Abstract
Background
The aim of this study was to compare the clinical history and audiovestibular function test results of patients suffering from intralabyrinthine schwannoma or delayed endolymphatic hydrops (DEH).
Patients and methods
Five patients diagnosed with intralabyrinthine schwannoma by magnetic resonance imaging (MRI) and five patients diagnosed with DEH by locally enhanced inner ear MRI (LEIM) were retrospectively studied.
Results
All patients with intralabyrinthine schwannoma or DEH initially presented with hearing loss. Vertigo occurred in two patients with intralabyrinthine schwannoma and in all patients with DEH. While audiometry achieved poorer results for patients with intralabyrinthine schwannomas, vestibular function tests revealed normal results in about half of the patients in both groups.
Conclusion
Patients with intralabyrinthine schwannomas may present with clinical symptoms similar to patients suffering from other inner ear disorders such as delayed endolymphatic hydrops and they may obtain similar findings in audiovestibular function tests. High-resolution magnetic resonance imaging with locally applied contrast agent may provide evidence of both underlying pathologies.
Zusammenfassung
Hintergrund
Ziel der Studie war es, die Krankengeschichte und die Befunde in audiovestibulären Funktionsuntersuchungen bei Patienten mit intralabyrinthärem Schwannom oder „delayed endolymphatic hydrops“ (DEH) zu vergleichen.
Patienten und Methoden
Retrospektiv wurden die Daten von 5 Patienten mit durch MR-Bildgebung diagnostiziertem intralabyrinthärem Schwannom und von 5 Patienten mit durch lokal kontrastverstärkter MR-Bildgebung des Innenohrs (LEIM) bestätigtem DEH analysiert.
Ergebnisse
Alle Patienten mit intralabyrinthärem Schwannom oder DEH stellten sich anfangs mit Hörminderung vor. Schwindel trat bei 2 Patienten mit intralabyrinthärem Schwannom und allen Patienten mit DEH auf. Während die Audiometrie schlechtere Ergebnisse für Patienten mit intralabyrinthärem Schwannom ergab, zeigten vestibuläre Funktionsuntersuchungen Normalbefunde in etwa der Hälfte der Patienten beider Gruppen.
Schlussfolgerung
Patienten mit intralabyrinthärem Schwannom können sich mit ähnlichen Symptomen präsentieren wie Patienten mit anderen Innenohrerkrankungen wie DEH und können ähnliche Befunde in audiovestibulären Funktionsuntersuchungen haben. Hochauflösende MR-Bildgebung mit lokal appliziertem Kontrastmittel kann den Nachweis für beide zugrundeliegenden Pathologien erbringen.
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References
Bernstein M, Berger MS (2008) Neuro-Oncology. The essentials. Thieme, New York
Birzgalis AR, Ramsden RT, Curley JW (1991) Intralabyrinthine schwannoma. J Laryngol Otol 105:659–661
Fiorino F, Pizzini FB, Beltramello A, Barbieri F (2011) MRI performed after intratympanic gadolinium administration in patients with Ménière’s disease: correlation with symptoms and signs. Eur Arch Otorhinolaryngol 268(2):181–187
Green JD Jr, McKenzie JD (1999) Diagnosis and management of intralabyrinthine schwannomas. Laryngoscope 109:1626–1631
Gürkov R, Flatz W, Louza J, Strupp M, Krause E (2011) In vivo visualization of endolyphatic hydrops in patients with Meniere’s disease: correlation with audiovestibular function. Eur Arch Otorhinolaryngol 268:1743–1748
Gürkov R, Flatz W, Louza J, Strupp M, Ertl-Wagner B, Krause E (2012) In vivo visualized endolymphatic hydrops and inner ear functions in patients with electrocochleographically confirmed Ménière’s disease. Otol Neurotol 33:1040–1045
Jia H, Marzin A, Dubreuil C, Tringali S (2008) Intralabyrinthine schwannomas: symptoms and managements. Auris Nasus Larynx 35:131–136
Kamei T (2004) Delayed endolymphatic hydrops as a clinical entity. Int Tinnitus J 10:137–143
