Visualization of endolymphatic hydrops in patients with Meniere's disease
Visualization of endolymphatic hydrops in patients with Meniere's disease
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DOI：
10.1097/mlg.0b013e31802c300c
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发表时间：
2007-03-01
期刊：
影响因子：
2.6
通讯作者：
Ishida, Ieda Maria
中科院分区：
文献类型：
--
作者：
Nakashima, Tsutomu;Naganawa, Shinji;Ishida, Ieda Maria
Objective.近年来，有许多关于庆大霉素鼓室内注射治疗难治性梅尼埃病的报道。类固醇的鼓室内给药也被用于治疗突发性感音神经性听力损失。我们试图可视化鼓室内给药药物如何进入内耳。方法.用23 G针经鼓膜向9例内耳疾病患者鼓室内注射用生理盐水稀释8倍的水合钆。使用3 T磁共振成像（MRI）装置，进行三维液体衰减反转恢复（3D-FLAIR）成像。结果3D-FLAIR MRI清晰显示钆进入外淋巴间隙，并勾画出内耳外淋巴间隙和内淋巴间隙。内淋巴积水患者，内淋巴周围的外淋巴间隙变小或消失。钆最先出现在耳蜗底回的鼓阶和前庭的外淋巴间隙。在鼓室内注射钆后一天，几乎在外淋巴液的所有部分都观察到钆。鼓室内注射后6天，钆。几乎从内耳消失了。结论我们报告第一次可视化内淋巴积水的梅尼埃病患者。在不久的将来，内淋巴空间的图像和功能测试，如耳蜗电图和前庭诱发肌源性电位之间的关系，必须检查。研究药物如何进入和离开内耳，对内耳疾病鼓室内药物治疗的发展具有重要意义。
Objective. Recently, there have been many reports of intratympanic gentamicin therapy for the treatment of intractable Meniere's disease. Intratympanic administration of steroids has also been used to treat sudden sensorineural hearing loss. We attempted to visualize how the intratympanically administered drug enters the inner ear. Methods. Gadolinium hydrate diluted eightfold with saline was injected intratympanically through the tympanic membrane using a 23 G needle in nine patients with inner ear diseases. With a 3 Tesla magnetic resonance imaging (MRI) unit, three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) imaging was performed. Results. 3D-FLAIR MRI clearly revealed that the gadolinium entered the perilymphatic space and delineated the perilymphatic and endolymphatic spaces of the inner ear. In patients with endolymphatic hydrops, the perilymphatic space surrounding the endolymph was small or had disappeared. Gadolinium appeared first in the scala tympani of the basal turn of the cochlea and the perilymphatic space of the vestibule. One day after the intratympanic injection of gadolinium, the gadolinium was observed in almost all parts of the perilymph. Six days after the intratympanic injection, the gadolinium. had almost disappeared from the inner ear. Conclusion. 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.