Avaliação da relação clínico-imagiológia da hidrópsia endolinfática na doença de Menière
DOI:
https://doi.org/10.34631/sporl.3071Palavras-chave:
Hidrópsia, MeniéreResumo
A doença de Menière é caracterizada por episódios recorrentes de sintomas audiovestibulares. A presença de hidrópsia endolinfática no ouvido interno é uma possível resposta para a clínica. Este estudo pretende relacionar as características imagiológicas na ressonância magnética com os dados clínicos na doença de Menière. Na população estudada, 84,2% dos casos apresentam-se com doença unilateral e média de idade do início dos sintomas de 50.6 anos. A hidrópsia endolinfática foi identificada em 100% dos vestíbulos e 90,9% das cócleas dos ouvidos clinicamente afetados. O grau de hipoacusia apresenta relação com o grau de hidrópsia no vestíbulo (p=0,022), mas não com o grau de hidrópsia na cóclea (p=0,524). Nenhuma relação foi encontrada entre o tempo desde o início dos sintomas até à realização da ressonância magnética e a presença de hidrópsia. A hidrópsia não se relaciona com os resultados dos exames complementares vestibulares nem com a clínica.
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Bárány Society. International Classification of Vestibular Disorders (ICVD). [Internet]. Available from: https://www.thebaranysociety.org/icvd-consensus-documents/
Lopez-Escamez JA, Carey J, Chung WH, Goebel JA, Magnusson M, Mandalà M. et al. Diagnostic criteria for Menière's Disease. Journal of Vestibular Research, 2015, Vols. 25(1):1-7. DOI: 10.3233/VES-150549
Hallpike CS, Cairns H. Observations on the pathology of Meniere's Syndrome: (section of otology). Proc R Soc Med. 1938 Sep;31(11):1317-36. doi: 10.1177/003591573803101112.
Yamakawa K. Hearing organ of a patient who showed Meniere's symptoms. J Otolaryngol Soc Jpn. 1938; 44:2310–2312.
Kingma CM, Wit HP. The effect of changes in perilymphatic K+ on the vestibular evoked potential in the guinea pig. Eur Arch Otorhinolaryngol. 2010 Nov;267(11):1679-84. doi: 10.1007/s00405-010-1298-8.
Schuknecht HF. Histopathology of Meniere’s Disease. Meniere's Disease: The Hague: Kugler Pub, 1990.
Gibson WP. Hypothetical Mechanism for Vertigo in Meniere's Disease. Otolaryngol Clin North Am. 2010 Oct;43(5):1019-27. doi: 10.1016/j.otc.2010.05.013.
Foster CA, Breeze RE. Endolymphatic hydrops in Ménière's disease: cause, consequence, or epiphenomenon? Otology & Neurotology, 2013, Vols. 34(7):1210-1214. DOI: 10.1097/MAO.0b013e31829e83df.
McMullen KP, Lin C, Harris MS, Adunka OF. Correlation of objective audiometric and caloric function in Ménière’s disease. Otolaryngology–Head and Neck Surgery. 2017, Vols. 156(5):912-916, DOI: 10.1177/0194599817690103.
Maheu M, Alvarado-Umanzor JM, Delcenserie A, Champoux F. The clinical utility of vestibular-evoked myogenic potencials in the diagnosis of Menière's disease. Front Neurol. 2017 Aug 15:8:415. doi: 10.3389/fneur.2017.00415.
Rauch SD, Zhou G, Kujawa SG, Guinan JJ, Herrmann BS. Vestibular evoked myogenic potentials show altered tuning in patients with Ménière’s disease. Otol Neurotol. 2004 May;25(3):333-8. doi: 10.1097/00129492-200405000-00022.
Hannigan IP, Welgampola MS, Watson SRD. Dissociation of caloric and head impulse tests: a marker of Meniere's disease. J Neurol. 2021 Feb;268(2):431-439. doi: 10.1007/s00415-019-09431-9.
