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The Human Vestibular Aqueduct: Anatomical Characteristics and Enlargement Criteria
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
2016 (English)In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 37, no 10, p. 1637-1645Article in journal (Refereed) Published
Abstract [en]

Hypothesis: The human vestibular aqueduct (VA) shows great anatomical variations, and imaging can be difficult, so we need more data on the normal anatomy of the VA for better radiologic evaluation of large vestibular aqueduct syndrome (LVAS). Background: The normal anatomy of the human VA was analyzed in micro-dissected human temporal bones. Methods: The study is based on two sets of human temporal bones. One set of 32 human temporal bones was selected from a collection of 50 micro-dissected specimens. The outline of the intraosseous portion of the VA was drawn and digitized, and dimensions were assessed. The other set of 20 plastic molds were randomly selected from a collection of 324 specimens, and the VA dimensions were assessed. Results: Measurements from this study are presented in means, standard deviations, and ranges. The results from these measurements are considered normal and compared with previously published data. The variations in the normal anatomy of the VA are presented and discussed. Conclusion: The VA courses sagittal in the human skull. Therefore, we recommend the lateral projection (reformatted) to demonstrate the VA in LVAS patients. We advocate assessing: 1) the width (or height) of the external aperture (EA), 2) the width at the half distance between the EA and the common crus (CC), and if possible 3) the width of the proximal portion of the VA. Based on the measurements, our criteria for enlargement are 2.0mm or greater, 1.5mm or greater, and more than 1mm at these sites.

Place, publisher, year, edition, pages
2016. Vol. 37, no 10, p. 1637-1645
Keywords [en]
LVAS, Pendrin, SLC26A4, Vestibular aqueduct
National Category
Otorhinolaryngology
Identifiers
URN: urn:nbn:se:uu:diva-311179DOI: 10.1097/MAO.0000000000001203ISI: 000388185000036PubMedID: 27631836OAI: oai:DiVA.org:uu-311179DiVA, id: diva2:1059394
Available from: 2016-12-22 Created: 2016-12-22 Last updated: 2020-03-13Bibliographically approved
In thesis
1. The Human Vestibular Aqueduct, Endolymphatic Duct and Sac: A Morphological Study Using Micro-CT, Super Resolution Immunohistochemistry and Synchrotron Phase Contrast Imaging
Open this publication in new window or tab >>The Human Vestibular Aqueduct, Endolymphatic Duct and Sac: A Morphological Study Using Micro-CT, Super Resolution Immunohistochemistry and Synchrotron Phase Contrast Imaging
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The inner ear lies sheltered in the temporal bone and consists of basically three parts: the cochlea (the hearing organ), the vestibular (the balance organ), and the endolymphatic duct (ED) and endolymphatic sac (ES). The ES and ED are located in a bony canal, the vestibular aqueduct (VA), located on the medial side of the vestibule. While the functions of the cochlea and the vestibular part of the inner ear are rather well studied, our knowledge of the function/s of the ES and ED remains limited and has intrigued scientists for centuries. Earlier studies have supported several theories, such as being an immune mediator, an aid in pressure regulation, related to the absorption of endolymph, and the production of endolymph.

 Otologic disorders, which affect both hearing and balance, such as Meniere’s disease (MD) and large vestibular aqueduct syndrome (LVAS), have been linked to dysfunction of the ES/ED. Studies of the human inner ear are fairly sparse. Research on the ES and ED have mainly been performed on animals, although both the anatomy and function may differ among various species.

This thesis aims to further investigate the anatomy and function of the human ES and ED with the two otologic disorders MD and LVAS in mind. To achieve this, we have used novel imaging techniques, such as super-resolution structured illumination microscopy (SR-SIM), micro-computerized tomography (micro-CT), and synchrotron radiation phase-contrast imaging (SR-PCI). The material used for imaging comes from different sources: human archival temporal bones from the Uppsala temporal bone collection; human fresh-frozen cadaveric bones from our collaborators at Western University, in London, Ontario, Canada; and fresh-frozen human ES harvested during vestibular schwannoma surgery after securing ethical permission.

The results of these studies describe the micro-anatomy of the VA, ED and ES down to a nanoscopic level. The discussion is based on the findings, relating them to earlier research with clinical implications regarding MD and LVAS.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2020. p. 71
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1647
Keywords
Endolymphatic sac, endolymphatic duct, vestibular aqueduct, Meniere's disease, LVAS, micro-CT, synchrotron phase contrast imaging
National Category
Otorhinolaryngology
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-406848 (URN)978-91-513-0901-9 (ISBN)
Public defence
2020-05-07, Enghoffsalen, Akademiska sjukhuset, Ing 50, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2020-04-16 Created: 2020-03-13 Last updated: 2020-05-19

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Kämpfe Nordström, CharlottaLaurell, GöranRask-Andersen, Helge

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