{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:04:55Z","timestamp":1784613895940,"version":"3.55.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Delayed endolymphatic hydrops (DEH) and M\u00e9ni\u00e8re\u2019s disease (MD) are both hydropic ear disease. In MD patients, the endotypes of MD are classified based on pathological types of the endolymphatic sac (ES), which can be distinguished by a radiological indicator: the angular trajectory of the vestibular aqueduct (ATVA). Studies have exhibited that MD patients of different pathological types of ES manifest different clinical characteristics. Here, we aimed to investigate the prevalence of each ATVA category in DEH and MD, and to further explore the clinical significance of ATVA in ipsilateral DEH patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-seven ipsilateral DEH patients, 114 unilateral MD patients and 45 control participants were enrolled in the present study. The ATVA was determined using temporal bone CT imaging. Clinical features, including gender, age and the caloric test results, were collected. The prevalence of ATVA categories were compared between patients with ipsilateral DEH and unilateral MD. The association between ATVA and clinical features was also examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      (1) Compared to MD-affected ears, ATVA \u2264 120\u00b0 was more frequent (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f9.231,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002), whereas ATVA \u2265 140\u00b0 was less frequent in DEH-affected ears (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f6.865,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.009). (2) Compared to control ears, the distribution of ATVA categories in affected ears of ipsilateral DEH patients was not significantly different (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f1.190,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.510). (3) The prevalence of ATVA \u2265 140\u00b0, 120\u00b0\u202f&amp;lt;\u202fATVA &amp;lt; 140\u00b0 and ATVA \u2264 120\u00b0 in affected ears of ipsilateral DEH patients was comparable to that in non-affected ears (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f1.083,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.568).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared to unilateral MD patients, degenerative ES may be the dominant pathological type in ipsilateral DEH patients due to the high occurrence of ATVA \u2264 120\u00b0.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1896403","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T05:34:44Z","timestamp":1784612084000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Degeneration rather than hypoplasia may be the pathologic feature of the endolymphatic sac in patients with ipsilateral delayed endolymphatic hydrops"],"prefix":"10.3389","volume":"17","author":[{"given":"Kaijun","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, ENT Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Hubei Provincial Clinical Research Center for Precision Radiology & Interventional Medicine","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, ENT Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingzhao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, ENT Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Hubei Provincial Clinical Research Center for Precision Radiology & Interventional Medicine","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoye","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, ENT Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingqian","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, ENT Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziying","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, ENT Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, ENT Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Hubei Province Clinical Center for Deafness and Vertigo","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjun","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, ENT Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Hubei Province Clinical Center for Deafness and Vertigo","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangming","family":"Leng","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, ENT Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]},{"name":"Hubei Province Clinical Center for Deafness and Vertigo","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3233\/VES-150549","article-title":"Diagnostic criteria for Meni\u00e8re\u2019s disease","volume":"25","author":"Lopez-Escamez","year":"2015","journal-title":"J Vestib Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/s0194-5998(95)70102-8","volume":"113","year":"1995","journal-title":"Otolaryngol Head Neck 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disease","volume":"12","author":"B\u00e4chinger","year":"2021","journal-title":"Front Neurol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e170","DOI":"10.1097\/mao.0000000000004482","article-title":"Deafness progressing to cochlear implant eligibility is eight times more likely in the hypoplastic than the degenerative endotype of Meni\u00e8re's disease","volume":"46","author":"Br\u00fchlmann","year":"2025","journal-title":"Otol Neurotol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"6109","DOI":"10.1007\/s00405-025-09542-2","article-title":"Dual-target corticosteroid therapy for refractory M\u00e9ni\u00e8re's disease: influence of vestibular aqueduct patency and Endotypes","volume":"282","author":"Zou","year":"2025","journal-title":"Eur Arch Otorrinolaringol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1177\/000348947808700601","article-title":"Delayed endolymphatic 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Laryngol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1007\/bf00453673","article-title":"Pathophysiology of endolymphatic Hydrops","volume":"212","author":"Schuknecht","year":"1976","journal-title":"Arch Otorhinolaryngol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1080\/00016489.2016.1203993","article-title":"Preceding profound deafness and co-factors promote development of endolymphatic Hydrops in preliminary patients with delayed endolymphatic Hydrops","volume":"136","author":"Fukushima","year":"2016","journal-title":"Acta Otolaryngol"},{"key":"ref30","first-page":"282","article-title":"Delayed endolymphatic hydrops syndrome after heavy exposure to impulse noise","volume":"9","author":"Ylikoski","year":"1988","journal-title":"Am J Otol"},{"key":"ref31","first-page":"375","article-title":"Delayed endolymphatic hydrops","volume-title":"J Otolaryngol","author":"LeLiever","year":"1980"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1080\/00016480500266008","article-title":"Autoantibodies against inner ear proteins in patients with delayed endolymphatic Hydrops and unilateral juvenile deafness","volume":"126","author":"Suzuki","year":"2006","journal-title":"Acta Otolaryngol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.3174\/ajnr.A8339","article-title":"Retrolabyrinthine bone thickness as a radiologic marker for the Hypoplastic Endotype in Meni\u00e8re disease","volume":"45","author":"Juliano","year":"2024","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1177\/09574271251371541","article-title":"Prevalence of the endolymphatic sac hypoplasia in a cohort of individuals without Meniere disease","volume":"36","author":"Robles-Bolivar","year":"2026","journal-title":"J Vestib Res"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12092008","article-title":"Angular trajectory of the vestibular aqueduct in a cohort of Chinese patients with unilateral M\u00e9ni\u00e8re's disease: association with other imaging indices and clinical profiles","volume":"12","author":"Xia","year":"2024","journal-title":"Biomedicine"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.amjoto.2003.11.009","article-title":"Audiovestibular findings in patients with delayed and idiopathic endolymphatic Hydrops: a comparative study","volume":"25","author":"Pollak","year":"2004","journal-title":"Am J Otolaryngol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"362","DOI":"10.3389\/fneur.2020.00362","article-title":"Dissociation of caloric and video head impulse tests in patients with delayed endolymphatic Hydrops","volume":"11","author":"Leng","year":"2020","journal-title":"Front Neurol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e0206891","DOI":"10.1371\/journal.pone.0206891","article-title":"Bilateral delayed endolymphatic Hydrops evaluated by bilateral Intratympanic injection of Gadodiamide with 3t-Mri","volume":"13","author":"Iwasa","year":"2018","journal-title":"PLoS One"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1159\/000314696","article-title":"Indication of the side of delayed endolymphatic Hydrops by vestibular evoked myogenic potential and caloric test","volume":"72","author":"Egami","year":"2010","journal-title":"ORL J Otorhinolaryngol Relat Spec"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1896403\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T05:34:46Z","timestamp":1784612086000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1896403\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":39,"alternative-id":["10.3389\/fneur.2026.1896403"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1896403","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"article-number":"1896403"}}