Okazaki Yuriko, Yoshida Tadao, Sugimoto Satofumi, Teranishi Masaaki, Kato Ken, Naganawa Shinji, Sone Michihiko
*Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya †Department of Otorhinolaryngology, Aichi Children's Health and Medical Center, Obu ‡Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Otol Neurotol. 2017 Sep;38(8):1076-1080. doi: 10.1097/MAO.0000000000001499.
The purpose of this study was to investigate the existence of endolymphatic hydrops (EH) in affected and unaffected ears in patients with unilateral sensorineural hearing loss (SNHL) using contrast-enhanced magnetic resonance imaging (MRI), and to evaluate the significance of EH in various otological diseases.
Retrospective study.
University hospital.
One hundred eighty-two ears from 91 patients with unilateral SNHL were studied. The endolymphatic space was evaluated using 3-Tesla MRI with gadodiamide hydrate. Imaging data about the degree of EH in the cochlea and vestibule were analyzed and compared between ears with various otological diseases.
All affected ears with delayed endolymphatic hydrops had EH. In affected ears with definite Menière's disease, cochlear EH was observed in all ears and vestibular EH in 93% of ears, and these rates were significantly higher in the affected than in the unaffected ears. EH was also observed in the cochlea and vestibule in 66% and 41%, respectively, of the affected ears with idiopathic sudden SNHL; however, these percentages did not differ significantly from those in the unaffected ears (52% and 38%, respectively).
MRI showed that a high percentage of ears affected by Menière's disease or delayed endolymphatic hydrops had EH. Further studies should evaluate the implications of EH in ears, especially in those with sudden SNHL, in terms of secondary or pre-existing EH.
本研究旨在利用对比增强磁共振成像(MRI)研究单侧感音神经性听力损失(SNHL)患者患侧和未患侧耳内是否存在内淋巴积水(EH),并评估EH在各种耳科疾病中的意义。
回顾性研究。
大学医院。
对91例单侧SNHL患者的182只耳进行研究。使用含钆双胺的3特斯拉MRI评估内淋巴间隙。分析并比较不同耳科疾病患耳的耳蜗和前庭EH程度的影像数据。
所有存在延迟性内淋巴积水的患耳均有EH。在确诊为梅尼埃病的患耳中,所有耳均观察到耳蜗EH,93%的耳观察到前庭EH,且患耳的这些比例显著高于未患耳。在特发性突发SNHL的患耳中,分别有66%和41%的耳在耳蜗和前庭观察到EH;然而,这些百分比与未患耳(分别为52%和38%)相比无显著差异。
MRI显示,受梅尼埃病或延迟性内淋巴积水影响的耳中,有很高比例存在EH。进一步的研究应评估EH在耳中的意义,尤其是在突发SNHL的耳中,从继发性或既往存在的EH方面进行评估。