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1.
PLoS One ; 15(4): e0232417, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32349123

RESUMO

PURPOSE: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal structural deformity that occurs in otherwise normal individuals. Although curve progression and severity vary amongst individuals, AIS can lead to significant cosmetic and functional deformity. AIS etiology has been determined to be genetic, however, exact genetic and biological processes underlying this disorder remain unknown. Vestibular structure and function have potentially been related to the etiopathogenesis of AIS. Here, we aimed to characterize the anatomy of the semicircular canals (SCC) within the vestibular system through a novel approach utilizing T2-weighted magnetic resonance images (MRI). METHODS: Three dimensional, MRI-based models of the SCCs were generated from AIS subjects (n = 20) and healthy control subjects (n = 19). Linear mixed models were used to compare SCC morphological measurements in the two groups. We compared side-to-side differences in the SCC measurements between groups (group*side interaction). RESULTS: Side-to-side differences in the lateral SCC were different between the two groups [false discovery rate adjusted p-value: 0.0107]. Orientation of right versus left lateral SCC was significantly different in the AIS group compared to the control group [mean side-to-side difference: -4.1°, 95% CI: -6.4° to -1.7°]. Overall, among subjects in the AIS group, the left lateral SCC tended to be oriented in a more horizontal position than subjects in the control group. SIGNIFICANCE: Asymmetry within the SCCs of the vestibular system of individuals with AIS potentially results in abnormal efferent activity to postural muscles. Consequences of this muscular activity during periods of rapid growth, which often coincides with AIS onset and progression, warrant consideration.


Assuntos
Escoliose/patologia , Canais Semicirculares/patologia , Adolescente , Progressão da Doença , Feminino , Humanos , Imageamento Tridimensional/métodos , Imagem por Ressonância Magnética/métodos , Escoliose/diagnóstico por imagem , Canais Semicirculares/diagnóstico por imagem
2.
J Comput Assist Tomogr ; 44(3): 380-385, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32168084

RESUMO

OBJECTIVES: In the present study, we investigated whether mastoid pneumatization affects facial canal dimensions and distances of facial tympanic segment and scutum, and lateral semicircular (LSS) canal and scutum. METHODS: One hundred sixty-one temporal multidetector computed tomography scans were reviewed. Patients with unilateral sclerotic mastoid pneumatization (no aeration) (group 1, n = 81) and unilateral total mastoid pneumatization (100.0% aeration) (group 2, n = 80) were included. Facial canal dimensions at the labrythine, tympanic, and mastoid segments; facial canal dehiscence and length; and facial tympanic segment-scutum and LSS canal-scutum distances were evaluated. RESULTS: In the present study, facial canal dimensions of labyrinthine, tympanic, and mastoid segments in total pneumatized mastoid group were significantly lower than sclerotic mastoids on axial and coronal images (P < 0.05). Facial tympanic segment and scutum distance of the sclerotic mastoid group was significantly lower than those of the total pneumatized mastoid group (P < 0.05). However, LSS canal-scutum distance was not different between both groups (P > 0.05). The LSS canal-scutum distance of the females was lower than those of the males (P < 0.05). Facial canal dehiscence ratio was 11.3% and 11.1% in sclerotic and total pneumatized mastoids, respectively. The mean ± SD length of the dehiscence was 2.46 ± 1.29 mm in pneumatized mastoids and 1.92 ± 0.68 mm in sclerotic mastoids. CONCLUSIONS: In cholesteatoma cases, scutum erosion may occur. Because facial tympanic segment and scutum distance decreased in sclerotic mastoids compared with completely pneumatized ones, maximum care must be taken in the operations for avoiding to damage facial canal and nerve. Revision cases may be more difficult because of distorted anatomy. However, in pneumatized mastoids, the mean length of the facial canal was more than 2 mm, which must be kept in mind during operations.


Assuntos
Orelha Média/anatomia & histologia , Nervo Facial/anatomia & histologia , Processo Mastoide/anatomia & histologia , Processo Mastoide/citologia , Canais Semicirculares/anatomia & histologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Orelha Média/diagnóstico por imagem , Nervo Facial/diagnóstico por imagem , Feminino , Humanos , Masculino , Processo Mastoide/diagnóstico por imagem , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Estudos Retrospectivos , Canais Semicirculares/diagnóstico por imagem , Adulto Jovem
3.
J Comput Assist Tomogr ; 44(1): 53-58, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939882

