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Karch-Georges A, Veillon F, Vuong H, Rohmer D, Karol A, Charpiot A, Meyer N, Venkatasamy A. MRI of endolymphatic hydrops in patients with vestibular schwannomas: a case-controlled study using non-enhanced T2-weighted images at 3 Teslas. Eur Arch Otorhinolaryngol 2019; 276:1591-1599. [PMID: 30919061 DOI: 10.1007/s00405-019-05395-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 03/17/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Vestibular schwannomas (VS) may present with similar symptoms endolymphatic hydrops. Association between hydrops and internal auditory canal VS has been described by Naganawa et al. (Neuroradiology 53:1009-1015, 2011), but has never been confirmed since. The aim of this work was to study the prevalence of a saccular dilation on a T2-weighted sequence at 3 T MRI in VS compared to a control group. MATERIALS AND METHODS All patients presenting with typical VS between May 2009 and July 2018 were included (n = 183) and compared to a control group (n = 53). All underwent a high-resolution T2-weighted 3D sequence (FIESTA-C). The height and width of the saccule were measured on a coronal plane by two radiologists. RESULTS The saccule was dilated on the side of the schwannoma in 28% of the cases (p = 2.81 × 10- 5), with 15.7% of bilateral dilation. Saccular dilation was correlated to sensorineural hearing loss (OR 3.26, p = 0.02). There was also a significant correlation between saccular hydrops on the normal contralateral side of patients with VS and vertigo (p = 0.049), and between saccular hydrops on the side of the tumour and tinnitus (p = 0.006). CONCLUSION A third (29%) of VS are associated with a saccular dilation on the side of the tumour, which is an MR sign of endolymphatic hydrops (bilateral in 15.7% of the cases) and it appears related to sensorineural hearing loss and tinnitus, as well as vertigo if a contralateral dilation is present. This opens new therapeutic potentialities with the use of anti-vertiginous drugs, which could have a beneficial effect on the clinical symptoms.
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Affiliation(s)
- Aurélie Karch-Georges
- Service de Radiologie 1, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 avenue Molière, 67098, Strasbourg CEDEX, France
| | - Francis Veillon
- Service de Radiologie 1, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 avenue Molière, 67098, Strasbourg CEDEX, France
| | - Hella Vuong
- Service de chirurgie ORL, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg CEDEX, France
| | - Dominique Rohmer
- Service de chirurgie ORL, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg CEDEX, France
| | - Anne Karol
- Service de Radiologie 1, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 avenue Molière, 67098, Strasbourg CEDEX, France
| | - Anne Charpiot
- Service de chirurgie ORL, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg CEDEX, France
| | - Nicolas Meyer
- Département de Statistiques, Hôpitaux Universitaires de Strasbourg, 1 place de L'hôpital, 67000, Strasbourg, France
| | - Aina Venkatasamy
- Service de Radiologie 1, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 avenue Molière, 67098, Strasbourg CEDEX, France. .,Laboratory Stress Response and Innovative Therapies "Streinth", Université de Strasbourg, Inserm IRFAC UMR_S1113, Strasbourg, France.
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