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Volume-rendered computed tomography images of the surgical field for endolymphatic sac surgery

  • Shinya MiuchiEmail author
  • Masahiro Komori
  • Jun Hyodo
  • Daiki Takagi
  • Masafumi Sakagami
  • Naoaki Yanagihara
Otology
  • 31 Downloads

Abstract

Purpose

Identification of the endolymphatic sac has failed occasionally. Postoperative complications have also rarely been reported. Given a safer and more reliable surgery, preoperative anatomical assessments are valuable, however, the vestibular aqueduct has seldom been seen with multi-planar reconstruction (MPR) computed tomography (CT) images yet. Our study aimed to determine the significance and utility of volume-rendered (VR) CT images of the surgical field for identifying the vestibular aqueduct, compared with MPR CT images.

Subjects and methods

14 patients with Meniere’s disease who underwent endolymphatic sac surgery between 2008 and 2011. Location and size of the vestibular aqueduct were assessed using VR and MPR CT images, independently.

Results

Accuracy of identifying the location differed significantly between VR and MPR CT images (rate of total correct evaluations: 100% by VR CT images vs 75% by MPR CT images, p = 0.02). Size was correctly identified in cases with a small endolymphatic sac using VR CT images (rate of total correct evaluations for size of the vestibular aqueduct: 100% by VR CT vs 57% by MPR CT, p = 0.046). VR CT images also demonstrated clearly the relationship between the endolymphatic sac and high jugular bulb. In two cases, the endolymphatic sac was identified by VR images, not by MPR images.

Conclusion

Accurate information about the location and size of vestibular aqueduct can allow sac surgeons to identify a tiny endolymphatic sac more easily and certainly, and also aids surgical trainees to learn sac surgery safely.

Keywords

Meniere’s disease Endolymphatic sac Cone-beam CT Volume-rendering technique Three-dimensional image 

Notes

Funding

There was no financial and material support for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplementary material 1 (WMV 7948 KB)

