Fanet Jean, Bourdoncle Sylvain, Poillon Guillaume, Daval Mary, Levy Daniel, Ayache Denis, Gargula Stéphane
Department of Otolaryngology Hôpital Fondation Adolphe de Rothschild Paris France.
Department of Neuroradiology Hôpital Fondation Adolphe de Rothschild Paris France.
OTO Open. 2025 Jun 3;9(2):e70136. doi: 10.1002/oto2.70136. eCollection 2025 Apr-Jun.
To describe and assess the usefulness of delayed postcontrast three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequences on 3-Tesla (3 T) magnetic resonance imaging (MRI) in patients presenting with acute inner ear complications after stapes surgery.
Case series.
French tertiary referral center.
The clinical records and imaging of patients who underwent delayed postcontrast 3D-FLAIR MRI sequences for labyrinthine complications after stapes surgery, performed between January 2019 and April 2023, were retrospectively reviewed.
A total of 712 patients underwent stapes surgery between January 2019 and December 2023. Eight patients (1.12%) were included in the study, with a median age of 52 years (interquartile range 40-54). After the surgery, seven patients presented with vertigo and sensorineural hearing loss (SNHL), and one patient presented with only vertigo with complete areflexia on caloric testing. Computed tomography (CT) of the temporal bone showed a slightly excessive penetration of the prosthesis (>1 mm) into the vestibule in one patient and a periprosthetic granuloma in another patient. CT was normal for six patients. Delayed postcontrast 3D-FLAIR MRI sequences showed blood-labyrinth barrier (BLB) impairment in the cochlea, the vestibule, and the semicircular canals in seven patients. No endolymphatic hydrops were found, but one patient presented with utricular collapse, and the saccule was not visible in three other patients.
Delayed postcontrast MRI sequences may reveal BLB impairment and help analyzing the endolymphatic compartment in cases of SNHL or vestibular disorders after stapes surgery. Those sequences could help uncovering the causes of such events.
描述并评估3特斯拉（3T）磁共振成像（MRI）上的延迟增强三维液体衰减反转恢复（3D-FLAIR）序列在镫骨手术后出现急性内耳并发症患者中的应用价值。
病例系列。
法国三级转诊中心。
回顾性分析2019年1月至2023年4月期间因镫骨手术后迷路并发症接受延迟增强3D-FLAIR MRI序列检查的患者的临床记录和影像学资料。
2019年1月至2023年12月期间共有712例患者接受了镫骨手术。8例患者（1.12%）纳入研究，中位年龄52岁（四分位间距40 - 54岁）。术后，7例患者出现眩晕和感音神经性听力损失（SNHL），1例患者仅出现眩晕，冷热试验时完全无反射。颞骨计算机断层扫描（CT）显示1例患者假体进入前庭的深度略超过（>1 mm），另1例患者出现假体周围肉芽肿。6例患者CT检查正常。延迟增强3D-FLAIR MRI序列显示7例患者的耳蜗、前庭和半规管存在血迷路屏障（BLB）损伤。未发现内淋巴积水，但1例患者出现椭圆囊塌陷，另外3例患者球囊不可见。
延迟增强MRI序列可能揭示BLB损伤，并有助于分析镫骨手术后SNHL或前庭疾病病例中的内淋巴腔。这些序列有助于揭示此类事件的原因。
