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Surgical Induction of Endolymphatic Hydrops by Obliteration of the Endolymphatic Duct
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Published on: January 22, 2010

Endolymphatic space imaging in patients with delayed endolymphatic hydrops.

Sachio Kasai1, Masaaki Teranishi, Naomi Katayama

  • 1Department of Otorhinolaryngology, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Japan.

Acta Oto-Laryngologica
|October 30, 2009
PubMed
Summary

Magnetic resonance imaging (MRI) with intratympanic gadolinium injection can diagnose endolymphatic hydrops (ELH) in delayed (DELH) patients. This imaging technique may reveal bilateral ELH, even in cases of contralateral DELH.

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Area of Science:

  • Otolaryngology
  • Neurology
  • Radiology

Background:

  • Delayed endolymphatic hydrops (DELH) is traditionally diagnosed using clinical history and audiological/vestibular tests.
  • DELH is categorized as ipsilateral, contralateral, or bilateral, based on the ear(s) affected by hearing loss.

Purpose of the Study:

  • To evaluate the utility of magnetic resonance imaging (MRI) following intratympanic gadolinium injection for diagnosing endolymphatic hydrops (ELH).
  • To explore the potential of imaging to enhance the diagnosis and management of DELH.

Main Methods:

  • Gadolinium hydrate was diluted and administered via intratympanic injection to seven patients (two with ipsilateral DELH, five with contralateral DELH).
  • 3 Tesla MRI was performed one day post-injection to visualize the endolymphatic space.

Main Results:

  • Endolymphatic hydrops (ELH) was detected in all patients who received the gadolinium injection.
  • In three patients with contralateral DELH who received bilateral injections, ELH was observed in both ears.
  • One patient exhibited ELH in the cochlea of one ear and the vestibule of the other.

Conclusions:

  • Intratympanic gadolinium-enhanced MRI is effective in visualizing endolymphatic hydrops (ELH) in patients with delayed endolymphatic hydrops (DELH).
  • This imaging modality can identify bilateral ELH, even in patients diagnosed with contralateral DELH, suggesting a broader involvement than previously recognized.