References

  1. 1.
    Portmann G (1927) Vertigo: surgical treatment by opening saccus endolymphaticus. Arch Otolaryngol 6:309–315CrossRefGoogle Scholar
  2. 2.
    House WF (1962) Subarachnoid shunt for drainage of endolymphatic hydrops. A preliminary report. Laryngoscope 72:713–729.  https://doi.org/10.1288/00005537-196206000-00003 Google Scholar
  3. 3.
    Durland WF Jr, Pyle GM, Connor NP (2005) Endolymphatic sac decompression as a treatment for Meniere’s disease. Laryngoscope 115:1454–1457CrossRefGoogle Scholar
  4. 4.
    Kitahara T, Kubo T, Okumura S, Kitahara M (2008) Effects of endolymphatic sac drainage with steroids for intractable Meniere’s disease: a long-term follow-up and randomized controlled study. Laryngoscope 118:854–861.  https://doi.org/10.1097/MLG.0b013e3181651c4a CrossRefGoogle Scholar
  5. 5.
    Derebery MJ, Fisher LM, Berliner K, Chung J, Green K (2010) Outcomes of endolymphatic shunt surgery for Ménière’s disease: comparison with intratympanic gentamicin on vertigo control and hearing loss. Otol Neurotol 31:649–655.  https://doi.org/10.1097/MAO.0b013e3181dd13ac Google Scholar
  6. 6.
    Sood AJ, Lambert PR, Nguyen SA, Meyer TA (2014) Endolymphatic sac surgery for Ménière’s disease: a systematic review and meta-analysis. Otol Neurotol 35:1033–1045.  https://doi.org/10.1097/MAO.0000000000000324 CrossRefGoogle Scholar
  7. 7.
    Kitahara T, Horii A, Imai T, Ohta Y, Morihana T, Inohara H, Sakagami M (2014) Effects of endolymphatic sac decompression surgery on vertigo and hearing in patients with bilateral Ménière’s disease. Otol Neurotol 35:1852–1857.  https://doi.org/10.1097/MAO.0000000000000469 CrossRefGoogle Scholar
  8. 8.
    Shambaugh GE Jr (1966) Surgery of endolymphatic sac. Arch Otolaryngol 83:301–315Google Scholar
  9. 9.
    House WF (1975) Meniere’s disease: management and therapy. Otolaryngol Clin N Am 8:515–535Google Scholar
  10. 10.
    Chung JW, Fayad J, Linthicum F, Ishiyama A, Merchant SN (2011) Histopathology after endolymphatic sac surgery for Meniere’s syndrome. Otol Neurotol 32: 660–664.  https://doi.org/10.1097/MAO.0b013e31821553ce CrossRefGoogle Scholar
  11. 11.
    Me´nie`re P (1861) Sur une forme de surdite´ grave de´pendant d’une le´sion de l’oreille interne [in French]. Gaz Me´d de Paris 16:29Google Scholar
  12. 12.
    Sando I, Ikeda M (1984) The vestibular aqueduct in patients with Meniere’s disease. A temporal bone histopathological investigation. Acta Otolaryngol 97:558–570CrossRefGoogle Scholar
  13. 13.
    Monsanto RD, Pauna HF, Kwon G, Schachern PA, Tsuprun V, Paparella MM, Cureoglu S (2017) A three-dimensional analysis of the endolymph drainage system in Ménière disease. Laryngoscope 127:E170–E175.  https://doi.org/10.1002/lary.26155 CrossRefGoogle Scholar
  14. 14.
    Arenberg IK, Rask-Andersen H, Wilbrand H, Stahle J (1977) The surgical anatomy of the endolymphatic sac. Arch Otolaryngol 103:1–11CrossRefGoogle Scholar
  15. 15.
    Yazawa Y, Suzuki M, Tanaka H, Kitano H, Kitajima K (1998) Surgical observation on the endolymphatic Sac in Meniere’s disease. Am J Otol 19:71–75Google Scholar
  16. 16.
    Park JJ, Shen A, Keil S, Kuhl C, Westhofen M (2015) Jugular bulb abnormalities in patients with Meniere’s disease using high-resolution computed tomography. Eur Arch Otorhinolaryngol 272:1879–1884.  https://doi.org/10.1007/s00405-014-2996-4 CrossRefGoogle Scholar
  17. 17.
    Arenberg IK, Balkany TJ (1982) Prevention of complications and failures in endolymphatic system surgery. Otolaryngol Clin North Am 15:869–882Google Scholar
  18. 18.
    Xu HX, Deroee AF, Joglekar S, Pollak N, Hobson F, Santori T, Paparella MM (2011) Delayed facial nerve palsy after endolymphatic sac surgery. Ear Nose Throat J 90:E28–E31CrossRefGoogle Scholar
  19. 19.
    Kiumehr S, Mahboubi H, Djalilian HR (2012) Posterior semicircular canal dehiscence following endolymphatic sac surgery. Laryngoscope 122:2079–2081.  https://doi.org/10.1002/lary.23474 CrossRefGoogle Scholar
  20. 20.
    Xenellis J, Vlahos L, Papadopoulos A, Nomicos P, Papafragos K, Adamopoulos G (2000) Role of the new imaging modalities in the investigation of Meniere’s disease. Otolaryngol Head Neck Surg 123:114–119CrossRefGoogle Scholar
