Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment

Research Objective: To investigate the correlation between clinical features and MRI-confirmed endolymphatic hydrops (EH) and blood-labyrinth barrier (BLB) impairment.Study Design: Retrospective cross-sectional study.Setting: Vertigo referral center (Haga Teaching Hospital, The Hague, the Netherland...

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Autores principales:	Lisa M. H. de Pont, Josephine M. van Steekelenburg, Thijs O. Verhagen, Maartje Houben, Jelle J. Goeman, Berit M. Verbist, Mark A. van Buchem, Claire C. Bommeljé, Henk M. Blom, Sebastiaan Hammer
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	endolymphatic hydrops blood-labyrinth barrier magnetic resonance imaging clinical features audiovestibular function Surgery RD1-811
Acceso en línea:	https://doaj.org/article/410a2bf8b4be478f8c9cef47f5e44fdb
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spelling	oai:doaj.org-article:410a2bf8b4be478f8c9cef47f5e44fdb2021-11-04T04:50:36ZHydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment2296-875X10.3389/fsurg.2021.758947https://doaj.org/article/410a2bf8b4be478f8c9cef47f5e44fdb2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.758947/fullhttps://doaj.org/toc/2296-875XResearch Objective: To investigate the correlation between clinical features and MRI-confirmed endolymphatic hydrops (EH) and blood-labyrinth barrier (BLB) impairment.Study Design: Retrospective cross-sectional study.Setting: Vertigo referral center (Haga Teaching Hospital, The Hague, the Netherlands).Methods: We retrospectively analyzed all patients that underwent 4 h-delayed Gd-enhanced 3D FLAIR MRI at our institution from February 2017 to March 2019. Perilymphatic enhancement and the degree of cochlear and vestibular hydrops were assessed. The signal intensity ratio (SIR) was calculated by region of interest analysis. Correlations between MRI findings and clinical features were evaluated.Results: Two hundred and fifteen patients with MRI-proven endolymphatic hydrops (EH) were included (179 unilateral, 36 bilateral) with a mean age of 55.9 yrs and median disease duration of 4.3 yrs. Hydrops grade is significantly correlated with disease duration (P < 0.001), the severity of low- and high-frequency hearing loss (both P < 0.001), and the incidence of drop attacks (P = 0.001). Visually increased perilymphatic enhancement was present in 157 (87.7%) subjects with unilateral EH. SIR increases in correlation with hydrops grade (P < 0.001), but is not significantly correlated with the low or high Fletcher index (P = 0.344 and P = 0.178 respectively). No significant differences were found between the degree of EH or BLB impairment and vertigo, tinnitus or aural fullness.Conclusion: The degree of EH positively correlates with disease duration, hearing loss and the incidence of drop attacks. The BLB is impaired in association with EH grade, but without clear contribution to the severity of audiovestibular symptoms.Lisa M. H. de PontLisa M. H. de PontJosephine M. van SteekelenburgThijs O. VerhagenThijs O. VerhagenThijs O. VerhagenMaartje HoubenMaartje HoubenJelle J. GoemanBerit M. VerbistMark A. van BuchemClaire C. BommeljéHenk M. BlomHenk M. BlomHenk M. BlomSebastiaan HammerFrontiers Media S.A.articleendolymphatic hydropsblood-labyrinth barriermagnetic resonance imagingclinical featuresaudiovestibular functionSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	endolymphatic hydrops blood-labyrinth barrier magnetic resonance imaging clinical features audiovestibular function Surgery RD1-811
spellingShingle	endolymphatic hydrops blood-labyrinth barrier magnetic resonance imaging clinical features audiovestibular function Surgery RD1-811 Lisa M. H. de Pont Lisa M. H. de Pont Josephine M. van Steekelenburg Thijs O. Verhagen Thijs O. Verhagen Thijs O. Verhagen Maartje Houben Maartje Houben Jelle J. Goeman Berit M. Verbist Mark A. van Buchem Claire C. Bommeljé Henk M. Blom Henk M. Blom Henk M. Blom Sebastiaan Hammer Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment
description	Research Objective: To investigate the correlation between clinical features and MRI-confirmed endolymphatic hydrops (EH) and blood-labyrinth barrier (BLB) impairment.Study Design: Retrospective cross-sectional study.Setting: Vertigo referral center (Haga Teaching Hospital, The Hague, the Netherlands).Methods: We retrospectively analyzed all patients that underwent 4 h-delayed Gd-enhanced 3D FLAIR MRI at our institution from February 2017 to March 2019. Perilymphatic enhancement and the degree of cochlear and vestibular hydrops were assessed. The signal intensity ratio (SIR) was calculated by region of interest analysis. Correlations between MRI findings and clinical features were evaluated.Results: Two hundred and fifteen patients with MRI-proven endolymphatic hydrops (EH) were included (179 unilateral, 36 bilateral) with a mean age of 55.9 yrs and median disease duration of 4.3 yrs. Hydrops grade is significantly correlated with disease duration (P < 0.001), the severity of low- and high-frequency hearing loss (both P < 0.001), and the incidence of drop attacks (P = 0.001). Visually increased perilymphatic enhancement was present in 157 (87.7%) subjects with unilateral EH. SIR increases in correlation with hydrops grade (P < 0.001), but is not significantly correlated with the low or high Fletcher index (P = 0.344 and P = 0.178 respectively). No significant differences were found between the degree of EH or BLB impairment and vertigo, tinnitus or aural fullness.Conclusion: The degree of EH positively correlates with disease duration, hearing loss and the incidence of drop attacks. The BLB is impaired in association with EH grade, but without clear contribution to the severity of audiovestibular symptoms.
format	article
author	Lisa M. H. de Pont Lisa M. H. de Pont Josephine M. van Steekelenburg Thijs O. Verhagen Thijs O. Verhagen Thijs O. Verhagen Maartje Houben Maartje Houben Jelle J. Goeman Berit M. Verbist Mark A. van Buchem Claire C. Bommeljé Henk M. Blom Henk M. Blom Henk M. Blom Sebastiaan Hammer
author_facet	Lisa M. H. de Pont Lisa M. H. de Pont Josephine M. van Steekelenburg Thijs O. Verhagen Thijs O. Verhagen Thijs O. Verhagen Maartje Houben Maartje Houben Jelle J. Goeman Berit M. Verbist Mark A. van Buchem Claire C. Bommeljé Henk M. Blom Henk M. Blom Henk M. Blom Sebastiaan Hammer
author_sort	Lisa M. H. de Pont
title	Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment
title_short	Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment
title_full	Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment
title_fullStr	Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment
title_full_unstemmed	Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment
title_sort	hydropic ear disease: correlation between audiovestibular symptoms, endolymphatic hydrops and blood-labyrinth barrier impairment
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/410a2bf8b4be478f8c9cef47f5e44fdb
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Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment

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