Endolymphatic Hydrops Revealed by Magnetic Resonance Imaging in Patients With Acute Low-Tone Sensorineural Hearing Loss

Shimono, Mariko; Teranishi, Masaaki; Yoshida, Tadao; Kato, Masahiro; Sano, Rui; Otake, Hironao; Kato, Ken; Ohmiya, Naoki; Naganawa, Shinji; Nakashima, Tsutomu

doi:10.1097/mao.0b013e3182990e81

Cited by 68 publications

(50 citation statements)

References 25 publications

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“…Despite the radiological presence of hydrops in patients with MD, there are patients with hydrops shown on imaging studies without any MD symptoms [6,8]. This might well indicate that endolymphatic hydrops is one cause or part of the problem and that there might be an additional factor contributing to the clinical presentation of MD.…”

Section: Introductionmentioning

confidence: 99%

“…It was almost 80 years following the disease's first description by Prosper Ménière that endolymphatic hydrops of the membranous labyrinth was histopathologically recognized as the underlying element of MD [3,4]. Recently, the advances of magnetic resonance imaging enabled us to identify endolymphatic hydrops in high-resolution scans, showing that hydrops is present in patients with MD [5,6,7,8]. …”

Section: Introductionmentioning

confidence: 99%

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Ménière's Disease and Underlying Medical and Mental Conditions: Towards Factors Contributing to the Disease

Khan¹,

Iliodromiti²,

Gaggini³

et al. 2016

ORL

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Purpose of the Study: To investigate the relation of Ménière's disease (MD) with medical comorbidity or mental conditions. Procedures: Demographic data, medical and mental comorbidities were retrospectively collected and compared from 3 groups of 30 patients each: a group with patients with definite MD, a second one with patients with vestibulopathies other than MD (non-Ménière's vertigo, NMV) and a third one with patients without any vestibular symptoms (control). The level of significance was set at 0.05. Results: The prevalence of mental conditions was 26.7, 23.3 and 6.7% for the MD, the NMV and the control group, respectively. Medical comorbidity was found in 80% of patients in the MD, 63% in the NMV and 20% in the control group. Arthritis was encountered in 8 patients with MD, 3 with NMV and none from the control group. The differences in prevalence of mental disease, comorbidities and arthritis between the MD and the control group were statistically significant (p = 0.02, p < 0.001 and p = 0.008, respectively). Conclusion: Psychological conditions play an important role in patients with MD. The significantly increased prevalence of arthritis in the MD group suggests an inflammatory/autoimmune background as a contributing factor to the disease.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ménière's Disease and Underlying Medical and Mental Conditions: Towards Factors Contributing to the Disease

Khan¹,

Iliodromiti²,

Gaggini³

et al. 2016

ORL

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show abstract

“…However, histopathology can only be performed post mortem [Zou et al, 2009], precluding its use in clinical practice. To overcome this problem, many studies have attempted to visualize endolymphatic hydrops using magnetic resonance imaging (MRI) and intratympanic (IT) injection of gadolinium (Gd) Nakashima et al, 2007;Shimono et al, 2013;Suzuki et al, 2011;Yamazaki et al, 2012;Zou et al, 2009]. With the advancement of MRI imaging of the inner ear microstructures, we are now able to detect endolymphatic space distention in living patients with Mé-nière's disease [Fiorino et al, 2011;Fukuoka et al, 2012;Nakashima et al, 2007].…”

Section: Introductionmentioning

confidence: 96%

Diverse Patterns of Perilymphatic Space Enhancement in the Rat Inner Ear after Intratympanic Injection of Two Different Types of Gadolinium: A 9.4-Tesla Magnetic Resonance Study

Park¹,

Lee²,

Choi³

et al. 2015

Audiol Neurotol

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Objective: To compare the quality of perilymphatic enhancement in the rat inner ear after intratympanic injection of two types of gadolinium with a 9.4-tesla micro-MRI. Materials and Methods: Gadolinium was injected into the middle ear in 6 Sprague-Dawley rats via the transtympanic route. The left ear was injected with Gd-DO3A-butrol first, and then the right ear was injected with Gd-DOTA. MR images of the inner ear were acquired 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, and 4 h after intratympanic (IT) injection using an Agilent MRI system 9.4T/160/AS. The normalized signal intensity was quantitatively analyzed at the scala vestibuli (SV), scala media, and scala tympani (ST) using a Marosis M-view system. Then the normalized signal intensities (SIs) were compared between the two contrast agents. Results: For Gd-DO3A-butrol, the SI was as low as 1.0-1.5 throughout 1-4 h at the SV and ST of the basal turn. The maximum SI was 1.5 ± 0.5 at the SV (2 h) and 1.3 ± 0.5 at the ST (2 h). For Gd-DOTA, the 1-hour postinjection SI at the basal turn was 2.5 ± 0.5 at the SV, 1.6 ± 0.3 at the ST, and 1.2 ± 0.3 at the scala media. In the apical turn, the maximum SI was reached after 2.5 h. The maximum SI in the apical turn was 1.8 ± 0.4 at the SV (3.5 h), 1.8 ± 0.4 at the ST (4 h), and 1.4 ± 0.3 at the scala media (4 h). Conclusions: We were able to clearly visualize and separate the ST and SV using IT Gd and 9.4-tesla micro-MRI. We recommend using Gd-DO3A-butrol over Gd-DOTA and to perform the MRI 2.5 h after using IT Gd in the rat inner ear.

