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Electrophysiological and inner ear MRI findings in patients with bilateral vestibulopathy

  • Otology
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Abstract

Purpose

Bilateral vestibulopathy (BV) is an uncommon disorder and the etiology remained idiopathic in most cases. Delayed 3D-FLAIR sequences have provided new insights into various inner ear diseases, allowing the evaluation of the endolymphatic space and the permeability of the blood–labyrinthine barrier (BLB). The aim of this study was to assess both the morphology of the endolymphatic space and the permeability of the BLB in patients with BV as evaluated by delayed 3D-FLAIR sequences.

Methods

In this retrospective study, we performed 3D-FLAIR sequences 4 h after administering contrast media to 42 patients with BV. Two radiologists independently evaluated the morphology of the endolymphatic space (either vestibular atelectasis or endolymphatic hydrops) and the permeability of the BLB.

Results

Morphologic anomalies of the endolymphatic space and vestibular blood–labyrinthine barrier impairment were observed in 59.6% of patients with BV. Bilateral vestibular atelectasis (VA) was found in 21 patients (50%), involving only the utricle and all three ampullas while the saccule was always observed with no sign of collapse: idiopathic BV (n = 19), aminoglycoside administration (n = 1) and few days following abdominal surgery (n = 1). One patient had bilateral vestibular malformation. BLB impairment was observed in five patients (11.9%): paraneoplastic (n = 1), lymphoma (n = 1), autoimmune (n = 1), and vestibular “neuritis” (n = 2). Seventeen patients (40.4%) had normal MRI with no endolymphatic space anomaly or BLB impairment.

Conclusion

Patients with BV presented with morphologic anomalies of the endolymphatic space or BLB impairment in 59.6% of patients.

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Acknowledgements

We thank Pamela Haylock (Lariboisiere University Hospital) for critically editing the manuscript.

Funding

None.

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Author notes

  1. Michael Eliezer and Charlotte Hautefort contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Neuroradiology and MR Unit, Lariboisière University Hospital, 75010, Paris, France

    Michael Eliezer, Jean-Pierre Guichard & Emmanuel Houdart

  2. Department of Head and Neck Surgery, Lariboisiere University Hospital, Paris, France

    Charlotte Hautefort, Philippe Herman & Romain Kania

  3. Clinique Des Vertiges, Brussel, Belgique

    Christian Van Nechel & Ulla Duquesne

  4. Department of Neuroradiology and MRI, SFR RMN Neurosciences, Grenoble Alpes University Hospital, Grenoble, France

    Arnaud Attyé

  5. Centre d’Explorations Fonctionnelles Otoneurologiques, Paris, France

    Michel Toupet

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Correspondence to Michael Eliezer.

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Eliezer, M., Hautefort, C., Van Nechel, C. et al. Electrophysiological and inner ear MRI findings in patients with bilateral vestibulopathy. Eur Arch Otorhinolaryngol 277, 1305–1314 (2020). https://doi.org/10.1007/s00405-020-05829-8

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  • DOI: https://doi.org/10.1007/s00405-020-05829-8

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