We reported the first visualization of endolymphatic hydrops in patients with Meniere's disease. The relationship between the image of the endolymphatic space and functional tests, such as electrocochleography and vestibular-evoked myogenic potential, must be examined in the near future. It is important for the development of intratympanic drug therapies for inner-ear diseases to investigate how the drugs enter and leave the inner ear.
A simple three-stage grading system was acceptable for hydrops in both the vestibule and the cochlea: none, mild, and significant. In the vestibule, the grading was determined by the ratio of the area of endolymphatic space to the vestibular fluid space (sum of the endolymphatic and perilymphatic spaces). Patients with no hydrops have a ratio of one-third or less, those with mild hydrops have between one-third and a half, and those with significant hydrops have a ratio of more than 50%. In the cochlea, patients classified as having no hydrops show no displacement of Reissner's membrane; those with mild hydrops show displacement of Reissner's membrane but the area of the endolymphatic space does not exceed the area of the scala vestibuli; and in those with significant hydrops the area of the endolymphatic space exceeds the area of the scala vestibuli.
3D-FLAIR findings show that high signals in the cochlea on precontrast 3D-FLAIR are related to a poor hearing prognosis. These signals may reflect minor hemorrhage or an increased concentration of protein in the inner ear, which has passed through blood vessels with increased permeability or has originated in disrupted cells in the inner ear.
The results suggest that nasal surgery is useful for lowering nasal resistance, ameliorating sleep-disordered breathing, and improving sleep quality and daytime sleepiness in OSAS.
Fourteen ears with Ménière's disease showed intense Gd contrast on MRI compared with that in the 10 asymptomatic contralateral ears of patients with unilateral Ménière's disease (1.12 ± 0.36 vs 0.82 ± 0.15). The hydrops grade was correlated significantly with the contrast effect. The 14 ears with Ménière's disease had endolymphatic hydrops. Of the 10 contralateral ears of patients with unilateral Ménière's disease, 2 had endolymphatic hydrops in the cochlea and 6 had endolymphatic hydrops in the vestibule.
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