Uno Atsuhiko, Imai Takao, Watanabe Yoshiyuki, Tanaka Hisashi, Kitahara Tadashi, Horii Arata, Kamakura Takefumi, Takimoto Yasumitsu, Osaki Yasuhiro, Nishiike Suetaka, Inohara Hidenori
Department of Otolaryngology Head & Neck Surgery, Japan.
Acta Otolaryngol. 2013 Sep;133(9):924-9. doi: 10.3109/00016489.2013.795290. Epub 2013 Jun 14.
Endolymphatic hydrops could be a reversible inner ear pathological condition. After sac surgery, hydrops was reduced and symptoms went into remission in some cases, although vertigo suppression was not always a result of the reduced hydrops.
To examine the changes in endolymphatic hydrops detected by gadolinium (Gd) contrast-enhanced magnetic resonance imaging (MRI) before and 6 months after endolymphatic sac surgery in patients with unilateral Ménière's disease.
Fluid-attenuated inversion recovery MRI was obtained 4 h after intravenous administration or 24 h after intratympanic administration of Gd contrast medium. An enlarged negative stain corresponding to the cochlear duct and endolymphatic space of the vestibule was assessed as hydrops.
Of seven patients with hydrops confirmed by MRI before surgery, both cochlear and vestibular hydrops became negative in two, cochlear hydrops became negative in one, both hydrops were present, but reduced, in one, and there was no change in three patients. The number of vertigo spells was reduced in all cases at 6-12 months after surgery. As for the three cases of negative hydrops, vertigo was completely suppressed. In two cases in which hearing level improved, hydrops became negative after surgery.
内淋巴积水可能是一种可逆的内耳病理状态。内淋巴囊手术后，积水减少，部分病例症状缓解，尽管眩晕的抑制并不总是积水减少的结果。
研究单侧梅尼埃病患者内淋巴囊手术前及术后6个月钆（Gd）增强磁共振成像（MRI）检测到的内淋巴积水变化。
静脉注射Gd造影剂4小时后或鼓室内注射24小时后，行液体衰减反转恢复MRI检查。对应于蜗管和前庭内淋巴间隙的扩大阴性染色被评估为积水。
术前MRI证实有积水的7例患者中，2例耳蜗和前庭积水均转为阴性，1例耳蜗积水转为阴性，1例两者积水仍存在但减轻，3例无变化。术后6 - 12个月，所有病例的眩晕发作次数均减少。对于3例积水阴性的病例，眩晕完全得到抑制。在2例听力水平改善的病例中，术后积水转为阴性。
