Clinical significance of posterior expansion of the utricular endolymphatic space

Abstract

Background

Posterior expansion of the utricular endolymphatic space (ES) is a finding occasionally observed, and often occurs in bilateral ears. The clinical significance of posterior expansion of the utricular ES is not clear.

Objectives

To investigate the clinical significance of posterior expansion of the utricular ES detected on magnetic resonance imaging (MRI).

Materials and Methods

Among 957 patients who underwent contrast-enhanced MRI to investigate the presence of endolymphatic hydrops (EH), clinical findings in cases with posterior expansion of the utricular ES were evaluated and the significance of their existence is considered.

Results

Posterior expansion of the utricular ES was detected in 30 ears from 20 cases (7 males, 13 females; mean age 48.7 years). The ears with posterior expansion had a significantly lower incidence of vestibular EH than those without, and this tendency was more prominent in cases in bilateral ears. Some cases with posterior expansion had vestibular symptoms and were diagnosed with Ménière’s disease, although EH was not detected in their vestibules.

Conclusion and Significance

Posterior expansion of the utricular ES was associated with Ménière’s disease without vestibular EH. Posterior expansion of the utricular ES might not be associated with the formation of EH but may occur independently.

Chinese Abstract

背景：偶尔观察到的椭圆囊内淋巴间隙（ES）后部扩张, 常发生于双耳。 椭圆囊ES后部扩张的临床意义尚不清楚。

目的：探讨经磁共振成像（MRI）检测到的椭圆囊 ES 后部扩张的临床意义。

材料和方法：在 957 名接受对比增强 MRI 以调查是否存在内淋巴积水（EH）的患者中, 评估了椭圆囊 ES后部扩张的临床表现并考虑其存在的意义。

结果：20 例患者（7 名男性, 13 名女性； 平均年龄 48.7 岁）的 30 只耳朵中检测到椭圆囊 ES 后部扩张。具后部扩张的耳朵的前庭EH的发生率比没有后部扩张的耳朵的发生率明显较低, 且这种趋势在双耳病例中更为突出。一些后部扩张的病例具有前庭症状, 被诊断为梅尼埃病, 尽管在他们的前庭中没有检测到 EH。

结论和意义：椭圆囊 ES 后部扩张与无前庭 EH 的梅尼埃病相关。 椭圆囊 ES 的后部扩张可能与EH 的形成无关, 但可能独立发生。

Keywords:

• Endolymphatic hydrops
• utricle
• ménière’s disease
• magnetic resonance imaging

Disclosure statement

The authors have no funding, financial relationships, or conflicts of interest to disclose.