Baráth K, Schuknecht B, Naldi AM, Schrepfer T, Bockisch CJ, Hegemann SC. Detection and grading of endolymphatic hydrops in Menière disease using MR imaging. AJNR Am J Neuroradiol. 2014 Jul;35(7):1387-92. doi: 10.3174/ajnr.A3856.
BIAP. International Bureau for Audiophonology [Internet]. BIAP Recommendation 02/1: Audiometric Classification of Hearing Impairments. 1996. Available from: www.biap.org/es/recommandations/recommendations/tc-02-classification/213-rec-02-1-en-audiometric-classification-of-hearing-impairments.
Hoskin JL. Ménière’s disease: new guidelines, subtypes, imaging, and more. Curr Opin Neurol. 2022 Feb 1;35(1):90-97. doi: 10.1097/WCO.0000000000001021.
Havia M, Kentala E, Pyykkö I. Prevalence of Menière's disease in general population of Southern Finland. Otolaryngol Head Neck Surg. 2005 Nov;133(5):762-8. doi: 10.1016/j.otohns.2005.06.015.
Basura GJ, Adams ME, Monfared A, Schwartz SR, Antonelli PJ, Burkard R. et al. Clinical Practice Guideline: Menière's disease. Otolaryngol Head Neck Surg. 2020 Apr;162(2_suppl):S1-S55. doi: 10.1177/0194599820909438.
Huppert D, Strupp M, Brandt T. Long-term course of Menière's disease revisited. Acta Otolaryngol. 2010 Jun;130(6):644-51. doi: 10.3109/00016480903382808.
Sobhy OA, Elmoazen DM, Abd-Elbaky FA. Towards a new staging of Ménière’s disease: a vestibular approach. Acta Otorhinolaryngol Ital. 2019 Dec;39(6):419-428. doi: 10.14639/0392-100X-2461.
Jasińska A, Lachowska M, Wnuk E, Pierchała K, Rowiński O, Niemczyk K. Correlation between magnetic resonance imaging classification of endolymphatic hydrops and clinical manifestations and audiovestibular test results in patients with definite Ménière's disease. Auris Nasus Larynx. 2022 Feb;49(1):34-45. doi: 10.1016/j.anl.2021.03.027.
Gürkov R, Flatz W, Louza J, Strupp M, Ertl-Wagner B, Krause E. In vivo visualized endolymphatic hydrops and inner ear functions in patients with electrocochleographically confirmed Ménière's disease. Otol Neurotol. 2012 Aug;33(6):1040-5. doi: 10.1097/MAO.0b013e31825d9a95.
Merchant SN, Adams JC, Nadol JB Jr. Pathophysiology of Meniere's syndrome: are symptoms caused by endolymphatic hydrops? Otol Neurotol. 2005 Jan;26(1):74-81. doi: 10.1097/00129492-200501000-00013.
van Steekelenburg JM, van Weijnen A, de Pont LMH, Vijlbrief OD, Bommeljé CC, Koopman JP. et al. Value of endolymphatic hydrops and perilymph signal intensity in suspected Ménière Disease. AJNR Am J Neuroradiol. 2020 Mar;41(3):529-534. doi: 10.3174/ajnr.A6410.
Gürkov R, Pyykö I, Zou J, Kentala E. What is Menière's disease? A contemporary re-evaluation of endolymphatic hydrops. J Neurol. 2016 Apr:263 Suppl 1:S71-81. doi: 10.1007/s00415-015-7930-1.
Rauch SD. Clinical hints and precipitating factors in patients suffering from Meniere's disease. Otolaryngol Clin North Am. 2010 Oct;43(5):1011-7. doi: 10.1016/j.otc.2010.05.003.
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Direitos de Autor (c) 2025 Beatriz Brites Ramada, Diliana Rebelo, Daniela Jardim Pereira, Luís Filipe Silva, João Elói Moura, Ana Margarida Amorim, Jorge Miguéis

Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-CompartilhaIgual 4.0.