RESUMO

OBJECTIVE: In the diagnosis of superior semicircular canal dehiscence (SSCD), computed tomography (CT) is the only imaging method. The aims of the study were to show that reformat images are more accurate than standard planes for diagnosis of SSCD and to determine the prevalence of SSCD. METHODS: The retrospective review yielded 1309 temporal CTs performed in our radiology department for any reason. Two radiologist interpreted CTs in standard planes collaboratively. Patients with SSCD were reinterpreted in Pöschl and Stenvers planes by 2 radiologists separately. RESULTS: Statistical analysis was made by accepting that 2 radiologists diagnosis were accurate in Pöschl plane. Coronal plane sensitivity 86%, specificity 64%, Stenvers plane sensitivity 96%, and specificity 52% have been found in the mean result of 2 observers (P < 0.001). CONCLUSIONS: In the diagnosis of SSCD, standard and Stenvers planes can cause false-negative and false-positive diagnoses. Interpretation in Pöschl plane can significantly increase sensitivity, specificity, negative, and positive predictive values for diagnosing dehiscence.


Assuntos
Doenças do Labirinto/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Canais Semicirculares/anormalidades , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Canais Semicirculares/diagnóstico por imagem , Sensibilidade e Especificidade , Adulto Jovem
4.
Otolaryngol Head Neck Surg ; 162(3): 353-358, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31959048

RESUMO

OBJECTIVES: To determine the relationship, if any, between body mass index (BMI) and attenuation of the arcuate eminence (AE). STUDY DESIGN: Case series with chart review. SETTING: Tertiary neurotologic referral center. SUBJECTS AND METHODS: Submillimeter distances were recorded from high-resolution temporal bone computed tomography (CT) scans of 50 patients (100 sides). The AE (defined as the superiormost location of the petrous bone over the otic capsule), the bony apex of the superior semicircular canal (SSC), and the geniculate ganglion (GG) were identified and 3-dimensional distances measured. The height of the AE relative to the bony apex of the superior semicircular canal was determined using Euclidean geometry using the fixed anatomical landmark of the GG as the origin. Correlations between AE and BMI were calculated using Pearson's, linear mixed effects, and sensitivity analysis models. RESULTS: The mean (SD) BMI was 30 (8.1) kg/m2, with 16 (30%) patients falling in the underweight/normal category (BMI <25 kg/m2), 10 (20%) overweight patients (25 kg/m2≤ BMI ≤ 30 kg/m2), and 24 (48%) patients considered obese (BMI >30 kg/m2). The mean (SD) AE heights for the left and right ears were 2.5 (1.11) and 2.6 (1.09), respectively. The results of the linear mixed-effects models indicated little evidence that BMI is associated with AE height when including all patients (partial R2 = 0.040) and when using BMI categories (partial R2 = 0.025). CONCLUSION: Contrary to other structures within the lateral skull base, the relative prominence of the arcuate eminence does not correlate with BMI or any other demographic variables.


Assuntos
Índice de Massa Corporal , Gânglio Geniculado/anatomia & histologia , Osso Petroso/anatomia & histologia , Canais Semicirculares/anatomia & histologia , Osso Temporal/anatomia & histologia , Pontos de Referência Anatômicos , Feminino , Gânglio Geniculado/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Osso Petroso/diagnóstico por imagem , Canais Semicirculares/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
5.
AJNR Am J Neuroradiol ; 40(8): 1383-1387, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31272961

RESUMO

BACKGROUND AND PURPOSE: Variable head positioning in the CT gantry results in variable and inconsistent temporal bone imaging planes. Our aim was to evaluate whether an automated postprocessing algorithm or an educational intervention with postprocessing by a technologist could result in consistent temporal bone image reformations into planes referenced to the lateral semicircular canal. MATERIALS AND METHODS: Instructions to reformat small-FOV images in planes referenced to the lateral semicircular canal were posted at 12 CT scanner consoles and e-mailed to 65 CT technologists at a single multisite institution. Automated reformatted images were also produced. The angles between the technologist- and automated-reformatted axial image planes and lateral semicircular canal planes were measured. Group differences were calculated with Mann-Whitney-Wilcoxon tests. Differences in homogeneity of variances were calculated with Fligner-Killeen tests. RESULTS: Two hundred ten temporal bones were imaged in 4 months following the intervention. Reformats by technologists were accurate in 87% of the axial and 81% of the coronal planes, with a trend toward improvement with time. Eighty percent of incorrectly reformatted images occurred at off-site, inpatient, and emergency department scanners. The error angle was significantly lower for technologist-reformatted images (median, 4.9°) than for acquisition plane images (median, 14.6°; P = 3 × 10-14) or automated-reformatted images (median, 13.8°; P = 9 × 10-13). The angle error variance was significantly more homogeneous for technologist-reformatted images (P = 3 × 10-8) and automated-reformatted images (P = 1 × 10-5) than for acquisition plane images. CONCLUSIONS: Both technologist and automated reformatting of temporal bone images resulted in significantly less imaging plane variance compared with images reformatted in the acquisition plane, but reformatting by technologists remains necessary at our institution given our preference for standardized planes referencing the lateral semicircular canals.


