Gadolinium angiography of inner ear in patients with sudden deafness and its clinical analysis / 中华耳鼻咽喉头颈外科杂志

Objective: To observe the gadolinium imaging findings of inner ear in patients with sudden deafness and to analyze its clinical features. Methods: From November 2017 to July 2020, 21 patients with sudden deafness in the People's Hospital of Dongsheng District, Ordos City were selected as the research objects, including 14 males and 7 females, aged 36-76 years, with a median age of 50 years. The course of disease was 1-19 days, with an average of 5.5 days. The patients received audiology tests, laboratory examination, and intravenous gadolinium angiography, each of whom was scanned twice by 3D-FLAIR sequence: once before intravenous gadolinium injection, and once again 4.5-6.0 h after intravenous gadolinium injection. The following corresponding clinical treatment was given. The imaging manifestations and clinical features were observed. Results: Among 21 cases of sudden deafness in acute stage, the signal intensity of 11 cases was significantly higher than that of the contralateral ear, and 2 cases had vestibular labyrinthine hydrops. In laboratory examination, only 2 cases of total deafness had increased WBC count and faster erythrocyte sedimentation rate, and the rest had no abnormality. The hearing types of 21 patients with sudden deafness were: total deafness in 8 cases, flat decline in 10 cases, low frequency decline in 1 case, high frequency decline in 2 cases. The total effective rate was 57% (12/21). The hearing types of 11 patients with abnormal gadolinium angiography were total deafness in 5 cases, flat decline in 5 cases and high frequency decline in 1 case. The total effective rate was 64% (7/11). Conclusion: Gadolinium angiography is abnormal in some patients with sudden deafness, and the permeability of blood labyrinth barrier may be increased, which is worthy of further study.

3D-FLAIR MRI findings in idiopathic sudden sensorineural hearing loss and the correlations with clinical features and prognosis / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the correlations of different appearances of labyrinthine 3D-FLAIR MRI with clinical features and prognosis in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Methods: Clinical data of patients with unilateral ISSNHL hospitalized from May 2017 to January 2019 were retrospectively analyzed. According to the results of 3D-FLAIR MRI, the patients were divided into three groups including hyperintense with absorption, hyperintense without absorption and normal. The differences and correlations among the three groups in clinical characteristics (gender, age, deafness side, duration, treatment days, dizziness/vertigo, basic diseases, vestibular function, deafness classification and typing) and prognosis were analyzed by SPSS 20.0 software. Results: Data were collected from 1 245 cases, including 739 (59.36%) with normal signal, 288 (23.13%) hyperintense without absorption, and 218 (17.51%) hyperintense with absorption. The side ratio, treatment days, dizziness/vertigo incidence, vestibular dysfunction, deafness classification and typing were different among the three groups (P<0.001). The incidence of right side was significantly higher in both the hyperintense with and without absorption groups than that in the normal. The vestibular dysfunction was more common in the hyperintense with absorption group than in the normal and hyperintense without absorption groups. It showed statistical differences in the dizziness/vertigo incidence, deafness classification, treatment days, and deafness typing compared between groups, which was the most significant in the hyperintense with absorption group, followed by the hyperintense without absorption group. There was no statistical difference in the total effective rate among the three groups (P=0.139), whereas a significant difference in the recovery rate (P<0.001). The prognosis was significantly correlated with duration, age, treatment days and dizziness/vertigo in the normal group (all P<0.001), correlated with duration and treatment days in the hyperintense with absorption group (both P<0.001), only correlated with the duration in the hyperintense without absorption group (P<0.001). Conclusion: 3D-FLAIR MRI manifestation is closely related to the clinical features and efficacy of ISSNHL. It is helpful to clarify the pathology of inner ear, which is expected to be a new imaging indicator for disease evaluation.