Endolymphatic Hydrops with Absence of Vein in Paravestibular Canaliculus

1980 ◽  
Vol 89 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Ruth Gussen

Unilateral endolymphatic hydrops is described associated with absence of the vein in the paravestibular canaliculus (PVC) and with decreased vascularity of the vestibular aqueduct and endolymphatic sac. The venous return from the vestibule was normal as far as the junction of the branches forming the PVC vein. At this junction, a blind venous loop was formed with no continuation of venous drainage through the PVC. This probably represents a developmental anomaly. The decreased vascularity of the endolymphatic sac may be related to the absence of the PVC vein. However, anatomical and functional relationships of these vessels are not clear and need further study. Perisac fibrosis and endosteal bone formation are possibly secondary to the decrease in vascularity. A large chronic rupture of the inferior saccule wall probably accounts for the absence of vertigo and the relatively mild degree of cochlear endolymphatic hydrops.

1978 ◽  
Vol 86 (2) ◽  
pp. ORL-327-ORL-339 ◽  
Author(s):  
Tetsuya Egami ◽  
Isamu Sando ◽  
F. Owen Black

Four temporal bones from three previously reported cases showing endolymphatic hydrops and pathology of the vestibular aqueduct (VA) and endolymphatic sac (ES) were investigated further. Pathology of the VA and ES was studied by measuring the sizes of the VA and ES, paying particular attention to the proximal rugose portions. A medial-view graphic reconstruction was created to delineate the course and size of the VA, as well as its correlation with neighboring structures (posterior canal and cochlea). In addition, 20 control temporal bones were selected and measured for quantitative study of the sizes of the VA and ES. The four pathologic temporal bones were shown to have small, simple, tube-like VA and ES, without surrounding bony pathology. This appeared to be congenital hypoplasia characterized by hypoplastic funnel-shaped dilatation of the VA and hypoplastic rugose portion of the ES. Anterior dislocation of the distal portion of the VA and poorly developed periaqueductal air cells were also noted in the pathologic bones. Susceptibility to endolymphatic hydrops, difficulty in radiologic visualization of the VA, and surgical exposure of the ES are discussed in relation to hypoplasia of the VA and ES.


1976 ◽  
Vol 85 (3) ◽  
pp. 368-376 ◽  
Author(s):  
Isamu Sando ◽  
Lauren D. Holinger ◽  
Thomas J. Balkany ◽  
Raymond P. Wood

A case of unilateral endolymphatic hydrops is presented in which several significant histopathological findings are observed in the affected inner ear and are absent in the opposite ear. Moderate endolymphatic hydrops is present in all cochlear turns on the involved side. Atrophic changes in the cochlear and vestibular end-organs, partial collapse and infolding of Reissner's and the saccular membranes, and collapse of the posterior canal membrane are also seen. There is also marked narrowing of the proximal rugose portion of the endolymphatic sac, associated with a flattened epithelial lining, dense fibrotic connective tissue, brown pigment deposition, and poor vascularity in a relatively narrowed and straightened vestibular aqueduct. Fibrosis, loss of vascularity, and brown pigment deposition are also observed in the bony channels surrounding die vestibular aqueduct.


1977 ◽  
Vol 86 (4) ◽  
pp. 518-524 ◽  
Author(s):  
Isamu Sando ◽  
Tetsuya Egami

Several significant histopathological findings were noted in a case of sudden hearing loss in a patient with chronic lymphocytic leukemia. The major pathological findings were leukemic hemorrhage into both perilymphatic and endolymphatic spaces in the cochlear and vestibular systems, endolymphatic hydrops in the cochlea and sacculus, and a relatively narrowed and straightened vestibular aqueduct and endolymphatic sac. Additional interesting findings include: loss of hair cells in the organ of Corti and vestibular end-organs; destruction of the stria vascularis (possibly the origin of the blood); fibrosis in the perilymphatic spaces in the cochlea and the vestibule, and in the endolymphatic space in the vestibule; and new bone formation in the perilymphatic spaces in the vestibule. The leukemic infiltrate observed in both the cochlea and the vestibule was not considered to be significant. Hemorrhage into the cochlea is thought to be the most reasonable cause of the sudden hearing loss in this case. Also discussed are fibrosis and osteogenesis as a late consequence of hemorrhage, and the coexistence of endolymphatic hydrops with an anomaly of the vestibular aqueduct and endolymphatic sac.


1981 ◽  
Vol 90 (1) ◽  
pp. 77-79 ◽  
Author(s):  
Syed S. Rizvi ◽  
Lee Eliott Smith

The vestibular aqueduct (VA) and endolymphatic sac were examined topographically in 29 human ears with idiopathic endolymphatic hydrops. When compared with 34 control ears, there was found to be a slight but statistically significant reduction in the width ( P < 0.005) and length ( P < 0.05) of the vestibular aqueduct. A small hypoplastic endolymphatic sac was found in three of the ears with hydrops but was also present in one control ear. It would appear that a marked reduction in sac size is not a consistent feature in ears with endolymphatic hydrops.


2019 ◽  
Vol 46 (3) ◽  
pp. 335-345 ◽  
Author(s):  
Kayoko Higashi-Shingai ◽  
Takao Imai ◽  
Tomoko Okumura ◽  
Atsuhiko Uno ◽  
Tadashi Kitahara ◽  
...  

1977 ◽  
Vol 86 (4_suppl) ◽  
pp. 1-39 ◽  
Author(s):  
Gary K. Thomas

This animal experimental study (144 cats) was designed to allow observation of the healing processes at the oval window following stapedectomy during the first two postoperative weeks. The first 61 animals (Series I) had no oval window cover except for a blood clot which might form spontaneously. The second 64 animals (Series II) had Gelfoam® as a cover to the oval window following stapedectomy. A third series of 19 animals had temporalis fascia used as the oval window cover, and these ears were studied histologically for up to nine weeks. The unoperated ear acted as a control for the operated ear in all animals and after the animals were killed, both temporal bones were decalcified, imbedded in celloidin, serially sectioned at 20μ, and every tenth section stained and mounted for histologic study. It was observed that oval window closure was effected by endosteal, periosteal, and fibrous tissue proliferation from the traumatized tissues about the oval window fenestra, and that this process was facilitated by the presence of some type of scaffolding material such as a blood clot or Gelfoam®. Temporalis fascia placed in the oval window was observed to be rapidly incorporated into a much thicker oval window neomembrane and to seal the fenestra promptly. Partial removal of the footplate also facilitated more rapid closure of the smaller oval window fenestra, but fibrous tissue and new bone formation was noted to form about bony fragments still attached at the oval window level. Free bony fragments within the vestibule were not observed to stimulate new bone formation. Suppuration was observed most frequently in Series I (no oval window cover), with 67.8% of these animals having some degree of otitis media. In Series II (Gelfoam® cover) 20.6% had otitis media, and in Series III (temporalis fascia) 21% had middle ear infection. Suppuration markedly impaired but did not completely prevent the oval window reparative processes. Animals having some type of oval window cover were noted to have a lesser incidence of suppurative labyrinthine involvement when otitis media was present. Other labyrinthine complications were observed, including endolymphatic hydrops, Wittmaack's hypotonic atrophy, as well as RBC, fibrin, and albuminous precipitates in the labyrinth. Hypotonic atrophy was observed in a high incidence of animals having rupture of one or more endolymphatic structures, suggesting a mechanical mechanism as one possible explanation for this condition. Hypotonic atrophy may represent the end-stage (collapse) in the fluctuant endolymphatic ballooning of hydrops which is seen when saccular or Reissner's membrane ruptures have occurred.


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