A Case of Calcification Discovered Within the Membranous Labyrinth During Resection of a Vestibular Schwannoma.

Objective: To report a case of calcification discovered in the membranous labyrinth of a patient with a vestibular schwannoma after transtemporal labyrinthectomy.

Study Design: Clinical capsule report.

Setting: Tertiary academic referral center.

Pain, Safety, and Image Quality of Magnetic Resonance Imaging With Cochlear Implants: A Prospective Trial.

Objective: To evaluate whether rotating cochlear implant (CI) magnets improve patient comfort and preserve scan usability during magnetic resonance imaging (MRI).

Study Design: Prospective cohort study.

Setting: Two tertiary academic centers.

High-resolution 7-Tesla magnetic resonance imaging and post-processing for 3-dimensional reconstruction of the membranous labyrinth in healthy adults.

The membranous labyrinth of the inner ear is a complex network of endolymph-filled structures critical for auditory and vestibular function. Pathological distension of these spaces, termed endolymphatic hydrops (EH), is associated with disorders such as Ménière's disease (MD). However, diagnosing inner ear pathologies remains challenging due to limitations in traditional imaging techniques, which lack the spatial resolution required to assess these intricate structures.

Bayesian nested frailty model for evaluating surgical management of patulous Eustachian tube dysfunction.

Background: The nested frailty model, a random effects survival model that can accommodate data clustered at two hierarchical levels, has been rarely used in practice. We aimed to evaluate the utility of the Bayesian nested frailty modeling approach in the context of a study to examine the effects of various surgical procedures for patients with patulous Eustachian tube dysfunction (PETD).

Methods: A nested frailty model was employed to account for the correlation between each pair of ears within patients and the correlation between multiple event times within each ear.

The International Classification of Vestibular Disorders: Achievements, challenges, and future directions.

In 2007, the Bárány Society embarked on a project to establish definitions of vestibular syndromes and disorders based on best available evidence, referred to as the International Classification of Vestibular Disorders (ICVD). Since then, numerous publications providing consensus-driven diagnostic criteria for vestibular symptoms, syndromes, and disorders have been published. Here, we reflect on the rationale for developing the ICVD as well as its subsequent achievements, challenges, and outlook.

A comprehensive analysis of MRI-related Cochlear implant adverse events reported by FDA's manufacturer and user facility device experience database.

Objective: Identify MRI-related cochlear implant (CI) adverse events from the Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database and determine whether devices with diametric magnets are associated with reduced adverse events.

Methods: Data on MRI-related adverse events were collected from the MAUDE database for reports filed between 01/01/2013 and 01/29/2023. Outcomes and interventions were manually extracted.

Modeling of magnetic vestibular stimulation experienced during high-field clinical MRI.

Background: High-field magnetic resonance imaging (MRI) is a powerful diagnostic tool but can induce unintended physiological effects, such as nystagmus and dizziness, potentially compromising the comfort and safety of individuals undergoing imaging. These effects likely result from the Lorentz force, which arises from the interaction between the MRI's static magnetic field and electrical currents in the inner ear. Yet, the Lorentz force hypothesis fails to explain observed eye movement patterns in healthy adults fully.

Investigation of Third Window Symptoms in Patients With Enlarged Vestibular Aqueduct: A Pilot Study.

Objective: To assess if patients with enlarged vestibular aqueduct (EVA) experience symptoms characteristic of other third mobile window disorders such as superior semicircular canal dehiscence syndrome (SCDS).

Study Design: Cross-sectional study.

Setting: Tertiary care center.

Harvest of Vestibular End-Organs under Physiologic Conditions during Labyrinthectomy.

The living human inner ear is challenging to study because it is encased within dense otic capsule bone that limits access to biological tissue. Traditional temporal bone histopathology methods rely on lengthy, expensive decalcification protocols that take 9-10 months and reduce the types of tissue analysis possible due to RNA degradation. There is a critical need to develop methods to access fresh human inner ear tissue to better understand otologic diseases, such as Ménière's disease, at the cellular and molecular level.

Reconstruction of the External Auditory Canal for Spontaneous Temporomandibular Joint Herniation.

Spontaneous herniation of the temporomandibular joint into the external auditory canal is rare and generally results from inflammation or trauma but is rarely documented as a result of osteoradionecrosis. We report the novel surgical management of TMJ herniation by reconstructing the anterior EAC using conchal cartilage and a vascularized pedicled muscle flap in two patients. At follow-up, both had healing of the ear canal and TM without any evidence of joint herniation, with improved QOL and hearing.

Rapid imaging of intravenous gadolinium-based contrast agent (GBCA) entering ventricular cerebrospinal fluid (CSF) through the choroid plexus in healthy human subjects.

