From the Department of Radiology (K.B., L.V.R., M.J.B., A.F.J., H.D.C., K.L.R.), Massachusetts Eye and Ear, Boston, Massachusetts.
Neuroradiology Division (B.M.K.), Massachusetts General Hospital, Boston, Massachusetts.
AJNR Am J Neuroradiol. 2023 Jan;44(1):70-73. doi: 10.3174/ajnr.A7734. Epub 2022 Dec 15.
Temporal bones in some patients with Ménière disease have demonstrated small vestibular aqueducts; however, the prevalence and clinical importance of small vestibular aqueducts remain unclear in patients without Ménière disease. This study correlates the presence of a small vestibular aqueduct with cochleovestibular symptoms.
Consecutive temporal bone CTs in adults from January to December 2020 were reviewed. The midpoint vestibular aqueduct size in the 45°-oblique Pöschl view was measured by 2 reviewers independently in 684 patients (1346 ears). Retrospective chart review for the clinical diagnosis of Ménière disease, the presence of cochleovestibular symptoms, and indications for CT was performed.
Fifty-two of 684 patients (7.6% of patients, 62/1346 ears) had small vestibular aqueducts. Twelve patients (15/1346 ears) had Ménière disease. Five of 12 patients with Ménière disease (5 ears) had a small vestibular aqueduct. There was a significant correlation between a small vestibular aqueduct and Ménière disease ( < .001). There was no statistical difference between the small vestibular aqueduct cohort and the cohort with normal vestibular aqueducts (0.3-0.7 mm) regarding tinnitus ( = .06), hearing loss ( = .88), vertigo ( = .26), dizziness ( = .83), and aural fullness ( = .61).
While patients with Ménière disease were proportionately more likely to have a small vestibular aqueduct than patients without Ménière disease, the small vestibular aqueduct was more frequently seen in patients without Ménière disease and had no correlation with hearing loss, vertigo, dizziness, or aural fullness. We suggest that the finding of a small vestibular aqueduct on CT could be reported by radiologists as a possible finding in Ménière disease, but it remains of uncertain, and potentially unlikely, clinical importance in the absence of symptoms of Ménière disease.
一些梅尼埃病患者的颞骨显示小前庭水管；然而，在没有梅尼埃病的患者中，小前庭水管的患病率和临床重要性仍不清楚。本研究将小前庭水管的存在与耳蜗前庭症状相关联。
回顾 2020 年 1 月至 12 月期间连续进行的成人颞骨 CT。由 2 位研究者分别在 45°斜位 Pöschl 视图中测量前庭水管中点的大小，共 684 例患者（1346 耳）。对梅尼埃病的临床诊断、耳蜗前庭症状的存在以及 CT 适应证进行回顾性图表审查。
684 例患者中（1346 耳）有 52 例（7.6%的患者，62/1346 耳）存在小前庭水管。12 例患者（1346 耳中的 62 耳）患有梅尼埃病。在 12 例梅尼埃病患者中，有 5 例（5 耳）存在小前庭水管。小前庭水管与梅尼埃病之间存在显著相关性（<0.001）。在小前庭水管组和前庭水管正常组（0.3-0.7mm）之间，耳鸣（=0.06）、听力损失（=0.88）、眩晕（=0.26）、头晕（=0.83）和耳闷（=0.61）无统计学差异。
虽然梅尼埃病患者出现小前庭水管的比例高于无梅尼埃病患者，但小前庭水管在无梅尼埃病患者中更常见，且与听力损失、眩晕、头晕或耳闷无关。我们认为，放射科医生可以报告 CT 上发现小前庭水管，这可能是梅尼埃病的一个潜在表现，但在没有梅尼埃病症状的情况下，其临床重要性不确定，而且可能不大。