Kennedy RJ, Shelton C, Salzman KL, Davidson HC, Harnsberger HR (2004) Intralabyrinthine schwannomas: diagnosis, management, and a new classification system. Otol Neurotol 25:160–167
Montague ML, Kishore A, Hadley DM, O’Reilly BF (2002) MR findings in intralabyrinthine schwannomas. Clin Radiol 57:355–358
Nadol JB, Weiss AD, Parker SW (1975) Vertigo of delayed onset after sudden deafness. Ann Otol Rhinol Laryngol 84:841–846
Naganawa S, Nakashima T (2014) Visualization of endolymphatic hydrops with MR imaging in patients with Ménière’s disease and related pathologies: current status of its methods and clinical significance. Jpn J Radiol 32:191–204
Nakashima T, Naganawa S, Sugiura M et al (2007) Visualization of endolymphatic hydrops in patients with Meniere’s disease. Laryngoscope 117:415–420
Neff BA, Willcox TO Jr, Sataloff RT (2003) Intralabyrinthine schwannomas. Otol Neurotol 24:299–307
Rosahl S (2009) Acoustic neuroma: treatment or observation? Dtsch Arztebl Int 106:505–506
Salzman KL, Childs AM, Davidson HC, Kennedy RJ, Shelton C, Harnsberger HR (2012) Intralabyrinthine schwannomas: imaging diagnosis and classification. AJNR Am J Neuroradiol 33:104–109
Schuknecht HF (1976) Pathophysiology of endolymphatic hydrops. Arch Otorhinolaryngol 212:253–262
Schuknecht HF (1978) Delayed endolymphatic hydrops. Ann Otol Rhinol Laryngol 87:743–748
Schuknecht HF, Suzuka Y, Zimmermann C (1990) Delayed endolymphatic hydrops and its relationship to Meniere’s disease. Ann Otol Rhinol Laryngol 99:843–853
Seo YJ, Kim J, Choi JY, Lee WS (2013) Visualization of endolymphatic hydrops and correlation with audio-vestibular functional testing in patients with definite Meniere’s disease. Auris Nasus Larynx 40(2):167–172
Tieleman A, Casselman JW, Somers T, Delanote J, Kuhweide R, Ghekiere J, De Foer B, Offeciers EF (2008) Imaging of intralabyrinthine schwannomas: a retrospective study of 52 cases with emphasis on lesion growth. AJNR Am J Neuroradiol 29:898–905
Van Abel KM, Carlson ML, Link MJ, Neff BA, Beatty CW, Lohse CM, Eckel LJ, Lane JI, Driscoll CL (2013) Primary inner ear schwannomas: a case series and systematic review of the literature. Laryngoscope 123:1957–1966
Wolf JS, Mattox DE (1999) Imaging quiz case 2. Intralabyrinthine schwannoma. Arch Otolaryngol Head Neck Surg 125:107–109
Wolfson RJ, Leiberman A (1975) Unilateral deafness with subsequent vertigo. Laryngoscope 85:1762–1766
Wu Q, Dai C, Zhao M, Sha Y (2016) The correlation between symptoms of definite Meniere’s disease and endolymphatic hydrops visualized by magnetic resonance imaging. Laryngoscope 126(4):974–979
Zou J, Pyykkö I, Bjelke B, Dastidar P, Toppila E (2005) Communication between the perilymphatic scalae and spiral ligament visualized by in vivo MRI. Audiol Neurotol 10:145–152
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C. Jerin, E. Krause, B. Ertl-Wagner and R. Gürkov declare that they have no competing interests. This study was supported by the Federal German Ministry of Education and Research (grant No. 01EO0901).
The accompanying manuscript does not include studies on humans or animals perfomed by any of the authors. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.
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Jerin, C., Krause, E., Ertl-Wagner, B. et al. Clinical features of delayed endolymphatic hydrops and intralabyrinthine schwannoma. HNO 65 (Suppl 1), 41–45 (2017). https://doi.org/10.1007/s00106-016-0199-6
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DOI: https://doi.org/10.1007/s00106-016-0199-6
Keywords
- Vestibular schwannoma
- Sensorineural hearing loss
- Labyrinth
- Vertigo
- Tinnitus
- Delayed endolymphatic hydrops
- Intralabyrinthine schwannoma