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Intratympanic gadolinium magnetic resonance imaging supports the role of endolymphatic hydrops in the pathogenesis of immune-mediated inner-ear disease

Published online by Cambridge University Press:  11 June 2018

D Lobo ,
M Tuñón ,
I Villarreal ,
B Brea  and
J R García-Berrocal
D Lobo*
Affiliation:
Department of Otolaryngology, Hospital Universitario El Escorial, Universidad Francisco de Vitoria, Madrid, Spain
M Tuñón
Affiliation:
Department of Radiology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Spain
I Villarreal
Affiliation:
Department of Otolaryngology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Spain
B Brea
Affiliation:
Department of Radiology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Spain
J R García-Berrocal
Affiliation:
Department of Otolaryngology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Spain
*
Address for correspondence: Dr D Lobo, Department of Otolaryngology, Hospital Universitario Marqués de Valdecilla, Avenida Valdecilla 25, Santander 39008, Spain E-mail: dlobo28@gmail.com
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Abstract

Objective

To evaluate the presence of endolymphatic hydrops in patients with immune-mediated inner-ear disease.

Methods

The presence of endolymphatic hydrops was prospectively evaluated in 17 patients clinically diagnosed with secondary (n = 5) or primary (n = 12) immune-mediated inner-ear disease, who attended the ENT department of a tertiary care centre for evaluation or treatment over the previous year. All patients underwent magnetic resonance imaging of the temporal bone.

Results

Intratympanic gadolinium three-dimensional magnetic resonance imaging diagnosed hydrops in 11 of 12 patients with primary immune-mediated inner-ear disease (92 per cent). Of these, seven patients (64 per cent) presented only cochlear (n = 5) or predominantly cochlear (n = 2) hydrops. A positive magnetic resonance imaging result was observed in only one of five patients with secondary immune-mediated inner-ear disease (20 per cent).

Conclusion

This study confirms the presence of endolymphatic hydrops in immune-mediated inner-ear disease patients. The virtual absence of hydrops in patients with secondary immune-mediated inner-ear disease is remarkable, although firm conclusions cannot be drawn; this should be explored in a multicentre study with a larger sample of patients. A different immune reaction without development of endolymphatic hydrops should not be ruled out in secondary immune-mediated inner-ear disease patients.

Keywords

AutoimmunityEar, InnerEndolymphatic HydropsHearing Loss, SensorineuralMagnetic Resonance Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 6 , June 2018 , pp. 554 - 559
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr D Lobo takes responsibility for the integrity of the content of the paper

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