{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:45:37Z","timestamp":1792442737972,"version":"4.5.0"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The discovery of the glymphatic system in the brain and eye has raised the hypothesis of a similar system in the inner ear. Dysfunctional lymph fluid dynamics may contribute to inner ear conditions such as Meniere's Disease (MD) and endolymphatic hydrops (EH). This scoping review evaluates inner ear waste clearance mechanisms by tracking gadolinium\u2010based contrast agent (GBCA) signal over time using magnetic resonance imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Embase, Cochrane, Web of Science, and Scopus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>A systematic search identified studies reporting inner ear GBCA signal &gt;\u20094\u2009h after intravenous (IV) administration. Data on study design, cohort characteristics, and time points were extracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifteen studies (three animal; 12 human) met inclusion criteria. Three studies had a goal of studying clearance. Animal studies demonstrated a decrease in GBCA signal following a 4\u2010h peak. Of the human studies, three analyzed healthy controls, four studied EH without MD, three focused on MD, and two focused on neurological disorders but provided insight into inner ear enhancement. In healthy and MD ears, the internal auditory canal was enhanced before other inner ear structures. In EH, a reduced superior petrosal sinus area was noted, and delayed excretion rates were observed in MD patients 24\u2009h post\u2010IV administration. A positive association between endolymph and perilymph signal was identified in EH patients after 24\u2009h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most studies were not designed to assess clearance mechanisms. Future in\u00a0vivo and histopathological studies are needed to clarify the potential presence of glymphatic system involvement in the inner ear.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70240","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T14:31:17Z","timestamp":1757428277000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Blood Labyrinth Barrier Waste Clearance as Assessed by\n                    <scp>GBCAs<\/scp>\n                    on\n                    <scp>MRI<\/scp>\n                    : A Scoping Review"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6179-5252","authenticated-orcid":false,"given":"Syed Ameen","family":"Ahmad","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine Department of Otolaryngology\u2010Head and Neck Surgery  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Y.","family":"Huang","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine Department of Otolaryngology\u2010Head and Neck Surgery  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine Department of Otolaryngology\u2010Head and Neck Surgery  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yassine","family":"Balhi","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine Department of Otolaryngology\u2010Head and Neck Surgery  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Spann","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine Department of Otolaryngology\u2010Head and Neck Surgery  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan K.","family":"Ward","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine Department of Otolaryngology\u2010Head and Neck Surgery  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348948109000208"},{"issue":"1","key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1038\/s41598-017-00330-5","article-title":"The Blood Labyrinthine Barrier in the Human Normal and Meniere's Disease Macula Utricle","volume":"7","author":"Ishiyama G.","year":"2017","journal-title":"Scientific Reports"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.662264"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/2045-8118-9-23"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3003748"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.adc8810"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-18115-2"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-27887-0"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fneur.2022.1016577","article-title":"17O\u2010Labeled Water Distribution in the Human Inner Ear: Insights Into Lymphatic Dynamics and Vestibular Function","volume":"13","author":"Yoshida T.","year":"2022","journal-title":"Frontiers in Neurology"},{"key":"e_1_2_8_11_1","unstructured":"NHLBI NIH Study Quality Assessment Tools. Accessed November 26 2024(2025) https:\/\/www.nhlbi.nih.gov\/health\u2010topics\/study\u2010quality\u2010assessment\u2010tools."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7842"},{"issue":"5","key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"407","DOI":"10.5152\/iao.2023.22977","article-title":"Clinical Analysis of 3D\u2010Fluid Attenuated Inversion Recovery and T1volume Interpolated Body Examination Sequences on Delayed Gadolinium\u2010Enhanced Scanning in Ramsay Hunt Syndrome","volume":"19","author":"Han Y.","year":"2023","journal-title":"Journal of International Advanced Otology"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-024-10620-y"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30816"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diii.2017.06.002"},{"key":"e_1_2_8_17_1","doi-asserted-by":"crossref","DOI":"10.3389\/fsurg.2021.673323","article-title":"Imaging Analysis of Patients With Meniere's Disease Treated With Endolymphatic Sac\u2010Mastoid Shunt Surgery","volume":"8","author":"Li Y.","year":"2021","journal-title":"Frontiers in Surgery"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-023-03176-z"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002768"},{"issue":"2","key":"e_1_2_8_20_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.21037\/atm-22-6313","article-title":"Longitudinal Variation of Endolymphatic Hydrops in Patients