Inui Hiroshi, Sakamoto Tsuyoshi, Ito Taeko, Kitahara Tadashi
Inui ENT Clinic, 47-1 Miwa, Sakurai-city, Nara, 6330001, Japan.
PixSpace Ltd., 3-8-1 Asano, Kokurakita-ku, Kitakyusyu-city, Fukuoka, Japan.
Auris Nasus Larynx. 2019 Aug;46(4):493-497. doi: 10.1016/j.anl.2018.11.008. Epub 2018 Nov 30.
To employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere's disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis.
Forty-one patients with ALHL, 82 with SD, 48 with cMD, 72 with uMD, and 47 CS participated in the study. With the exception of all uMD patients, none of the subjects had vertigo. Images of the inner ear fluid space, positive perilymph signal, and positive endolymph signal were acquired using a 3-T MRI scanner. Three-dimensional images were reconstructed semi-automatically by using anatomical and tissue information to fuse the inner ear fluid space images and the ELS images.
The cochlear ELS/total fluid space (TFS) volume ratio was 10.2±6.7% (mean±standard deviation) in the CS group, 12.1±5.7% in ALHL patients, 15.2±8.7% in SD patients, 18.1±8.2% in cMD patients, and 21.9±16.4% in uMD patients. The vestibular ELS/TFS volume ratio was 17.7±10.2% in the CS group, 18.9±8.3% in ALHL patients, 19.9±11.3% in SD patients, 22.5±13.7% in cMD patients, and 35.7±24.1% in uMD patients. The cochlear ELS/TFS volume ratio in patients with uMD was similar to that in the cMD group and significantly higher than that in the CS, ALHL, and SD groups (CS=ALHL<SD<cMD=uMD: p<0.05 for CS vs. SD and p<0.01 for CS vs. cMD). The vestibular ELS/TFS volume ratio in patients with uMD was significantly higher than that in the CS and all other patient groups (CS=ALHL=SD=cMD<uMD: p<0.01 for uMD vs. all other groups).
The cochlear ELS volume of patients with MD and other endolymphatic hydrops-related diseases differed from that of CS. Our results suggest that ALHL may not be caused by endolymphatic hydrops. We confirmed the presence of extended ELS in patients with SD.
采用磁共振成像（MRI）测量急性低频感音神经性听力损失（ALHL）、突发性聋（SD）、耳蜗梅尼埃病（cMD）和单侧梅尼埃病（uMD）患者内耳内淋巴间隙（ELS）的体积，并与慢性鼻窦炎对照受试者（CS）进行比较。
41例ALHL患者、82例SD患者、48例cMD患者、72例uMD患者和47例CS受试者参与了本研究。除所有uMD患者外，其他受试者均无眩晕症状。使用3-T MRI扫描仪获取内耳液间隙、阳性外淋巴信号和阳性内淋巴信号的图像。利用解剖和组织信息半自动重建三维图像，以融合内耳液间隙图像和ELS图像。
CS组耳蜗ELS/总液间隙（TFS）体积比为10.2±6.7%（平均值±标准差），ALHL患者为12.1±5.7%，SD患者为15.2±8.7%，cMD患者为18.1±8.2%，uMD患者为21.9±16.4%。前庭ELS/TFS体积比在CS组为17.7±10.2%，ALHL患者为18.9±8.3%，SD患者为19.9±11.3%，cMD患者为22.5±13.7%，uMD患者为35.7±24.1%。uMD患者的耳蜗ELS/TFS体积比与cMD组相似，且显著高于CS、ALHL和SD组（CS = ALHL < SD < cMD = uMD：CS与SD比较，p < 0.05；CS与cMD比较，p < 0.01）。uMD患者的前庭ELS/TFS体积比显著高于CS组及所有其他患者组（CS = ALHL = SD = cMD < uMD：uMD与所有其他组比较，p < 0.01）。
MD及其他内淋巴积水相关疾病患者的耳蜗ELS体积与CS不同。我们的结果表明，ALHL可能不是由内淋巴积水引起的。我们证实了SD患者存在扩大的ELS。