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“…However, it was revealed that ALHL has a relatively high incidence of spontaneous hearing recovery as well as recurrence and/ or progression to definite Ménière's disease (MD) after a long-term follow-up [Fushiki et al, 2009;Imamura et al, 1997;Junicho et al, 2008;Yamasoba et al, 1994]. These characteristic clinical courses, together with the results of electrocochleographic examination, glycerol tests, vestibular-evoked myogenic potential and 3-tesla magnetic resonance imaging (MRI) after intratympanic or intravenous gadolinium injection, suggest that the pathogenesis of ALHL may be attributable to cochlea-specific endolymphatic hydrops (EH) [Junicho et al, 2008;Noguchi et al, 2004;Nozawa et al, 2002;Shimono et al, 2013;Wang et al, 2010;Yamasoba et al, 1993Yamasoba et al, , 1994. Thus, ALHL has been interpreted as a potential early stage of MD and an independent disease entity distinct from ISSNHL [Morita et al, 2010;Selivanova et al, 2005;Shimono et al, 2013;Yamasoba et al, 1993].…”

Section: Introductionmentioning

confidence: 99%

“…Acute low-tone sensorineural hearing loss (ALHL) is defined as hearing impairment confined to the low frequencies with preservation of high-frequency hearing acuity and no episodes of vertigo [Morita et al, 2010;Okada et al, 2012;Shimono et al, 2013]. ALHL appears to partially overlap with the low-tone type of idiopathic sudden sensorineural hearing loss (ISSNHL).…”

Section: Introductionmentioning

confidence: 99%

The Short- and Long-Term Outcome of Intratympanic Steroid Therapy as a Salvage Treatment for Acute Low-Tone Sensorineural Hearing Loss without Episodes of Vertigo

et al. 2016

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Objectives: To evaluate the hearing outcomes of intratympanic steroid (ITS) treatment for patients with acute low-tone sensorineural hearing loss (ALHL) after failure of initial therapy and to investigate the recurrence and progression to definite Ménière's disease (MD) during a long-term follow-up. Methods: We retrospectively reviewed the medical records of 90 patients with refractory ALHL who were followed up for at least 1 year between January 2000 and April 2014. Patients who responded poorly to initial medical treatment received intratympanic dexamethasone injections (ITS group) or isosorbide administration for 4 weeks (diuretic group) as salvage treatment options according to their choice of management. The control group did not receive ITS or the diuretic, due to their refusal of both medical treatments. The hearing outcomes were evaluated 1 month, 1 year and 5 years after the completion of the second-line therapy, and the rates of recurrence and progression to MD were measured during a follow-up period of at least 1 year. Results: Twenty-seven patients in the ITS group, 39 patients in the diuretic group and 24 patients in the control group were enrolled. Of these, 12 patients in the ITS group, 15 patients in the diuretic group and 12 patients in the control group were followed up for over 5 years. We found that the recovery rates and the audiometric functional values after 1 month and 1 year in the ITS group were significantly higher than those in the diuretic and control groups. However, there were no significant differences in the recovery rates or the audiometric functional values after 5 years, or in the rates of recurrence and progression to MD between the groups. Conclusions: Salvage ITS therapy can provide a relatively good short-term hearing outcome for ALHL patients who have persistent hearing loss despite conventional treatment. However, both recurrence and progression to MD after treatment were observed in some patients during the long-term follow-up.

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Endolymphatic Hydrops Revealed by Magnetic Resonance Imaging in Patients With Acute Low-Tone Sensorineural Hearing Loss

Abstract: In ALHL, EH was observed not only in the cochlea but also in the vestibule as in Ménière's disease.

Cited by 68 publications

References 25 publications

Ménière's Disease and Underlying Medical and Mental Conditions: Towards Factors Contributing to the Disease

Ménière's Disease and Underlying Medical and Mental Conditions: Towards Factors Contributing to the Disease

Diverse Patterns of Perilymphatic Space Enhancement in the Rat Inner Ear after Intratympanic Injection of Two Different Types of Gadolinium: A 9.4-Tesla Magnetic Resonance Study

The Short- and Long-Term Outcome of Intratympanic Steroid Therapy as a Salvage Treatment for Acute Low-Tone Sensorineural Hearing Loss without Episodes of Vertigo

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