Assuntos
Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/normas , Algoritmos , Automação , Humanos , Processamento de Imagem Assistida por Computador , Melhoria de Qualidade , Reprodutibilidade dos Testes , Canais Semicirculares/diagnóstico por imagem
6.
BMJ Case Rep ; 12(7)2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31270089

RESUMO

Third window defects have increasingly been identified as a cause of vertigo. These defects are bony dehiscences that occur in the bony labyrinth, resulting in abnormal pressure gradient in the inner ear fluids leading to sound (Tullio's phenomenon) or pressure (Hennebert's sign) induced vertigo. The superior semicircular canal dehiscence syndrome is a well-described entity in this regard, however defects of the posterior semicircular canal are rare and may have overlapping symptomatology. We describe the history, clinical profile and management of a patient who had importunate symptoms despite being on conservative management for a year and had resolution of vestibular symptoms following surgical management.


Assuntos
Doenças do Labirinto/diagnóstico por imagem , Doenças do Labirinto/cirurgia , Canais Semicirculares/diagnóstico por imagem , Canais Semicirculares/cirurgia , Humanos , Doenças do Labirinto/patologia , Masculino , Pessoa de Meia-Idade , Canais Semicirculares/patologia , Tomografia Computadorizada por Raios X/métodos , Vestíbulo do Labirinto/diagnóstico por imagem , Vestíbulo do Labirinto/patologia , Vestíbulo do Labirinto/cirurgia
7.
Acta Otolaryngol ; 139(6): 473-478, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31035843

RESUMO

BACKGROUND: Superior semicircular canal dehiscence syndrome (SSCD) is a current diagnosis that is due to a loss of bone covering the superior semicircular canal (SSC). This results in pressure-/sound- induced vertigo and oscillopsia. OBJECTIVE: To find the variation of the thickness of the bone that covers the Superior Semicircular Canal with relation to age and gender among the Chinese descents. MATERIALS AND METHODS: Three hundred and eleven temporal bone Cone Beam Computed Tomography (CBCT) images of patients who attended Otology clinic at Second Hospital of Shandong University from January, 2017 to April, 2018 were retrospectively studied. The images were reconstructed in the line of Poschl and the thinnest area of the bone covering the SSC was taken. RESULTS: We included 172 (55.31%) females and 139 (44.69%) males. Mean age was 41 years. Overall mean difference in thickness was found to be -0.0210. There was no significant difference between the female and male bone thickness (p = .7113). With age the mean difference was 0.0801 (p = .1557) which was not statistically significant. CONCLUSION AND SIGNIFICANCE: There was no significant change in bone thickness with advancing age. CBCT is the best method of assessing SSCD.


Assuntos
Densidade Óssea/fisiologia , Reabsorção Óssea/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Doenças do Labirinto/diagnóstico por imagem , Canais Semicirculares/diagnóstico por imagem , Adulto , Fatores Etários , Idoso , Reabsorção Óssea/epidemiologia , China , Feminino , Hospitais Universitários , Humanos , Incidência , Doenças do Labirinto/epidemiologia , Doenças do Labirinto/patologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Canais Semicirculares/patologia , Índice de Gravidade de Doença , Fatores Sexuais
8.
J Clin Neurosci ; 66: 128-132, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31103254

RESUMO

Superior semicircular canal dehiscence (SSCD) is a rare inner ear disorder with variable amounts of auditory and vestibular dysfunction. In addition to the absence of bone overlying the superior semicircular canal, thinning of bone in this area can also initiate the vestibulocochlear symptoms of SSCD. We evaluated normal bone thickness overlying the course of the semicircular canal using computed tomography (CT) scans and assessed correlations between bone thickness and age, gender, and location of the thinnest bone. A single-institution retrospective chart review was conducted on 133 high-resolution CT scans from 76 healthy, asymptomatic patients between ages 9 and 96 years. These CT scans of the temporal bone were obtained between January 2012 and August 2017. The superior semicircular canal dome thickness at the apex was reported with a mean of 1.25 mm for all 76 patients; the 10th percentile was 0.60 mm, and the 90th percentile was 2.08 mm. The thinnest area of bone at any location yielded a mean of 0.86 mm. The normal bone thickness overlying the superior semicircular canal does not depend on gender or age. The thinnest location was evenly distributed across the superior semicircular canal. A bone thickness of 0.40 mm or greater was present in 90% of normal patients based on CT scan measurements at the thinnest location.