With M\u00e9ni\u00e8re's Disease","volume":"11","author":"Li J.","year":"2023","journal-title":"Annals of Translational Medicine"},{"issue":"1","key":"e_1_2_8_21_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-023-49066-5","article-title":"MRI Can Help Differentiate M\u00e9ni\u00e8re's Disease From Other Menieriform Diseases","volume":"13","author":"Li J.","year":"2023","journal-title":"Scientific Reports"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.2174\/1874440001307010027","article-title":"MRI Evidence of Endolymphatic Impermeability to the Gadolinium Molecule in the in Vivo Mouse Inner Ear at 9.4 Tesla","volume":"7","author":"Counter S. A.","year":"2013","journal-title":"Open Neuroimaging Journal"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000584"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002471"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200111000-00017"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002571"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215113000017"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2021.1957500"},{"issue":"12","key":"e_1_2_8_29_1","doi-asserted-by":"crossref","first-page":"2650","DOI":"10.1007\/s00330-003-1922-8","article-title":"High\u2010Resolution T1\u2010Weighted 3D Real IR Imaging of the Temporal Bone Using Triple\u2010Dose Contrast Material","volume":"13","author":"Naganawa S.","year":"2003","journal-title":"European Radiology"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-005-0046-8"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.2463\/mrms.2013-0056"},{"issue":"8","key":"e_1_2_8_32_1","first-page":"2043","article-title":"Transthyretin\u2010Related Familial Amyloid Polyneuropathy: Evaluation of CSF Enhancement on Serial T1\u2010Weighted and Fluid\u2010Attenuated Inversion Recovery Images Following Intravenous Contrast Administration","volume":"26","author":"Hirai T.","year":"2005","journal-title":"American Journal of Neuroradiology"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0000000000000533"},{"issue":"1","key":"e_1_2_8_34_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2463\/mrms.mp.2020-0030","article-title":"Intracranial Distribution of Intravenously Administered Gadolinium\u2010Based Contrast Agent Over a Period of 24 Hours: Evaluation With 3D\u2010Real IR Imaging and MR Fingerprinting","volume":"20","author":"Naganawa S.","year":"2020","journal-title":"Magnetic Resonance in Medical Sciences"},{"issue":"3","key":"e_1_2_8_35_1","doi-asserted-by":"crossref","first-page":"459","DOI":"10.2463\/mrms.mp.2021-0010","article-title":"Cross\u2010Sectional Area of the Superior Petrosal Sinus Is Reduced in Patients With Significant Endolymphatic Hydrops","volume":"21","author":"Naganawa S.","year":"2021","journal-title":"Magnetic Resonance in Medical Sciences"},{"issue":"3","key":"e_1_2_8_36_1","first-page":"1","article-title":"Contrast\u2010Enhanced Three\u2010Dimensional Fluid\u2010Attenuated Inversion Recovery Imaging With an Optimal Scan Interval and Angulation to Visualize Endolymphatic Hydrops","volume":"19","author":"Li J.","year":"2022","journal-title":"Iranian Journal of Radiology"},{"issue":"2","key":"e_1_2_8_37_1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.2463\/mrms.mp.2024-0011","article-title":"Direct Visualization of Tracer Permeation Into the Endolymph in Human Patients Using MR Imaging","volume":"24","author":"Naganawa S.","year":"2024","journal-title":"Magnetic Resonance in Medical Sciences"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.2463\/mrms.11.43"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2024.01.002"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2018.10.030"},{"issue":"8","key":"e_1_2_8_41_1","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.tem.2024.11.005","article-title":"Rewiring of the Glymphatic Landscape in Metabolic Disorders","volume":"36","author":"Chen B.","year":"2024","journal-title":"Trends in Endocrinology and Metabolism"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep18599"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A0968"},{"issue":"1","key":"e_1_2_8_44_1","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1177\/000348947908800603","article-title":"Vein of the Vestibular Aqueduct","volume":"88","author":"Mazzoni A.","year":"1979","journal-title":"Annals of Otology, Rhinology, and Laryngology"},{"key":"e_1_2_8_45_1","unstructured":"Sciencedirect Cochlear Aqueduct\u2014An Overview. ScienceDirect Topics. Accessed December 3 2024(2024) https:\/\/www.sciencedirect.com\/topics\/neuroscience\/cochlear\u2010aqueduct."},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.7.1498"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aaw3210"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-291X(02)02296-9"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00418-016-1471-2"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.449"},{"issue":"1","key":"e_1_2_8_51_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-61459-8","article-title":"Hypertonic Saline\u2010 and Detergent\u2010Accelerated EDTA\u2010Based Decalcification Better Preserves mRNA of Bones","volume":"14","author":"Li Z.","year":"2024","journal-title":"Scientific Reports"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002082"},{"key":"e_1_2_8_53_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1159\/000490268","article-title":"Imaging of Temporal Bone","volume":"82","author":"Pyykk\u00f6 I.","year":"2019","journal-title":"Advances in Oto\u2010Rhino\u2010Laryngology"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T14:54:35Z","timestamp":1761663275000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.70240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":52,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/lio2.70240"],"URL":"https:\/\/doi.org\/10.1002\/lio2.70240","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,9]]},"assertion":[{"value":"2025-05-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70240"}}