Mukaida Tohru, Sone Michihiko, Yoshida Tadao, Kato Ken, Teranishi Masaaki, Naganawa Shinji, Nakashima Tsutomu
*Department of Otorhinolaryngology, Toyota Memorial Hospital, Toyota, Japan; †Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan; ‡Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; and §Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, Obu, Japan.
Otol Neurotol. 2015 Aug;36(7):1146-50. doi: 10.1097/MAO.0000000000000685.
Endolymphatic hydrops (EH) has been reported in cases with otosclerosis, and preoperative EH could be a risk factor for inner ear disturbances after stapes surgery. Visualization of EH has recently become possible using magnetic resonance imaging (MRI) with contrast agents. This study investigated the presence of EH on MRI in ears with clinical otosclerosis.
Retrospective case series.
University hospital.
27 ears of 15 cases diagnosed with otosclerosis.
Ears were evaluated by 3-T MRI performed 4 hours after intravenous injection of gadolinium. The degree of EH in the vestibule and cochlea was classified into three grades (none, mild, and significant). Imaging data were compared with clinical findings for all ears.
Imaging and clinical findings.
Varying degrees of cochlear EH and vestibular EH were observed in 20 and 15 ears, respectively. Episodes of acute sensorineural hearing loss with rotatory vertigo occurred in four ears that showed severe EH in the cochleae and vestibules. Severe EH, however, was also observed in ears without such symptoms.
The presence of EH in ears with otosclerosis was clearly visualized in the present patient series. Such MRI evaluation could provide useful information for managing symptoms related to EH.
耳硬化症患者中曾有内淋巴积水（EH）的报道，术前EH可能是镫骨手术后内耳功能障碍的一个危险因素。近来，使用含造影剂的磁共振成像（MRI）能够实现对EH的可视化。本研究调查了临床诊断为耳硬化症的耳朵在MRI上EH的存在情况。
回顾性病例系列研究。
大学医院。
15例诊断为耳硬化症患者的27只耳朵。
静脉注射钆剂4小时后，采用3-T MRI对耳朵进行评估。将前庭和耳蜗内EH的程度分为三个等级（无、轻度和重度）。将所有耳朵的影像学数据与临床检查结果进行比较。
影像学和临床检查结果。
分别在20只和15只耳朵中观察到不同程度的耳蜗EH和前庭EH。4只耳蜗和前庭显示重度EH的耳朵出现了伴有旋转性眩晕的急性感音神经性听力损失发作。然而，在没有此类症状的耳朵中也观察到了重度EH。
在本患者系列中，耳硬化症耳朵中EH的存在情况清晰可见。这种MRI评估可为处理与EH相关的症状提供有用信息。
