Department of Neuroradiology, Neuroradiology Unit, Lariboisière University Hospital, 75010, Paris, France.
Department of Radiology, Rouen University Hospital, Rouen, France.
Eur Arch Otorhinolaryngol. 2021 Jul;278(7):2229-2238. doi: 10.1007/s00405-020-06282-3. Epub 2020 Aug 14.
Patients with superior semicircular canal dehiscence syndrome, which can only be treated by surgery, present cochleo-vestibular symptoms related to a third-mobile window but also endolymphatic hydrops. Since cVEMP and oVEMP are disturbed by the presence of the dehiscence, the aim of the study is to assess the value of MRI for the diagnosis of endolymphatic hydrops in patients with superior semicircular canal dehiscence syndrome in comparison with cVEMP and oVEMP.
In this retrospective cohort study we enrolled 33 ears in 24 patients with superior semicircular dehiscence syndrome who underwent a 4-h delayed intravenous Gd-enhanced 3D-FLAIR MRI and pure tone audiometry, cVEMP and oVEMP. For each patient MRI images were evaluated by two radiologists who used a compartmental endolymphatic hydrops grading system in comparison with cVEMP and oVEMP.
Endolymphatic hydrops was found on MRI in 9 out of 33 SCDS ears (27.3%). We found no significant correlation between the presence of endolymphatic hydrops on MRI and cVEMP and oVEMP (p = 0.36 and p = 0.7, respectively). However, there was a significant correlation between the presence of endolymphatic hydrops on MRI and the degree of sensorineural hearing loss, Air Conduction-Pure Tone Average level (p = 0.012) and Bone Conduction-Pure Tone Average level (p = 0.09), respectively.
We demonstrated that EH might be observed in 27.3% of superior semicircular dehiscence syndrome ears. The role of inner ear MRI is important to detect endolymphatic hydrops, since cVEMP and oVEMP are disturbed by the presence of the dehiscence, because these patients could benefit from a medical treatment.
Level 3.
上半规管裂综合征患者只能通过手术治疗，表现出与第三个活动窗口相关的耳蜗-前庭症状，但也存在内淋巴积水。由于 cVEMP 和 oVEMP 受到裂孔的干扰，因此本研究旨在评估 MRI 对上半规管裂综合征患者内淋巴积水的诊断价值，并与 cVEMP 和 oVEMP 进行比较。
在这项回顾性队列研究中，我们纳入了 24 例上半规管裂综合征患者的 33 只耳朵，这些患者接受了 4 小时延迟静脉内钆增强 3D-FLAIR MRI 和纯音听阈测试、cVEMP 和 oVEMP。每位患者的 MRI 图像均由两名放射科医生进行评估，他们使用分区内淋巴积水分级系统与 cVEMP 和 oVEMP 进行比较。
在 33 只 SCDS 耳朵中有 9 只（27.3%）在 MRI 上发现内淋巴积水。我们发现 MRI 上内淋巴积水的存在与 cVEMP 和 oVEMP 之间没有显著相关性（p=0.36 和 p=0.7，分别）。然而，MRI 上内淋巴积水的存在与感音神经性听力损失、气导纯音平均水平（p=0.012）和骨导纯音平均水平（p=0.09）之间存在显著相关性。
我们证明，EH 可能在 27.3%的上半规管裂综合征耳朵中观察到。由于裂孔的存在会干扰 cVEMP 和 oVEMP，因此内耳 MRI 的作用对于检测内淋巴积水非常重要，因为这些患者可能受益于药物治疗。
3 级。
