Abstract
Objective: Endolymphatic sac surgery is effective in treating intractable Meniere's disease (MD), but the underlying mechanism is still unknown. Our study investigated the mechanism by which endolymphatic sac-mastoid shunt (EMS) surgery is effective in treating MD by means of imaging.Methods: The experiment included 19 patients with intractable MD who underwent 3D-fluid-attenuated inversion recovery (FLAIR) MRI with a 3-Tesla unit 6 h after intravenous administration of gadolinium, before EMS, and 2 years after the surgery. The enhanced perilymphatic space in the bilateral cochlea, vestibule, and canals was visualized and compared with that in the endolymphatic space by quantitatively scoring the scala vestibuli of the cochlea and by measuring the developing area of the vestibules quantitatively.Results: Gadolinium was present in the perilymph of the inner ear in the cochlea, vestibules, and canals of all patients. At the 2-year follow-up, 14 (73.68%) patients had vertigo control. Both before and 2 years after surgery, significant differences were observed in the scala vestibuli scores and the area of vestibular perilymph between the affected and healthy sides. The scala vestibuli scores and the area of vestibular perilymph, however, did not differ when comparing them before and after surgery.Conclusions: According to our results, endolymphatic hydrops was not significantly reduced by surgery. The mechanism by which EMS controls vertigo might be unrelated to the improvement in hydrops.
Highlights
Endolymphatic hydrops was definitively diagnosed only by histopathological examination after death until Gadolinium (Gd)-enhanced inner ear MRI was introduced
The scala vestibuli score on the affected side was 0.57 ± 0.52, and
The endolymphatic sac was exposed, and the drainage tube was embedded in the cavity of Meniere’s disease (MD) is a complicated inner ear disease, and endolymphatic hydrops is thought to be the pathological basis for this condition
Summary
Endolymphatic hydrops was definitively diagnosed only by histopathological examination after death until Gadolinium (Gd)-enhanced inner ear MRI was introduced. A 3-T MRI scan showed the first distinct images of endolymphatic hydrops in a patient with Meniere’s disease (MD) in 2007 [1]. Imaging Analysis of Meniere’s Disease After Surgery on the symptomatic side, and an elevated percentage in the asymptomatic ear. Fukuoka used 3D-fluidattenuated inversion recovery (FLAIR) MRI following bilateral intratympanic Gd to semi-quantitatively evaluate endolymphatic hydrops in patients with MD [7]. The mechanism of EMS for this disease remains unclear. By comparing the imaging results before and after EMS surgery, we aimed to investigate the mechanism by which it is effective in vertigo control. Some scholars have studied the mechanism of sac surgery by imaging, the results varied and the mechanism remained unclear
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