Assuntos
Doenças do Labirinto/diagnóstico por imagem , Canais Semicirculares/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
AJNR Am J Neuroradiol ; 40(4): 709-712, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30819770

RESUMO

BACKGROUND AND PURPOSE: Prior studies of radiologic superior semicircular canal dehiscence have suggested that CT may overcall dehiscence. However, many of those studies were performed before the advent of multichannel helical CT. Furthermore, there are limited data investigating the prevalence of radiologic superior semicircular canal dehiscence in asymptomatic individuals. The purpose of this study was to determine the rate of radiologic superior semicircular canal dehiscence in an asymptomatic population using 64-channel helical CT. MATERIALS AND METHODS: We retrospectively enrolled 500 consecutive adult patients without symptoms of superior semicircular canal dehiscence who had undergone CT of the temporal bones in the emergency department of a tertiary academic center between February 2012 and June 2017. The superior semicircular canals were evaluated bilaterally by 2 dedicated head and neck radiologists and subjectively classified as either dehiscent or nondehiscent. A secondary group of 110 scans of patients with symptoms consistent with superior semicircular canal dehiscence was similarly interpreted, and the rate of radiologic superior semicircular canal dehiscence was calculated for each group. RESULTS: Ten of the 500 asymptomatic patients (2.0%; 95% CI, 1.1%-3.6%) had CT evidence of superior semicircular canal dehiscence, compared with 15 of 110 symptomatic patients (13.6%; 95% CI, 7.8%-21.5%). There was excellent interobserver agreement (κ = 0.91). CONCLUSIONS: Only 2% of asymptomatic patients had radiologic evidence of superior semicircular canal dehiscence on 64-detector row helical CT. This is markedly lower than previous reports and approaches the postmortem rate of asymptomatic superior semicircular canal dehiscence. We therefore recommend that asymptomatic patients with CT evidence of superior semicircular canal dehiscence undergo audiologic evaluation because the rate of false-positive scans is extremely low.


Assuntos
Doenças do Labirinto/epidemiologia , Canais Semicirculares/diagnóstico por imagem , Canais Semicirculares/patologia , Adulto , Feminino , Humanos , Doenças do Labirinto/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Tomografia Computadorizada Espiral , Adulto Jovem
11.
Eur Arch Otorhinolaryngol ; 276(4): 1029-1034, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30725208

RESUMO

OBJECTIVES: Lateral semicircular canal (LSCC) malformations  are one of the most common inner ear malformations. The purpose of this study is to analyze the prevalence and type of hearing losses associated with LSCC malformations, compared to a control group. MATERIALS AND METHODS: We retrospectively included 109 patients (166 ears) presenting with a CT-confirmed LSCC malformation, compared to a control group (24 patients). The bony island surface and the width of the inner portion of the LSCC were measured to confirm the malformation. There results were correlated to audiogram data: sensorineural (SHNL), mixed (MHL) or conductive hearing loss (CHL) by an otologist. RESULTS: In the LSCC group, 60.9% of patients presented with an audiogram-confirmed hearing loss, especially SNHL (39.2%, n = 65) and MHL (12.7%, n = 21). Hearing was normal in 39.2% (n = 65) of the cases. Bilateral LSCC malformations (n = 57) were frequently associated with hearing loss (80.7%), SNHL in most of the cases (33.3%). Unilateral LSCC malformations were associated with hearing alterations (51.9%, n = 27), but we also observed a high rate (81%, n = 42) of contralateral abnormalities of the audiogram. CONCLUSION: LSCC malformations are commonly associated with hearing loss (61%), especially SHNL (39%). The high rate (81%) of contralateral hearing disturbances in unilateral LSCC malformations should be taken into account in the patient's daily life to avoid triggering or exacerbating any hearing loss. Otologists and radiologists must cooperate to ensure that all malformations are correctly described on CT, especially to improve the patient's education regarding hearing preservation.


