Non-invasive visualization of endolymphatic hydrops in patients with Meniere's disease / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To visualize the endolymph in Meniere's disease by applying for non-invasive intratympanic gadolinium through eustachian tube and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI).</p><p><b>METHODS</b>With a 3 Tesla magnetic resonance imaging (MRI) unit, 3D-FLAIR imaging was performed 24 h after intratympanic gadolinium through eustachian tube in seven patients with Meniere's disease. Pure tone test was performed 24 h before and after administered gadolinium. Tympanometry was performed 24 h before, 24 h and 3 months after administered gadolinium.</p><p><b>RESULTS</b>In five patients, the gadolinium could appear in parts of the perilymph inside the inner ear but not in the middle ear and mastoid, moreover, the border between the perilymph and endolymph was visible so that endolymphatic space was clearly shown on 3D-FLAIR imaging. In two patients with endolymphatic hydrops, the perilymphatic space surrounding endolymph was small or disappeared. In two patients, the gadolinium could appear in parts of the middle ear and mastoid but not in the inner ear. No significant changes in pure tone test and tympanometry were noted.</p><p><b>CONCLUSIONS</b>3D-FLAIR MRI with intratympanic gadolinium through eustachian tube could clearly reveal the visualization of endolymphatic space in Meniere's disease.</p>

Hidrops laberintico con hidrocefalia comunicante: a propósito de un caso / Labyrinthine hydrops with communicates hydrocephalies: purpose of a case

El Hidrops Laberíntico se define como la dilatación de las membranas laberínticas asociadas a un incremento de los líquidos endolaberínticos. Clínicamente se manifiesta por Vértigo, Acúfenos, Plenitud Otica e Hipoacusia. Su etiología es desconocida; sin embargo, la obstrucción del conducto endolinfático y los trastornos de la microhomeostasis de los líquidos del oído interno se han considerado factores patogénicos responsables. Se presenta el caso de una paciente femenina de 28 años de edad con crisis de vértigo rotatorio, posicional, de 3 meses de evolución concomitante con nauseas, tinitus bilateral, plenitud ótica y cefalea persistente. Se practica estudio Otoneurológico Integral que revela: Irritabilidad laberíntica bilateral y RMN Cerebral: Hidrocefalia global comunicante. Se interviene quirúrgicamente para derivación Ventriculo Peritoneal, obteniéndose resolución satisfactoria de la Hidrodefalia y desaparición franca de la sintomatología Cocleo Vestibular.

Management of stapes gusher presentation of 5 cases

The etiology of stapes gusher is discussed. Suspecting this potentially fatal condition should be taken in consideration in young adults with signs of congenital anomalies in the external or middle ear. How to detect it by polytomes is mentioned. The management of this serious condition is discussed, and differs according to its severity and its occurrence during the different steps of stapedectomy. Variable methods of management are discussed to choose the suitable one according to circumstances especially when one method fails to stop the CSF gusher