Background: Pathways for intravenously administered gadolinium-based-contrast-agents (GBCAs) entering cerebrospinal-fluid (CSF) circulation in the human brain are not well-understood. The blood-CSF-barrier (BCSFB) in choroid-plexus (CP) has long been hypothesized to be a main entry-point for intravenous-GBCAs into CSF. Most existing studies on this topic were performed in animals and human patients with various diseases.

Superior Canal Dehiscence and the Risk of Additional Dehiscences: A Retrospective CT Cohort Study.

Objective: Determine if superior canal dehiscence (SCD) found on flat-panel CT increases the risk for other defects in the otic capsule.

Study Design: Retrospective cohort study.

Setting: Tertiary care center.

Popularizing Surgical Cures: Walter Dandy and the Vestibular Neurectomy for Menière's Disease at the Johns Hopkins Hospital.

Objectives: To uncover the context that allowed for the vestibular neurectomy to grow in favor and practice at the Johns Hopkins Hospital in the early 20th century, and the reasons for its broad abandonment since.

Methods: The Walter E. Dandy (1905-1946) and Samuel J.

SVPath: A Deep Learning Tool for Analysis of Stria Vascularis from Histology Slides.

Introduction: The stria vascularis (SV) may have a significant role in various otologic pathologies. Currently, researchers manually segment and analyze the stria vascularis to measure structural atrophy. Our group developed a tool, SVPath, that uses deep learning to extract and analyze the stria vascularis and its associated capillary bed from whole temporal bone histopathology slides (TBS).

A Deep Learning Framework for Analysis of the Eustachian Tube and the Internal Carotid Artery.

Objective: Obtaining automated, objective 3-dimensional (3D) models of the Eustachian tube (ET) and the internal carotid artery (ICA) from computed tomography (CT) scans could provide useful navigational and diagnostic information for ET pathologies and interventions. We aim to develop a deep learning (DL) pipeline to automatically segment the ET and ICA and use these segmentations to compute distances between these structures.

Study Design: Retrospective cohort.

Patterns of Signal Intensity in CISS MRI of the Inner Ear and Eye.

Background: Constructive interference in steady state (CISS) is a gradient echo magnetic resonance imaging (MRI) pulse sequence that provides excellent contrast between cerebrospinal fluid and adjacent structures but is prone to banding artifacts due to magnetic field inhomogeneities. We aimed to characterize artifacts in the inner ear and eye.

Methods: In 30 patients (60 ears/eyes) undergoing CISS sequence MRI, nine low-signal intensity regions were identified in the inner ear and compared to temporal bone histopathology.

Association Between Retinal Pathology and Hearing in Older Adults.

We investigated the association between retinal microvascular changes and hearing loss based on the hypothesis that both may result from shared microvascular pathology. Data from 536 older adults from the National Health and Nutritional Examination Survey 2005 to 2006 including sociodemographic and health characteristics, pure-tone hearing thresholds, and retinal pathologies were collected and analyzed. Associations between retinal and hearing pathologies were modeled with multivariable-adjusted linear regressions.

Longer duration entry mitigates nystagmus and vertigo in 7-Tesla MRI.

Introduction: Patients and technologists commonly describe vertigo, dizziness, and imbalance near high-field magnets, e.g., 7-Tesla (T) magnetic resonance imaging (MRI) scanners.

Acoustic Noise Levels in High-field Magnetic Resonance Imaging Scanners.

7-Tesla (T) magnetic resonance imaging may allow for higher resolution images but may produce greater acoustic noise than 1.5- and 3-T scanners. We sought to characterize the intensity of acoustic noise from 7- versus 3-T scanners.

Historical Therapies for Suspected Autonomic Dysregulation in Meniere's Disease.

Objective: This narrative review examines how speculative belief that the autonomic nervous system causes Meniere's Disease (MD) led otolaryngologists to adopt invasive surgical procedures and medical treatments still offered today.

Data Sources: Google Scholar, PubMed.

Review Methods: A comprehensive literature review (1860-2022) was performed using the terms "Meniere AND (sympathetic OR sympathectomy OR vasomotor OR cervical ganglion)," returning 5360 items.

Differential Volume Increase of Endolymphatic Compartments in Ménière's Disease Is Inversely Associated With Membrane Thickness.

Objectives: Our aim in this study was to characterize the morphology of the endolymphatic compartment on histopathology in individuals with Ménière's disease (MD) and to determine why hydrops of the saccule is more pronounced than that of other compartments of the inner ear in MD.

Methods: Temporal bones from 9 patients with idiopathic MD and from 10 individuals without MD/endolymphatic hydrops were examined. The inner ear fluid compartments in normal ears, and ears with MD were three-dimensionally reconstructed and their volume was calculated.