Albane Ray1,2, Charlotte Hautefort3, Jean-Pierre Guichard1, Julien Horion1,2, Philippe Herman3, Romain Kania3, Emmanuel Houdart1, Benjamin Verillaud3, Hélène Vitaux3, Arnaud Attyé1,4, Michael Eliezer5. 1. Department of Neuroradiology, Neuroradiology Unit, Lariboisière University Hospital, 75010, Paris, France. 2. Department of Radiology, Rouen University Hospital, Rouen, France. 3. Department of Head and Neck Surgery, Lariboisière University Hospital, Paris, France. 4. Department of Neuroradiology and MRI, Grenoble Alps University Hospital-SFR RMN Neurosciences, Grenoble, France. 5. Department of Neuroradiology, Neuroradiology Unit, Lariboisière University Hospital, 75010, Paris, France. michael.eliezer@aphp.fr.
Abstract
PURPOSE: Patients with superior semicircular canal dehiscence syndrome, which can only be treated by surgery, present cochleo-vestibular symptoms related to a third-mobile window but also endolymphatic hydrops. Since cVEMP and oVEMP are disturbed by the presence of the dehiscence, the aim of the study is to assess the value of MRI for the diagnosis of endolymphatic hydrops in patients with superior semicircular canal dehiscence syndrome in comparison with cVEMP and oVEMP. METHODS: In this retrospective cohort study we enrolled 33 ears in 24 patients with superior semicircular dehiscence syndrome who underwent a 4-h delayed intravenous Gd-enhanced 3D-FLAIR MRI and pure tone audiometry, cVEMP and oVEMP. For each patient MRI images were evaluated by two radiologists who used a compartmental endolymphatic hydrops grading system in comparison with cVEMP and oVEMP. RESULTS: Endolymphatic hydrops was found on MRI in 9 out of 33 SCDS ears (27.3%). We found no significant correlation between the presence of endolymphatic hydrops on MRI and cVEMP and oVEMP (p = 0.36 and p = 0.7, respectively). However, there was a significant correlation between the presence of endolymphatic hydrops on MRI and the degree of sensorineural hearing loss, Air Conduction-Pure Tone Average level (p = 0.012) and Bone Conduction-Pure Tone Average level (p = 0.09), respectively. CONCLUSION: We demonstrated that EH might be observed in 27.3% of superior semicircular dehiscence syndrome ears. The role of inner ear MRI is important to detect endolymphatic hydrops, since cVEMP and oVEMP are disturbed by the presence of the dehiscence, because these patients could benefit from a medical treatment. LEVEL OF EVIDENCE: Level 3.
PURPOSE:Patients with superior semicircular canal dehiscence syndrome, which can only be treated by surgery, present cochleo-vestibular symptoms related to a third-mobile window but also endolymphatic hydrops. Since cVEMP and oVEMP are disturbed by the presence of the dehiscence, the aim of the study is to assess the value of MRI for the diagnosis of endolymphatic hydrops in patients with superior semicircular canal dehiscence syndrome in comparison with cVEMP and oVEMP. METHODS: In this retrospective cohort study we enrolled 33 ears in 24 patients with superior semicircular dehiscence syndrome who underwent a 4-h delayed intravenous Gd-enhanced 3D-FLAIR MRI and pure tone audiometry, cVEMP and oVEMP. For each patient MRI images were evaluated by two radiologists who used a compartmental endolymphatic hydrops grading system in comparison with cVEMP and oVEMP. RESULTS: Endolymphatic hydrops was found on MRI in 9 out of 33 SCDS ears (27.3%). We found no significant correlation between the presence of endolymphatic hydrops on MRI and cVEMP and oVEMP (p = 0.36 and p = 0.7, respectively). However, there was a significant correlation between the presence of endolymphatic hydrops on MRI and the degree of sensorineural hearing loss, Air Conduction-Pure Tone Average level (p = 0.012) and Bone Conduction-Pure Tone Average level (p = 0.09), respectively. CONCLUSION: We demonstrated that EH might be observed in 27.3% of superior semicircular dehiscence syndrome ears. The role of inner ear MRI is important to detect endolymphatic hydrops, since cVEMP and oVEMP are disturbed by the presence of the dehiscence, because these patients could benefit from a medical treatment. LEVEL OF EVIDENCE: Level 3.
Entities:
Keywords:
Cervical vestibular evoked myogenic potentials (cVEMP); Endolymphatic hydrops (EH); Magnetic resonance imaging (MRI); Minor syndrome; Ocular vestibular evoked myogenic potentials (oVEMP); Superior semicircular canal dehiscence (SCDS)
Authors: Michael Eliezer; Charles Maquet; Julien Horion; André Gillibert; Michel Toupet; Benoit Bolognini; Nicolas Magne; Laureline Kahn; Charlotte Hautefort; Arnaud Attyé Journal: Eur Radiol Date: 2018-11-09 Impact factor: 5.315
Authors: M Eliezer; G Poillon; A Gillibert; J Horion; Y Cruypeninck; E Gerardin; N Magne; A Attyé Journal: Diagn Interv Imaging Date: 2018-02-15 Impact factor: 4.026
Authors: Michael Johanis; Russell De Jong; Tyler Miao; Leslie Hwang; Meachelle Lum; Taranjit Kaur; Shelby Willis; John J Arsenault; Courtney Duong; Isaac Yang; Quinton Gopen Journal: Int J Surg Case Rep Date: 2020-12-26