Change in endolymphatic hydrops 2 years after endolymphatic sac surgery evaluated by MRI

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  • Higashi-Shingai Kayoko
    Department of Otolaryngology, Yao Municipal Hospital
  • Imai Takao
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Okumura Tomoko
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Uno Atsuhiko
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka General Medical Center
  • Kitahara Tadashi
    Department of Otorhinolaryngology-Head and Neck Surgery, Nara Medical University
  • Horii Arata
    Department of Otorhinolaryngology-Head and Neck Surgery, Niigata University Graduate School of Medicine and Dentistry
  • Ohta Yumi
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Osaki Yasuhiro
    Department of Otolaryngology, Kinki University Faculty of Medicine
  • Sato Takashi
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Okazaki Suzuyo
    Department of Otolaryngology, Osaka City General Hospital
  • Kamakura Takefumi
    Department of Otorhinolaryngology, Otemae Hospital
  • Takimoto Yasumitsu
    Department of Otolaryngology, Osaka Police Hospital
  • Ozono Yoshiyuki
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Watanabe Yoshiyuki
    Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine
  • Imai Ryusuke
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Hanada Yukiko
    Department of Otolaryngology, National Hospital Organization Osaka National Hospital
  • Ohata Kazuya
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Oya Ryohei
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Inohara Hidenori
    Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine

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Other Title
  • MRI で評価した内リンパ嚢開放術後2年の内リンパ水腫の変化について

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This study was performed to determine whether endolymphatic sac surgery improves vestibular and cochlear endolymphatic hydrops 2 years after sac surgery and to elucidate the relationship between the degree of improvement of endolymphatic hydrops and the changes in vertigo symptoms, the hearing level, and the summating potential/action potential ratio (-SP/AP ratio) by electrocochleography (ECochG) in patients with Ménière's disease (MD).Twenty-one patients with unilateral MD who underwent sac surgery were included in this study. All patients underwent gadolinium-enhanced magnetic resonance imaging (Gd-MRI) before and 2 years after sac surgery. We evaluated the difference in vestibular and cochlear endolymphatic hydrops between before and after surgery in both ears and compared these findings with the frequency of vertigo attacks, hearing level, and ECochG findings.In affected ears, the presence of vestibular endolymphatic hydrops and the frequency of vertigo attacks significantly decreased after surgery. However, affected ears showed no significant improvement in the presence of cochlear endolymphatic hydrops or the -SP/AP ratio by ECochG; there was also no significant improvement or deterioration in the hearing level.The present findings suggest that sac surgery reduces vestibular endolymphatic hydrops and prevents aggravation of cochlear endolymphatic hydrops, and these changes lead to a reduction of vertigo attacks and suppress the progression of hearing impairment associated with vertigo attacks.

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