Etiology-Specific Mineralization Patterns in Patients with Labyrinthitis Ossificans

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Fig 1.
Example of LO mineralization grades (0–4) within the basal turn of the cochlea. Axial, noncontrast temporal bone images through the basal turn of the cochlea demonstrate various grades of mineralization/ossification. A, Grade 0, no evidence of mineralization/ossification. B, Grade 1, mineralization/ossification between 0% and 25%. C, Grade 2, mineralization/ossification between 25% and 50%. D, Grade 3, mineralization/ossification between 50% and 75%. E, Grade 4, Mineralization/ossification of >75%.
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Fig 2.
Example of LO mineralization grades (0–4) within the lateral semicircular canal. Axial, noncontrast temporal bone images through the lateral semicircular canals demonstrate various grades of mineralization/ossification. A, Grade 0, no evidence of mineralization/ossification. B, Grade 1, mineralization/ossification between 0% and 25%. C, Grade 2, mineralization/ossification between 25% and 50%. D, Grade 3, mineralization/ossification between 50% and 75%. E, Grade 4, mineralization/ossification of >75%.

Table 1:

Distribution of labyrinthitis ossificans grade by membranous labyrinthine structures^{^a}

	No.	Mean	SD
Overall
Apical turn of cochlea	57	0.81	1.51
Middle turn of cochlea	57	0.86	1.46
Basal turn of cochlea	57	1.04	1.48
Vestibule	58	0.55	1.14
Lateral semicircular canal	58	1.81	1.37
Posterior semicircular canal	58	1.31	1.56
Superior semicircular canal	58	1.02	1.54
Right side
Apical turn of cochlea	31	0.90	1.60
Middle turn of cochlea	31	0.94	1.48
Basal turn of cochlea	31	1.26	1.57
Vestibule	32	0.66	1.18
Lateral semicircular canal	32	2.03	1.40
Posterior semicircular canal	32	1.50	1.59
Superior semicircular canal	32	1.25	1.63
Left side
Apical turn of cochlea	26	0.69	1.41
Middle turn of cochlea	26	0.77	1.45
Basal turn of cochlea	26	0.77	1.34
Vestibule	26	0.42	1.10
Lateral semicircular canal	26	1.54	1.30
Posterior semicircular canal	26	1.08	1.52
Superior semicircular canal	26	0.73	1.40

Note:—No. indicates the total number of patients.
↵a LO grades stratified by each structure in the membranous labyrinth and stratified for the left-versus-right ear.

Table 2:

Comparing mean labyrinthitis ossificans grade by anatomic location

	Apical Turn of Cochlea	Middle Turn of Cochlea	Basal Turn of Cochlea	Vestibule	Lateral Semicircular Canal	Posterior Semicircular Canal	Superior Semicircular Canal
Apical turn of cochlea	–	0.839	.377	.371	.001	.071	.423
Middle turn of cochlea		–	.490	.256	.001	.109	.539
Basal turn of cochlea			–	.061	.011	.342	.966
Vestibule				–	<.001	.004	.069
Lateral semicircular canal					–	.060	.004
Posterior semicircular canal						–	.308
Superior semicircular canal							–

Table 3:

Comparing mean labyrinthitis ossificans grade by chronic otomastoiditis^{^a}

	Mean (SE)		P Value
	No Chronic Otomastoiditis (n = 35)	Chronic Otomastoiditis (n = 23)	P Value
Apical turn of cochlea^{^b}	0.79 (0.29)	0.82 (0.35)	.947
Middle turn of cochlea^{^b}	0.80 (0.28)	0.96 (0.34)	.720
Basal turn of cochlea^{^b}	0.98 (0.29)	1.23 (0.35)	.578
Vestibule	0.44 (0.22)	0.76 (0.27)	.347
Lateral semicircular canal	1.81 (0.23)	1.74 (0.28)	.853
Posterior semicircular canal	1.13 (0.26)	1.54 (0.33)	.328
Superior semicircular canal	0.75 (0.26)	1.39 (0.32)	.136

Note:—n indicates the number of ears; SE, standard error.
↵a LO grade for each structure within the membranous labyrinth is reported stratified by risk factor. P value is from a mixed-effects model.
↵b Analysis based on 57 ears (34 with no chronic otomastoiditis and 23 with chronic otomastoiditis).