Assuntos
Audiometria/métodos , Perda Auditiva Condutiva , Perda Auditiva Neurossensorial , Canais Semicirculares , Adulto , Anormalidades Congênitas/epidemiologia , Feminino , França/epidemiologia , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/epidemiologia , Perda Auditiva Condutiva/etiologia , Perda Auditiva Condutiva/prevenção & controle , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/epidemiologia , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/prevenção & controle , Humanos , Masculino , Administração dos Cuidados ao Paciente/métodos , Prevalência , Estudos Retrospectivos , Canais Semicirculares/anormalidades , Canais Semicirculares/diagnóstico por imagem , Canais Semicirculares/fisiopatologia , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
12.
Otolaryngol Head Neck Surg ; 160(6): 1095-1100, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30667318

RESUMO

OBJECTIVES: (1) Describe common patterns of semicircular canal (SCC) anomalies in CHARGE syndrome (CS) and (2) recognize that in CS, the architecture of the superior SCC may be relatively preserved. STUDY DESIGN: This is a retrospective review of temporal bone imaging studies. SETTING: Quaternary care center. SUBJECTS AND METHODS: A sample of 37 patients with CS. All subjects met clinical diagnostic criteria for CS. The presence/absence of anomalies of the middle ear, mastoid, temporal bone venous anatomy, inner ear, and internal auditory canal was recorded. Anomalies of each SCC were considered separately and by severity (normal, dysplasia, aplasia). RESULTS: Thirty-seven subjects (74 temporal bones) were reviewed. Thirty-four (92.0%) patients demonstrated bilateral SCC anomalies. Three (8.0%) had normal SCCs. In patients with SCC anomalies, all canals demonstrated bilateral abnormalities. Thirty-two (86.5%) patients had bilateral horizontal SCC aplasia. These 32 patients also demonstrated posterior SCC aplasia in at least 1 ear. Of 74 temporal bones, 37 (50.0%) had superior SCC dysplasia. All dysplastic superior SCCs showed preservation of the anterior limb. Complete superior SCC aplasia was found in 28 (37.8%) temporal bones. CONCLUSION: SCC anomalies occur with high frequency in CS. Complete absence of the horizontal and posterior canals is typical and usually bilateral. By contrast, the superior SCC often demonstrates relative preservation of the anterior limb.


Assuntos
Síndrome CHARGE/diagnóstico por imagem , Canais Semicirculares/anormalidades , Canais Semicirculares/diagnóstico por imagem , Síndrome CHARGE/complicações , Criança , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Estudos Retrospectivos , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
14.
Otol Neurotol ; 40(2): 213-217, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30570605

RESUMO

HYPOTHESIS: Flat panel computed tomography (FPCT) provides more accurate measurements of dimensions for superior semicircular canal dehiscence (SCD) than multislice CT (MSCT). BACKGROUND: SCD syndrome occurs when a bony defect of the superior semicircular canal causes vestibular and auditory symptoms. MSCT can overestimate the size of the canal defect, with possible over-diagnosis of SCD and suboptimal selection of surgical approach. The higher resolution of FPCT should afford more accurate measurements of these defects. METHODS: Radiographic and surgical measurements were compared in 22 patients (mean age 49.4) with clinical SCD syndrome and canal defects confirmed at surgery. Twenty second FPCT scans were acquired before surgery with parameters: 109Kv, small focus, 200 degrees rotation angle, and 0.4 degree per frame angulation step. Dehiscence dimensions were measured from orthogonal multiplanar reconstructions on a high-resolution liquid crystal display monitor and compared with actual measurements recorded during microsurgery. RESULTS: SCD dimensions by FPCT (x) were 2.8 ±â€Š1.6 mm for length and 0.72 ±â€Š0.28 mm for width. The surgical measurements (y) were 2.8 ±â€Š1.7 mm for length and 0.72 ±â€Š0.34 mm for width. Linear fits between x and y yielded R values of 0.93 (length) and 0.66 (width). Our previous study using MSCT had R values of 0.28 (length) and 0.48 (width). The average difference between each FPCT and corresponding surgical measurement was not significantly different from zero, whereas the results for MSCT were significantly different. CONCLUSION: FPCT can provide more accurate measurements of SCD than MSCT. Clinicians should consider using FPCT for imaging suspected SCD.


