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

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

Abstract

Objective

Like other vestibular schwannomas developing in the internal auditory canal, intralabyrinthine schwannomas (ILS) may present with similar symptoms as in endolymphatic hydrops. Two different studies have described MR saccular hydrops in ~ 30% of internal auditory canal vestibular schwannomas, but this association has never been studied in ILS before. The aim of this work is to study the prevalence of a saccular dilation in ILS, on a T2-weigthed sequence at 3 T, compared to a control group.

Material and methods

All patients presenting with typical ILS between January 2008 and October 2018 were included (n = 28, two patients with bilateral tumors) 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 47% of the cases (p = 0.0006 for the height, p = 0.0487 for the width). Bilateral saccular dilation was observed in 37% of the cases. There was a statistically significant correlation between the presence of a saccular hydrops and balance disorders (p = 0.02) as 50% of the patients with an intralabyrinthine schwannoma who presented with such symptoms had a saccular dilation.

Conclusion

Forty-seven percent of ILS are associated with homolateral saccular dilation, which is an MR sign of endolymphatic hydrops (bilateral in 37%) and it appears related to the presence of balance disorders. This opens new therapeutic potentialities with the possible use of anti-vertiginous drugs, which could have a beneficial effect on their clinical symptomatology.

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Authors and Affiliations

  1. Service de Radiologie 1, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67200, Strasbourg, France

    Aïna Venkatasamy, Pauline Bretz, Anne Karol, Aurélie Karch-Georges & Francis Veillon

  2. Service de Chirurgie ORL, Hôpitaux Universitaires de Strasbourg, Strasbourg, France

    Anne Charpiot

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

    Aïna Venkatasamy

Authors
  1. Aïna Venkatasamy
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  2. Pauline Bretz
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  4. Aurélie Karch-Georges
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  5. Anne Charpiot
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  6. Francis Veillon
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Correspondence to Aïna Venkatasamy.

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Venkatasamy, A., Bretz, P., Karol, A. et al. MRI of endolymphatic hydrops in patients with intralabyrinthine schwannomas: a case-controlled study using non-enhanced T2–weighted images at 3 T. Eur Arch Otorhinolaryngol 278, 1821–1827 (2021). https://doi.org/10.1007/s00405-020-06271-6

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  • DOI: https://doi.org/10.1007/s00405-020-06271-6

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