A Synchrotron and Micro-CT Study of the Human Endolymphatic Duct System: Is Meniere's Disease Caused by an Acute Endolymph Backflow?

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A Synchrotron and Micro-CT Study of the Human Endolymphatic Duct System : Is Meniere's Disease Caused by an Acute Endolymph Backflow?

Li, Hao, 1984- (författare): Uppsala universitet,Institutionen för medicinska vetenskaper,Öron-, näs- och halssjukdomar

Rajan, Gunesh P. (författare): Luzerner Kantonsspital, Dept Otolaryngol Head & Neck Surg, Luzern, Switzerland.;Univ Western Australia, Dept Otolaryngol Head & Neck Surg, Div Surg, Med Sch, Perth, WA, Australia.

Shaw, Jeremy (författare): Ctr Microscopy Characterisat & Anal, Perth, WA, Australia.

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Rohani, Seyed Alireza (författare): Western Univ, Dept Otolaryngol Head & Neck Surg, London, ON, Canada.

Ladak, Hanif M. (författare): Western Univ, Dept Med Biophys, London, ON, Canada.;Western Univ, Dept Elect & Comp Engn, London, ON, Canada.

Agrawal, Sumit (författare): Western Univ, Dept Otolaryngol Head & Neck Surg, London, ON, Canada.

Rask-Andersen, Helge (författare): Uppsala universitet,Öron-, näs- och halssjukdomar

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2021-05-31
2021
Engelska.
Ingår i: Frontiers in Surgery. - : Frontiers Media S.A.. - 2296-875X. ; 8

Relaterad länk:: https://doi.org/10.3...; visa fler...; https://uu.diva-port... (primary) (Raw object); https://www.frontier...; https://urn.kb.se/re...; https://doi.org/10.3...; visa färre...

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Abstract Ämnesord

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Background: The etiology of Meniere's disease (MD) and endolymphatic hydrops believed to underlie its symptoms remain unknown. One reason may be the exceptional complexity of the human inner ear, its vulnerability, and surrounding hard bone. The vestibular organ contains an endolymphatic duct system (EDS) bridging the different fluid reservoirs. It may be essential for monitoring hydraulic equilibrium, and a dysregulation may result in distension of the fluid spaces or endolymphatic hydrops. Material and Methods: We studied the EDS using high-resolution synchrotron phase contrast non-invasive imaging (SR-PCI), and micro-computed tomography (micro-CT). Ten fresh human temporal bones underwent SR-PCI. One bone underwent micro-CT after fixation and staining with Lugol's iodine solution (I2KI) to increase tissue resolution. Data were processed using volume-rendering software to create 3D reconstructions allowing orthogonal sectioning, cropping, and tissue segmentation. Results: Combined imaging techniques with segmentation and tissue modeling demonstrated the 3D anatomy of the human saccule, utricle, endolymphatic duct, and sac together with connecting pathways. The utricular duct (UD) and utriculo-endolymphatic valve (UEV or Bast's valve) were demonstrated three-dimensionally for the first time. The reunion duct was displayed with micro-CT. It may serve as a safety valve to maintain cochlear endolymph homeostasis under certain conditions. Discussion: The thin reunion duct seems to play a minor role in the exchange of endolymph between the cochlea and vestibule under normal conditions. The saccule wall appears highly flexible, which may explain occult hydrops occasionally preceding symptoms in MD on magnetic resonance imaging (MRI). The design of the UEV and connecting ducts suggests that there is a reciprocal exchange of fluid among the utricle, semicircular canals, and the EDS. Based on the anatomic framework and previous experimental data, we speculate that precipitous vestibular symptoms in MD arise from a sudden increase in endolymph pressure caused by an uncontrolled endolymphatic sac secretion. A rapid rise in UD pressure, mediated along the fairly wide UEV, may underlie the acute vertigo attack, refuting the rupture/K+-intoxication theory.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Oto-rhino-laryngologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Otorhinolaryngology (hsv//eng)

Nyckelord

human
synchrotron radiation phase-contrast imaging
reunion duct
Bast's valve
Meniere's disease

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Av författaren/redakt...: Li, Hao, 1984-; Rajan, Gunesh P.; Shaw, Jeremy; Rohani, Seyed Al ...; Ladak, Hanif M.; Agrawal, Sumit; visa fler...; Rask-Andersen, H ...; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Oto rhino laryng ...

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Av lärosätet: Uppsala universitet

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