Table 4:

Comparing mean labyrinthitis ossificans grade by meningitis^{^a}

	Mean (SE)		P Value
	No Meningitis (n = 52)	Meningitis (n = 6)	P Value
Apical turn of cochlea^{^b}	0.84 (0.23)	0.50 (0.71)	.657
Middle turn of cochlea^{^b}	0.88 (0.23)	0.72 (0.70)	.829
Basal turn of cochlea^{^b}	1.11 (0.24)	0.81 (0.73)	.697
Vestibule	0.63 (0.18)	0.04 (0.55)	.317
Lateral semicircular canal	1.77 (0.19)	1.91 (0.56)	.806
Posterior semicircular canal	1.22 (0.22)	1.96 (0.65)	.296
Superior semicircular canal	1.0 (0.22)	0.94 (0.64)	.925

↵a LO grade for each structure within the membranous labyrinth is reported stratified by risk factor. P value is from a mixed-effects model.
↵b Analysis is based on 57 ears (51 without meningitis and 6 with meningitis).

Table 5:

Comparing mean labyrinthitis ossificans grade by sickle cell disease^{^a}

	Mean (SE)		P Value
	No Sickle Cell Disease (n = 51)	Sickle Cell Disease (n = 7)	P Value
Apical turn of cochlea^{^b}	0.79 (0.24)	0.91 (0.65)	.858
Middle turn of cochlea^{^b}	0.89 (0.23)	0.67 (0.63)	.738
Basal turn of cochlea^{^b}	1.15 (0.24)	0.50 (0.65)	.349
Vestibule	0.63 (0.18)	0.09 (0.50)	.316
Lateral semicircular canal	1.84 (0.19)	1.40 (0.51)	.422
Posterior semicircular canal	1.32 (0.22)	1.11 (0.60)	.747
Superior semicircular canal	1.09 (0.22)	0.37 (0.60)	.261

↵a LO grade for each structure within the membranous labyrinth is reported stratified by risk factor. P value is from a mixed-effects model.
↵b Analysis is based on 57 ears (50 with no sickle cell disease and 7 with sickle cell disease).

Table 6:

Comparing mean labyrinthitis ossificans grade by trauma^{^a}

	Mean (SE)		P Value
	No Trauma (n = 50)	Trauma (n = 8)	P Value
Apical turn of cochlea^{^b}	0.75 (0.24)	1.15 (0.60)	.535
Middle turn of cochlea^{^b}	0.80 (0.23)	1.25 (0.58)	.477
Basal turn of cochlea^{^b}	1.0 (0.24)	1.58 (0.60)	.372
Vestibule	0.59 (0.18)	0.44 (0.46)	.763
Lateral semicircular canal	1.82 (0.19)	1.55 (0.48)	.605
Posterior semicircular canal	1.36 (0.21)	0.50 (0.52)	.130
Superior semicircular canal	1.03 (0.22)	0.66 (0.54)	.528

↵a LO grade for each structure within the membranous labyrinth is reported stratified by risk factor. P value is from a mixed-effects model.
↵b Analysis is based on 57 ears (49 with no trauma and 8 with trauma).

Table 7:

Comparing mean labyrinthitis ossificans grade by surgery^{^a}

	Mean (SE)		P Value
	No Surgery (n = 47)	Surgery (n = 11)	P Value
Apical turn of cochlea^{^b}	0.74 (0.24)	1.07 (0.51)	.553
Middle turn of cochlea^{^b}	0.74 (0.23)	1.41 (0.49)	.223
Basal turn of cochlea^{^b}	0.84 (0.23)	2.07 (0.48)	.027
Vestibule	0.30 (0.16)	1.67 (0.33)	.001
Lateral semicircular canal	1.49 (0.15)	3.04 (0.32)	<.001
Posterior semicircular canal	0.99 (0.20)	2.44 (0.43)	.004
Superior semicircular canal	0.75 (0.22)	2.13 (0.45)	.008

↵a LO grade for each structure within the membranous labyrinth is reported stratified by risk factor. P value is from a mixed-effects model.
↵b Analysis is based on 57 ears (47 with no prior temporal bone surgery and 10 with prior temporal bone surgery).

Table 8:

Comparing mean labyrinthitis ossificans grade by any condition^{^a}

	Mean (SE)		P Value
	No Risk Factor (n = 11)	Any Risk Factor (n = 47)	P Value
Apical turn of cochlea^{^b}	0.33 (0.49)	0.92 (0.24)	.280
Middle turn of cochlea^{^b}	0.22 (0.47)	1.03 (0.24)	.132
Basal turn of cochlea^{^b}	0.35 (0.48)	1.26 (0.24)	.095
Vestibule	0.01 (0.37)	0.71 (0.19)	.097
Lateral semicircular canal	1.29 (0.40)	1.90 (0.19)	.181
Posterior semicircular canal	0.65 (0.46)	1.44 (0.23)	.136
Superior semicircular canal	0.45 (0.47)	1.15 (0.23)	.190

↵a LO grade is reported per membranous labyrinth structure based on patients with an identified LO risk factor compared with those without a risk factor. P value is from a mixed-effects model.
↵b Analysis is based on 57 ears (11 with no condition and 46 with a condition).