Assuntos
Doenças do Labirinto/diagnóstico por imagem , Canais Semicirculares/diagnóstico por imagem , Canais Semicirculares/patologia , Tomografia Computadorizada por Raios X/métodos , Adulto , Feminino , Humanos , Doenças do Labirinto/patologia , Masculino , Pessoa de Meia-Idade
15.
Am J Phys Anthropol ; 168(1): 10-24, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30408143

RESUMO

OBJECTIVES: Recent evidence suggests that the amount of intraspecific variation in semicircular canal morphology may, itself, be evidence for varying levels of selection related to locomotor demands. To determine the extent of this phenomenon across taxa, we expand upon previous work by examining intraspecific variation in canal radii and canal orthogonality in a broad sample of strepsirrhine and platyrrhine primates. Patterns of interspecific variation are re-examined in light of intraspecific variation to better understand the resolution at which locomotion can be reconstructed from single individuals. MATERIALS AND METHODS: Data was collected from high-resolution CT scans of 14 size-matched, related species. Six of these taxa have existing data on rotational head speeds. RESULTS: The level of intraspecific variation was found to differ in strepsirrhine and in platyrrhine species pairs, with larger ranges of variation generally observed for the slower moving taxon than the faster moving one. Taxa that are classified as relatively agile can to some extent be separated from those who are slower-moving, but only when comparing similarly sized, closely related species with more extreme forms of locomotion. DISCUSSION: Our findings agree with previous research showing that canal intraspecific variation can fluctuate according to species-specific locomotor behavior and extends this further by identifying behaviors that may be under unusual selective pressure. It also demonstrates the complexity of interpreting inner ear morphology in the context of broadly applicable locomotor "categories" of the kind commonly used in behavioral studies. We suspect that simplified models predicting vestibular sensitivity may be unable to differentiate behaviors when only a single specimen is available.


Assuntos
Primatas/anatomia & histologia , Canais Semicirculares/anatomia & histologia , Animais , Antropologia Física , Feminino , Masculino , Canais Semicirculares/diagnóstico por imagem , Especificidade da Espécie , Tomografia Computadorizada por Raios X
16.
Auris Nasus Larynx ; 46(2): 210-217, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30205916

RESUMO

OBJECTIVES: It has been suggested that in Ménière's disease (MD) a dissociated result in the caloric test (abnormal result) and video head-impulse test (normal result) probably indicates that hydrops affects the membranous labyrinth in the horizontal semicircular canal (HSC). The hypothesis in this study is that based on endolymphatic hydrops' cochleocentric progression, hydrops should also be more severe in the vestibule of these patients than in those for whom both tests are normal. METHODS: 22 consecutive patients with unilateral definite MD were included and classified as NN if both tests were normal or AN if the caloric test was abnormal. MRI evaluation of endolymphatic hydrops was carried out with a T2-FLAIR sequence performed 4h after intravenous gadolinium administration. The laterality and degree of vestibular endolymphatic hydrops and the presence or absence of cochlear endolymphatic hydrops were recorded. Demographic data, audiometric and vestibular evoked myogenic potentials were collected, and video head-impulse and caloric tests were performed. RESULTS: Patients in both groups (NN and AN) were similar in terms of demographic data and hearing loss. The interaural asymmetry ratio was significantly higher for ocular and cervical VEMP in patients in the AN group. There was a significantly higher degree of hydrops in the vestibule of the affected ear of AN patients (χ2; p=0.028). CONCLUSION: Significant canal paresis in the caloric test is associated with more severe endolymphatic hydrops in the vestibule as detected with gadolinium-enhanced MRI and with a more severe vestibular deficit. LEVEL OF EVIDENCE: 2a.


Assuntos
Cóclea/diagnóstico por imagem , Doença de Meniere/diagnóstico por imagem , Canais Semicirculares/diagnóstico por imagem , Vestíbulo do Labirinto/diagnóstico por imagem , Audiometria de Tons Puros , Testes Calóricos , Hidropisia Endolinfática/diagnóstico por imagem , Hidropisia Endolinfática/fisiopatologia , Feminino , Teste do Impulso da Cabeça , Humanos , Imagem por Ressonância Magnética , Masculino , Doença de Meniere/fisiopatologia , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Potenciais Evocados Miogênicos Vestibulares/fisiologia , Testes de Função Vestibular
17.
Otol Neurotol ; 40(1): 130-138, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30461526

