Clinical Imaging Findings of Vestibular Aqueduct Trauma in a Patient With Posttraumatic Meniere's Syndrome

In conclusion, for the radiological assessment of TB fractures, the entire VA should be regarded as a part of the otic capsule, and delayed inner ear sequelae should be anticipated for retrolabyrinthine fracture lines that course into or through the VA. When considering treatment options in cases similar to the present, our findings suggest that surgical interventions targeting the eES (ES shunting/decompression procedures (31–33), which are used in MD with the intention to drain the hydropic endolymphatic fluid space, or to improve the fluid resorptive functions of the eES, respectively, most likely cannot work as proposed, because of the obliterated VA that separates the eES from the other labyrinthine fluid spaces. Limitations of this case review concern events in the patient's medical history that may be confounding factors in the etiology of Meniere's symptoms: At age 27, the patient received chemotherapeutic treatment with cisplatin for a neoplastic disease (extragonadal germ cell tumor in the mediastinum). Although cisplatin can have cochleo-/vestibulotoxic side effects, PTA after chemotherapy showed no significant threshold changes compared to pretreatment thresholds. Moreover, no association between cisplatin treatment and Meniere's-like symptoms has been reported in the literature. The differential diagnosis of “delayed endolymphatic hydrops”—i.e., the onset of episodic vestibular symptoms years after a profou...
Source: Frontiers in Neurology - Category: Neurology Source Type: research