Angular Trajectory of the Vestibular Aqueduct in a Cohort of Chinese Patients with Unilateral Ménière's Disease: Association with Other Imaging Indices and Clinical Profiles

Objective: We aimed to investigate the association between the angular trajectory of the vestibular aqueduct (ATVA) with other radiological parameters of temporal bone and clinical characteristics in patients with M & eacute;ni & egrave;re's disease (MD). Methods: A total of 125 unilateral MD patients and 118 controls were enrolled. Computer tomography (CT)-based radiological parameters included ATVA, vestibular aqueduct (VA) visibility, VA morphology, the vertical part of the posterior semicircular canal-the posterior fossa distance (PPD), and peri-VA pneumatization. The clinical characteristics of MD patients included gender, age of diagnosis/onset, disease duration, migraine history, clinical staging, and the results of audio-vestibular tests. The radiological parameters and clinical characteristics in MD patients were compared. Results: Compared with control ears, ATVA >= 140 degrees was more prevalent and ATVA <= 120 degrees was less frequent in the MD-affected side. For the MD-affected side, MD patients with ATVA >= 140 degrees exhibited more severe VA invisibility and obliteration and higher male preponderance than those with ATVA <= 120 degrees. Other radio-clinical features did not differ between these two subgroups. Conclusion: In the current study, ATVA >= 140 degrees, an indicator of a hypoplastic endolymphatic sac, was found in approximately one-third of the affected and unaffected ears of patients with MD, as well as in a minority of controls. This suggests that the indices may be a predisposing factor rather than a specific marker for the MD ear. The male preponderance in MD patients with hypoplastic ES suggests a gender difference in the anatomical factors for MD pathogenesis.