  21. 21.
    Shea JJ Jr, Ge X, Warner RM, Orchik DJ (2000) External aperture of the vestibular aqueduct in Meniere’s disease. Am J Otol 21:351–355CrossRefGoogle Scholar
  22. 22.
    Miyashita T, Toyama Y, Inamoto R, Mori N (2012) Evaluation of the vestibular aqueduct in Ménière’s disease using multiplanar reconstruction images of CT. Auris Nasus Larynx 39:567–571.  https://doi.org/10.1016/j.anl.2011.11.005 CrossRefGoogle Scholar
  23. 23.
    Maiolo V, Savastio G, Modugno GC, Barozzi L (2013) Relationship between multidetector CT imaging of the vestibular aqueduct and inner ear pathologies. Neuroradiol J 26:683–692CrossRefGoogle Scholar
  24. 24.
    Komori M, Miuchi S, Hyodo J, Kobayashi T, Hyodo M (2018) The gray scale value of ear tissues undergoing volume-rendering high-resolution cone-beam computed tomography. Auris Nasus Larynx.  https://doi.org/10.1016/j.anl.2018.01.012 Google Scholar
  25. 25.
    Ikeda M, Sando I (1984) Endolymphatic duct and sac in patients with Meniere’s disease. A temporal bone histopathological study. Ann Otol Rhinol Laryngol 93:540–546CrossRefGoogle Scholar
  26. 26.
    Clemis JD, Valvassori GE (1968) Recent radiographic and clinical observations on the vestibular aqueduct. Otolaryngol Clin North Am 1:339–346Google Scholar
  27. 27.
    Valvassori GE, Dobben GD (1984) Multidirectional and computerized tomography of the vestibular aqueduct in Meniere’s disease. Ann Otol Rhinol Laryngol 93:547–550CrossRefGoogle Scholar
  28. 28.
    Yamamoto E, Mizukami C, Isono M, Ohmura M, Hirono Y (1991) Observation of the external aperture of the vestibular aqueduct using three-dimensional surface reconstruction imaging. Laryngoscope 101:480–483CrossRefGoogle Scholar
  29. 29.
    Stahle J, Wilbrand H (1974) The vestibular aqueduct in patients with Menière’s disease. A tomographic and clinical investigation. Acta Otolaryngol 78:36–48CrossRefGoogle Scholar
  30. 30.
    Yazawa Y, Kitahara M (1994) Computerized tomographic findings in endolymphatic sac surgery in Menière’s disease. Acta Otolaryngol 510:73–76CrossRefGoogle Scholar
  31. 31.
    Calhoun PS, Kuszyk BS, Heath DG, Carley JC, Fishman EK (1999) Three-dimensional volume rendering of spiral CT data: theory and method. Radiographics 19:745–764CrossRefGoogle Scholar
  32. 32.
    Klingebiel R, Bauknecht HC, Kaschke O, Werbs M, Freigang B, Behrbohm H, Rogalla P, Lehmann R (2001) Virtual endoscopy of the tympanic cavity based on high-resolution multislice computed tomographic data. Otol Neurotol 22:803–807CrossRefGoogle Scholar
  33. 33.
    Martin C, Michel F, Pouget JF, Veyret C, Bertholon P, Prades JM (2004) Pathology of the ossicular chain: comparison between virtual endoscopy and 2D spiral CT-data. Otol Neurotol 25:215–219CrossRefGoogle Scholar
  34. 34.
    Dalchow CV, Weber AL, Yanagihara N, Bien S, Werner JA (2006) Digital volume tomography: radiologic examinations of the temporal bone. AJR Am J Roentgenol 186:416–423CrossRefGoogle Scholar
  35. 35.
    Komori M, Yanagihara N, Hinohira Y, Kashiba K, Miuchi S, Kishida Y (2012) Quality of temporal bone CT images: a comparison of flat panel cone beam CT and multi-slice CT. Int Adv Otol 8:57–62Google Scholar
  36. 36.
    Komori M, Yanagihara N, Hyodo J, Miuchi S (2012) Position of TORP on the stapes footplate assessed with cone beam computed tomography. Otol Neurotol 33:1353–1356.  https://doi.org/10.1097/MAO.0b013e31826a5260 CrossRefGoogle Scholar
  37. 37.
    Arenberg IK, Jackson CG, Gardner G, Huang TS, Hughes G, Neely JG, Paparella M, Steenerson RL, Wright JW (1987) 3rd. Panel discussion: the surgical anatomy and fine points of endolymphatic system surgery. Am J Otol 8:345–354Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OtolaryngologyTakanoko HospitalMatsuyamaJapan
  2. 2.Department of Otolaryngology, Head and Neck SurgeryHyogo College of MedicineNishinomiyaJapan
  3. 3.Department of Otolaryngology, Kochi Medical SchoolKochi UniversityNankokuJapan
  4. 4.Department of Otolaryngology, Head and Neck Surgery, School of MedicineEhime UniversityToonJapan

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