Abstract
Meniere’s disease remains enigmatic, and has no treatment with sufficient evidence. The characteristic histopathological finding is endolymphatic hydrops, suggesting either an overproduction or decreased reabsorption of endolymph in the human inner ear. This study presents the first analysis of the vascular plexus around the human endolymphatic duct using micro computed tomography and coherent synchrotron radiation with phase contrast imaging. Using a software program, data were processed by volume-rendering with scalar opacity mapping to create transparent three-dimensional reconstructions. A rich vascular plexus was discovered around the endolymphatic duct that drained into collecting channels, linked to the vestibular venous outflow system. This network is believed to make up the principal route for endolymph outflow, and its associated malfunction may result in endolymphatic hydrops and Meniere’s disease.
Highlights
The cause of MD has long been proposed to be an impaired reabsorption of endolymph[5]
While the bony vestibular aqueduct (VA) and vein of the vestibular aqueduct (VVA) were well visualised on micro-CT and synchrotron phase contrast imaging (SR-PCI) (Fig. 1B–D), the channel plexus around the endolymphatic duct (ED) was only seen in SR-PCI (Fig. 1A)
Extensive variations were noted in the VA and accessory canal anatomy
Summary
The cause of MD has long been proposed to be an impaired reabsorption of endolymph[5] This unique fluid bathes the apical poles of the sensory cells, and its proper regulation is essential for inner ear function. Www.nature.com/scientificreports termed the accessory canal (AC) by George Siebenmann in 187425 This canal contains the vein of the vestibular aqueduct (VVA) that drains blood from the vestibular organ. The ED contains a lympho-venous network located in the sub-epithelial matrix[27] This network may be physically attached to the epithelium and may drain endolymph. From the observed organisation we conclude that this system may constitute the principal outflow system for endolymph in the human ear, and its malfunction may lead to endolymphatic hydrops and MD
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