Abstract
Objective: To illustrate the merit of hydrops imaging during clinical workup of dizziness and balance disorders.Background: Ever since the first description of in-vivo endolymphatic hydrops imaging in 2007, this diagnostic tool has been implemented in an increasing number of centers. The more experience in its clinical application is gathered, the more it is possible to critically assess its potential value for the diagnostic workup. This article intends to provide information about the experience of handling and utilization of endolymphatic hydrops imaging in one of the first centers in Austria.Methods: Retrospective analysis and review of clinical cases.Results: Based on our experience of endolymphatic hydrops imaging (EHI), which was established in cooperation between our departments of radiology and otorhinolaryngology in 2017, we have exclusively used intratympanic application of a contrast agent prior to magnetic resonance imaging, as this approach provides high quality imaging results. In 42.6% of cases, EHI could lead to the diagnosis of MD or HED. Since precise vestibular examination is still necessary, EHI is not a tool to replace the clinical examination but rather to add significantly to the interpretation of the results.Conclusion: Endolymphatic hydrops imaging represents a valuable, safe and well-applicable tool for evaluating cases with inconclusive clinical results. However, its potential additional diagnostic benefits rely on a correct indication based on prior thorough vestibular investigations.
Highlights
The diagnostic work-up of recurrent vestibular disorders still represents a challenging task, due to their variable clinical presentation or inconsistent diacritic results
The selection of patients for hydrops imaging at our center is based on the following criteria and preconditions: Potential candidates are adult patients, presenting with typical symptoms, suspicious for Hydropic Ear Disease” (HED), according to the 1995 AAO-HNS Guidelines and the Equilibrium Committee Amendment [7, 8]
Endolymphatic hydrops imaging is a valuable method for the diagnostic workup in patients with recurring vestibular and auditory symptoms as described in Menière’s disease (MD), but inconclusive clinical examination results
Summary
The diagnostic work-up of recurrent vestibular disorders still represents a challenging task, due to their variable clinical presentation or inconsistent diacritic results. Hydrops Imaging for Diagnostic Work-Up. in several cases symptoms do not present themselves in a way such that a satisfactory conclusion is possible. Endolymphatic hydrops represents the anatomical correlate of a multifaceted clinical picture and provides a common ground for different perspectives on the actual cause and pathophysiology in the context of MD and diseases of the human labyrinth. Ever since the first description of in-vivo endolymphatic hydrops imaging in 2007, this diagnostic tool has been implemented in an increasing number of centers.
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