Acta Oto-Laryngologica 2009-11-01

Endolymphatic hydrops and therapeutic effects are visualized in 'atypical' Meniere's disease.

Maiko Miyagawa, Hisakuni Fukuoka, Keita Tsukada, Tomohiro Oguchi, Yutaka Takumi, Makoto Sugiura, Hitoshi Ueda, Masumi Kadoya, Shin-ichi Usami

Index: Acta Otolaryngol. 129(11) , 1326-9, (2009)

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Abstract

A 53-year-old male with fluctuating low frequency sensorineural hearing loss and tinnitus, but without vertigo, was evaluated by MRI obtained by intratympanic injection of a gadolinium-based contrast agent (GBCA) before and after the administration of isosorbide. The endolymphatic hydrops was semi-quantitatively evaluated by a 3.0-T MR scanner. For quantification, the affected side/contralateral side ratios were calculated. A gadodiamide (a kind of GBCA)-enhanced space surrounding the endolymph in the affected side with a 0.50 ratio (which may have represented endolymphatic hydrops) improved after isosorbide therapy to a 0.98 ratio. Thus, endolymphatic hydrops was demonstrated in a patient with 'atypical' Meniere's disease (MD), suggesting that at least some atypical MD may share similar etiology with, and therefore be a continuum of, MD. Also, therapeutic effects could be visualized by using MRI. Therefore, MRI-based diagnosis of MD-related disease will be a powerful tool not only because of its precision but also its usefulness for therapeutic evaluation.