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MRI of endolymphatic hydrops in patients with vestibular schwannomas: a case-controlled study using non-enhanced T2-weighted images at 3 Teslas

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

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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Authors and Affiliations

  1. Service de Radiologie 1, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 avenue Molière, 67098, Strasbourg CEDEX, France

    Aurélie Karch-Georges, Francis Veillon, Anne Karol & Aina Venkatasamy

  2. Service de chirurgie ORL, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg CEDEX, France

    Hella Vuong, Dominique Rohmer & Anne Charpiot

  3. Département de Statistiques, Hôpitaux Universitaires de Strasbourg, 1 place de L’hôpital, 67000, Strasbourg, France

    Nicolas Meyer

  4. Laboratory Stress Response and Innovative Therapies “Streinth”, Université de Strasbourg, Inserm IRFAC UMR_S1113, Strasbourg, France

    Aina Venkatasamy

Authors
  1. Aurélie Karch-Georges
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  2. Francis Veillon
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  3. Hella Vuong
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Correspondence to Aina Venkatasamy.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Karch-Georges, A., Veillon, F., Vuong, H. et al. 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 276, 1591–1599 (2019). https://doi.org/10.1007/s00405-019-05395-8

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  • DOI: https://doi.org/10.1007/s00405-019-05395-8

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