RESUMO

OBJECTIVE: The etiology of symptoms following primary repair of superior canal dehiscence (SCD) may be due to a persistent third window. However, the extent of surgery cannot be seen on postoperative computed tomography (CT) since most repair materials are not radiopaque. We hypothesize that the extent of superior semicircular canal (SSC) occlusion following primary repair can be quantified based on postoperative magnetic resonance imaging (MRI) data. STUDY DESIGN: Retrospective series. SETTING: Tertiary care center. PATIENTS: Adult patients with a history of SCD syndrome who 1) report persistent symptoms following primary SCD repair and 2) underwent heavily T2-weighted MRI postoperatively. INTERVENTIONS: Analysis of SSC using 3D-reconstruction of CT co-registered with MRI data. MAIN OUTCOME MEASURES: Arc length of fluid void on MRI and quantification of persistent SCD based on CT/MRI co-registration. RESULTS: We identified 9 revision cases from a cohort of 145 SCD repairs at our institution (2002-2017) with CT/MRI data. A fluid void on postoperative MRI (indicating occlusion of the SSC) was observed in all cases (anterior limb: 50.1 degrees [±21.8 SD] and posterior limb 48.1 degrees [±28.5 SD]). Co-registration of CT/MRI revealed a residual defect that was most commonly found along the posterior limb in most patients with persistent symptoms. CONCLUSIONS: The extent of SCD repair can be determined using reformatted or direct T2-weighted MRI sequences in the plane of Pöschl. Co-registration of CT/MRI may be useful to determine the location of a residual superior canal defect and when present was found most commonly along the posterior limb.


Assuntos
Doenças do Labirinto/diagnóstico por imagem , Canais Semicirculares/diagnóstico por imagem , Feminino , Humanos , Doenças do Labirinto/patologia , Doenças do Labirinto/cirurgia , Imagem por Ressonância Magnética , Masculino , Período Pós-Operatório , Estudos Retrospectivos , Canais Semicirculares/patologia , Canais Semicirculares/cirurgia , Tomografia Computadorizada por Raios X , Falha de Tratamento
18.
Auris Nasus Larynx ; 46(4): 630-635, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30287116

RESUMO

OBJECTIVES: The patulous Eustachian tube (PET) and superior semicircular canal dehiscence syndrome (SCDS) have similarity in their symptoms and similar effects caused by positional changes, causing difficulty in the differentiation between the two disorders. This report describes a case of both SCDS and PET that was eventually successfully treated. METHODS: A 68-year-old man presented with hyperacusis to his own footsteps and gait disturbance. He had been diagnosed as PET two years before and had been treated by insertion of a silicone plug (Kobayashi plug) at the other hospital. Clinical case records, audiological data, cervical vestibular-evoked myogenic potential (cVEMP), Eustachian tube function tests and computed tomography (CT) were taken in the sitting position. RESULTS: While the CT confirmed superior semicircular canal dehiscence, the results of cVEMP was not typical of SCD likely due to preexisting hearing impairment in the right ear with a history of middle ear surgeries for the treatment of PET. He received round window reinforcement (RWR) and achieved relief from his symptoms but six months after the surgery, he visited again with complaints of autophony of his own voice and breathing. The tympanic membrane was found to move synchronous with respiration, and Eustachian tube function tests and the sitting CT confirmed the recurrence of severe PET. He had his silicone plug exchanged (increase in size of the Kobayashi plug) and achieved relief from symptoms. CONCLUSIONS: The present case was a rare instance showing that PET and SCDS can occur simultaneously in a patient. The patient achieved relief from symptoms after treatment with RWR and insertion of the Kobayashi plug.


Assuntos
Tuba Auditiva/fisiopatologia , Doenças do Labirinto/cirurgia , Procedimentos Cirúrgicos Otológicos/métodos , Próteses e Implantes , Janela da Cóclea/cirurgia , Canais Semicirculares/fisiopatologia , Idoso , Otopatias/complicações , Otopatias/cirurgia , Tuba Auditiva/diagnóstico por imagem , Humanos , Hiperacusia/etiologia , Doenças do Labirinto/complicações , Masculino , Canais Semicirculares/diagnóstico por imagem , Postura Sentada , Decúbito Dorsal
19.
Auris Nasus Larynx ; 46(1): 27-33, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30042018

