Volume ratio and distribution rate in patients with orthostatic vertigo/dizziness using MR imaging: a comparison with vertiginous diseases

Acta Otolaryngol. 2023 Aug;143(8):631-635. doi: 10.1080/00016489.2023.2238760. Epub 2023 Aug 3.

Abstract

Background: Orthostatic dizziness/vertigo (ODV) is characterized by lightheadedness owing to postural changes.

Aims/objectives: To measure the endolymphatic space (ELS)/total fluid space (TFS) volume ratio and the distribution rate of endolymphatic fluid (ELF) of patients with ODV and compare them with those of control subjects (CS).

Materials and methods: This study included 22 patients (44 ears) with ODV and 52 controls (104 ears, CS). The ELS/TFS volume ratio (%) and distribution rate (%) of the inner ear components were measured using 3-dimensional magnetic resonance imaging.

Results: In the ODV group, the mean ELS/TFS volume ratios of the cochlea, vestibule, and semi-circular canals (SCCs) were 12.1%, 18.6%, and 18.1%, respectively; the mean ELS distribution rates for the cochlea, vestibule, and SCCs were 27.3%, 26.2%, and 46.6%, respectively. The ELS distribution rate of the vestibule was significantly lower (p < .01) and the ELS distribution rate of the SCCs was significantly higher in the ODV than in the CS group (p < .01).

Conclusions and significance: The ELS distribution rate in the vestibule + SCCs among patients with ODV did not differ from that in the CS; ELF in the vestibule moved to the SCCs, and a large amount of ELF was distributed only in the SCCs.

Keywords: Benign paroxysmal positional vertigo; distribution rate; endolymphatic flow; endolymphatic space; inner ear MRI; meniere’s disease; orthostatic dizziness/vertigo; utriculo-endolymphatic valve; volumetric measurement.

MeSH terms

  • Dizziness
  • Endolymphatic Hydrops* / pathology
  • Humans
  • Magnetic Resonance Imaging / methods
  • Meniere Disease* / complications
  • Meniere Disease* / diagnostic imaging
  • Meniere Disease* / pathology
  • Vertigo / diagnostic imaging
  • Vestibule, Labyrinth* / pathology