First Experience with Inner Ear Imaging Using Magnetic Resonance after Intratympanic Application of Contrast Medium

Česká verzia

Authors: H. Doucek Abboudová ¹; J. Vodička ^1,2; O. Vincent ³
Authors place of work: Klinika otorinolaryngologie a chirurgie hlavy a krku, Nemocnice Pardubického kraje, a. s., Pardubická nemocnice, přednosta MUDr. J. Vodička, Ph. D. ¹; Fakulta zdravotnických studií, Univerzita Pardubice ²; Radiodiagnostické oddělení, Nemocnice Pardubického kraje, a. s., Pardubická nemocnice ³
Published in the journal: Otorinolaryngol Foniatr, 64, 2015, No. 1, pp. 28-34.
Category: Original Article

Summary

Objective:
The aim of this study was to identify persons with endolymphatic hydrops (using Magnetic Resonance Imaging - MRI and local application of gadobutrol) to subjects with clinical symptoms of inner ear disease (sudden hearing loss, peripheral type of vertigo, tinnitus). The goal was to confirm the method of inner ear imaging suitable for distinguishing endolymphatic and perilymphatic space.

Methods:
We included 34 patients of average age 56 years, 18 women and 16 men. Thirty three patients experienced acute sensorineural hearing loss, in 6 patients definite Ménière’s disease was diagnosed. Contrast agent (gadobutrol) diluted with saline solution (1:7) was administered in the tympanic cavity of 26 patients in outpatient setting, in 8 cases the transport was provided by a system Silverstein MicroWick. MRI examination (1.5 Tesla) was performed 24 hours (+/-7 hours) after administration of contrast medium (T1 sequence). The presence and size of hydrops was evaluated by the ratio of endolymphatic space compared to the whole vestibule. The ratio of 33 % and more was classified as endolymphatic hydrops. Subsequently, patients were observed including tone audiometry examination. The average follow-up time was 49 days.

Results:
The assessment of the size of the endolymphatic space in relation to the whole vestibule was relevant in 31 out of 34 patients. Result of 3 patients was not diagnostic. Extension of the endolymphatic space was present in 14 patients. In 5 patients with definite Ménière’s disease was detected endolymphatic hydrops. The hydrops was found in none of the patients with sensorineural hearing loss as a single symptom. In any patient wasn´t found retrocochlear disease, especially schwannoma of vestibular nerve.

Conclusion:
MRI examination of the inner ear with the intratympanic injection of the contrast agent appears to be a suitable method of choice to depict hydrops of the inner ear (most often in people with Ménière’s disease). This finding can be used for targeted treatment of these patients.

Keywords:
magnetic resonance imaging, Ménière’s disease, intratympanic applications, endolymphatic hydrops

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