RESUMO

OBJECTIVE: The aim of the present study was to examine the association of neuro-otological examination, blood test, and scoring questionnaire data with treatment-resistant intractability in idiopathic benign paroxysmal positional vertigo (BPPV) patients. METHODS: We experienced 1520 successive vertigo/dizziness patients at the Vertigo/Dizziness Center in Nara Medical University during May 2014 to April 2018. Six hundred and eleven patients were diagnosed as BPPV (611/1520; 40.2%) according to the diagnostic guideline of the International Classification of Vestibular Disorder in 2015. Among BPPV patients, there were 201 intractable patients (201/611; 32.9%), 66 of whom were idiopathic and enrolled to be hospitalized and receive neuro-otological examinations, including the caloric test (C-test), vestibular evoked cervical myogenic potentials (cVEMP), subjective visual vertical (SVV), glycerol test (G-test), electrocochleogram (ECoG), inner ear magnetic resonance imaging (ieMRI), blood tests including anti-diuretic hormone (ADH) and bone alkaline phosphatase (BAP), and self-rating questionnaires of depression score (SDS). Sixty-six patients were diagnosed as horizontal type cupula (hBPPVcu; n=30), horizontal type canal (hBPPVca; n=10), posterior type (n=20), and probable and/or atypical BPPV (n=6). Data are presented as ratios (+) of the number of idiopathic BPPV patients with examination and questionnaire data outside of the normal range. RESULTS: The ratio (+) data were as follows: C-test=21.2% (14/66), cVEMP=24.2% (16/66), SVV=48.5% (32/66), G-test=18.2% (12/66), ECoG=18.2% (12/66), ieMRI=12.1% (8/66), ADH=9.1% (6/66), BAP=13.6% (9/66), and SDS=37.9% (25/66). Multivariate regression analysis revealed that the periods of persistent vertigo/dizziness were significantly longer in BPPV patients with hBPPVcu, C-test (+), endolymphatic hydrops (+), and BAP (+) compared with those with negative findings. CONCLUSION: Although patients with idiopathic BPPV are usually treatable and curable within 1 month, the presence of hBPPVcu, canal paresis, endolymphatic hydrops, and elevated BAP may make the disease intractable, and thus require additional treatments.


Assuntos
Vertigem Posicional Paroxística Benigna/epidemiologia , Hidropisia Endolinfática/epidemiologia , Osteoporose/epidemiologia , Paresia/epidemiologia , Idoso , Fosfatase Alcalina/sangue , Audiometria de Resposta Evocada , Vertigem Posicional Paroxística Benigna/sangue , Vertigem Posicional Paroxística Benigna/diagnóstico por imagem , Vertigem Posicional Paroxística Benigna/fisiopatologia , Testes Calóricos , Hidropisia Endolinfática/sangue , Hidropisia Endolinfática/diagnóstico por imagem , Hidropisia Endolinfática/fisiopatologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neurofisinas/sangue , Osteoporose/sangue , Paresia/sangue , Paresia/diagnóstico por imagem , Paresia/fisiopatologia , Precursores de Proteínas/sangue , Análise de Regressão , Canais Semicirculares/diagnóstico por imagem , Canais Semicirculares/fisiopatologia , Vasopressinas/sangue , Potenciais Evocados Miogênicos Vestibulares
20.
Eur Arch Otorhinolaryngol ; 276(2): 375-382, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30554360

RESUMO

PURPOSE: With the increasing use of new minimally invasive approaches in temporal bone surgery, the need arises for evaluation of the risk of injury to sensitive anatomical structures. The factors that influence the measurement uncertainty (variation in representation of position and shape of anatomical structures) of imaging are of relevance. We investigate the effect of patients' anatomy on the measurement uncertainty of medical CT. METHODS: Six formalin-fixed temporal bones were used, fiducial markers were bone-implanted, and 20 CT scans of each temporal bone were generated. Surgically threatened anatomical structures of importance were defined. Manual segmentation was performed to create 3D surface models, and different Gaussian filters were applied. Analysis points were established along the border of the superior semicircular canal to determine the deviation between the 3D images of the labyrinth. The standard uncertainty was calculated, and one-way analysis of variance was performed (significance level = 5%) to evaluate the effect of certain factors (patient, side, Gaussian filter) on the measurement uncertainty. RESULTS: The influence of patient-specific anatomy on the measurement uncertainty of medical CT (p = 0.049) was demonstrated for the first time. The applied Gaussian filter (p = 0.622) and the patient's side (p = 0.341) showed no significant effect. CONCLUSION: The applied method and the results of the statistical analysis suggest that the patient's individual anatomical conditions affect the measurement uncertainty of medical CT. Thus, the patient's anatomy must be considered as an important influencing factor during risk evaluation concerning minimally invasive and image-guided surgery.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos , Seleção de Pacientes , Medição de Risco , Osso Temporal/anatomia & histologia , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Cadáver , Marcadores Fiduciais , Humanos , Imageamento Tridimensional , Canais Semicirculares/anatomia & histologia , Canais Semicirculares/diagnóstico por imagem , Cirurgia Assistida por Computador , Vestíbulo do Labirinto/anatomia & histologia , Vestíbulo do Labirinto/diagnóstico por imagem
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