title: A three-dimensional analysis of the endolymph drainage system in Ménière disease.
abstract: To measure the volume of the endolymph drainage system in temporal bone specimens with Ménière disease, as compared with specimens with endolymphatic hydrops without vestibular symptoms and with nondiseased specimens STUDY DESIGN: Comparative human temporal bone analysis.
  
  
  
  We generated three-dimensional models of the vestibular aqueduct, endolymphatic sinus and duct, and intratemporal portion of the endolymphatic sac and calculated the volume of those structures. We also measured the internal and external aperture of the vestibular aqueduct, as well as the opening (if present) of the utriculoendolymphatic (Bast's) valve and compared the measurements in our three study groups.
  
  
  
  The volume of the vestibular aqueduct and of the endolymphatic sinus, duct, and intratemporal endolymphatic sac was significantly lower in the Ménière disease group than in the endolymphatic hydrops group (P <.05). The external aperture of the vestibular aqueduct was also smaller in the Ménière disease group. Bast's valve was open only in some specimens in the Ménière disease group.
  
  
  
  In temporal bones with Ménière disease, the volume of the vestibular aqueduct, endolymphatic duct, and intratemporal endolymphatic sac was lower, and the external aperture of the vestibular aqueduct was smaller as compared with bones from donors who had endolymphatic hydrops without vestibular symptoms and with nondiseased bones. The open status of the Bast's valve in the Ménière disease group could be secondary to higher retrograde endolymph pressures caused by smaller drainage systems. These anatomic findings could correlate with the reason that some patients with hydrops develop clinical symptoms, whereas others do not.
  
  
  
  N/A Laryngoscope, 127:E170-E175, 2017.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.|Department of Otolaryngology and Head and Neck Surgery, Banco de Olhos de Sorocaba Hospital, Sorocaba, São Paulo, Brazil.
authors.forename: Rafael da Costa
authors.initials: RD
authors.lastname: Monsanto
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.|Department of Otolaryngology and Head and Neck Surgery, Campinas State University, Campinas, São Paulo, Brazil.
authors.forename: Henrique F
authors.initials: HF
authors.lastname: Pauna
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.
authors.forename: Geeyoun
authors.initials: G
authors.lastname: Kwon
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Schachern
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Tsuprun
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.|Paparella Ear, Head, & Neck Institute, Minneapolis, Minnesota, U.S.A.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Paparella
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.
authors.forename: Sebahattin
authors.initials: S
authors.lastname: Cureoglu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004710:Endolymph / Q000378:metabolism*; D004711:Endolymphatic Duct / Q000473:pathology; D018159:Endolymphatic Hydrops / Q000473:pathology; D004712:Endolymphatic Sac / Q000473:pathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008575:Meniere Disease / Q000473:pathology*; D008875:Middle Aged; D013701:Temporal Bone / Q000473:pathology*; D014723:Vestibular Aqueduct / Q000473:pathology
keywords: Bast's valve; Histopathology; Ménière disease; endolymphatic duct; endolymphatic hydrops; endolymphatic sac; endolymphatic sinus; human temporal bone; three-dimensional reconstruction; utriculoendolymphatic valve; vestibular aqueduct; volume