquiring and processing data from various imaging modalities such as X-ray computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, or confocal microscopy. The resulting 3D images offer a more detailed visualization of the anatomy and pathology compared to traditional 2D imaging techniques, allowing for improved diagnostic accuracy, surgical planning, and minimally invasive interventions.
In 3D imaging, specialized software is used to reconstruct the acquired data into a volumetric model, which can be manipulated and viewed from different angles and perspectives. This enables healthcare professionals to better understand complex anatomical relationships, detect abnormalities, assess disease progression, and monitor treatment response. Common applications of 3D imaging include neuroimaging, orthopedic surgery planning, cancer staging, dental and maxillofacial reconstruction, and interventional radiology procedures.
Contrast media are substances that are administered to a patient in order to improve the visibility of internal body structures or processes in medical imaging techniques such as X-rays, CT scans, MRI scans, and ultrasounds. These media can be introduced into the body through various routes, including oral, rectal, or intravenous administration.
Contrast media work by altering the appearance of bodily structures in imaging studies. For example, when a patient undergoes an X-ray examination, contrast media can be used to highlight specific organs, tissues, or blood vessels, making them more visible on the resulting images. In CT and MRI scans, contrast media can help to enhance the differences between normal and abnormal tissues, allowing for more accurate diagnosis and treatment planning.
There are several types of contrast media available, each with its own specific properties and uses. Some common examples include barium sulfate, which is used as a contrast medium in X-ray studies of the gastrointestinal tract, and iodinated contrast media, which are commonly used in CT scans to highlight blood vessels and other structures.
While contrast media are generally considered safe, they can sometimes cause adverse reactions, ranging from mild symptoms such as nausea or hives to more serious complications such as anaphylaxis or kidney damage. As a result, it is important for healthcare providers to carefully evaluate each patient's medical history and individual risk factors before administering contrast media.