Abstract
Purpose
Patients with superior semicircular canal dehiscence syndrome, which can only be treated by surgery, present cochleo-vestibular symptoms related to a third-mobile window but also endolymphatic hydrops. Since cVEMP and oVEMP are disturbed by the presence of the dehiscence, the aim of the study is to assess the value of MRI for the diagnosis of endolymphatic hydrops in patients with superior semicircular canal dehiscence syndrome in comparison with cVEMP and oVEMP.
Methods
In this retrospective cohort study we enrolled 33 ears in 24 patients with superior semicircular dehiscence syndrome who underwent a 4-h delayed intravenous Gd-enhanced 3D-FLAIR MRI and pure tone audiometry, cVEMP and oVEMP. For each patient MRI images were evaluated by two radiologists who used a compartmental endolymphatic hydrops grading system in comparison with cVEMP and oVEMP.
Results
Endolymphatic hydrops was found on MRI in 9 out of 33 SCDS ears (27.3%). We found no significant correlation between the presence of endolymphatic hydrops on MRI and cVEMP and oVEMP (p = 0.36 and p = 0.7, respectively). However, there was a significant correlation between the presence of endolymphatic hydrops on MRI and the degree of sensorineural hearing loss, Air Conduction-Pure Tone Average level (p = 0.012) and Bone Conduction-Pure Tone Average level (p = 0.09), respectively.
Conclusion
We demonstrated that EH might be observed in 27.3% of superior semicircular dehiscence syndrome ears. The role of inner ear MRI is important to detect endolymphatic hydrops, since cVEMP and oVEMP are disturbed by the presence of the dehiscence, because these patients could benefit from a medical treatment.
Level of evidence
Level 3.
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References
Minor LB, Solomon D, Zinreich JS, Zee DS (1998) Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg 124:249–258
Minor LB (2005) Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope 115:1717–1727. https://doi.org/10.1097/01.mlg.0000178324.55729.b7
Mau C, Kamal N, Badeti S, Reddy R, Ying Y-LM, Jyung RW et al (2018) Superior semicircular canal dehiscence: diagnosis and management. J Clin Neurosci Off J Neurosurg Soc Australas 48:58–65. https://doi.org/10.1016/j.jocn.2017.11.019
JankyKristen L, Nguyen KD, Welgampola M, Zuniga MG, Carey JP (2013) Air-conducted oVEMPs provide the best separation between intact and superior canal dehiscent labyrinths. Otol Neurotol 34:127–134. https://doi.org/10.1097/MAO.0b013e318271c32a
Zuniga MG, Janky KL, Nguyen KD, Welgampola MS, Carey JP (2013) Ocular versus cervical VEMPs in the diagnosis of superior semicircular canal dehiscence syndrome. Otol Neurotol Off Publ Am Otol Soc Am Neurotol Soc Eur Acad Otol Neurotol 34:121–126. https://doi.org/10.1097/MAO.0b013e31827136b0
Pisano DV, Niesten MEF, Merchant SN, Nakajima HH (2012) The effect of superior semicircular canal dehiscence on intracochlear sound pressures. Audiol Neurootol 17:338–348. https://doi.org/10.1159/000339653
Sone M, Yoshida T, Morimoto K, Teranishi M, Nakashima T, Naganawa S (2016) Endolymphatic hydrops in superior canal dehiscence and large vestibular aqueduct syndromes. Laryngoscope 126:1446–1450. https://doi.org/10.1002/lary.25747
Manzari L, Burgess AM, McGarvie LA, Curthoys IS (2013) An indicator of probable semicircular canal dehiscence: ocular vestibular evoked myogenic potentials to high frequencies. Otolaryngol-Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg 149:142–145. https://doi.org/10.1177/0194599813489494
Lopez-Escamez JA, Carey J, Chung W-H, Goebel JA, Magnusson M, Mandalà M et al (2015) Diagnostic criteria for Menière’s disease. J Vestib Res Equilib Orientat 25:1–7. https://doi.org/10.3233/VES-150549
Egami N, Ushio M, Yamasoba T, Yamaguchi T, Murofushi T, Iwasaki S (2013) The diagnostic value of vestibular evoked myogenic potentials in patients with Meniere’s disease. J Vestib Res Equilib Orientat 23:249–257. https://doi.org/10.3233/VES-130484
Maxwell R, Jerin C, Gürkov R (2017) Utilisation of multi-frequency VEMPs improves diagnostic accuracy for Meniere’s disease. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg 274:85–93. https://doi.org/10.1007/s00405-016-4206-z
Okumura T, Imai T, Takimoto Y, Takeda N, Kitahara T, Uno A et al (2017) Assessment of endolymphatic hydrops and otolith function in patients with Ménière’s disease. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg 274:1413–1421. https://doi.org/10.1007/s00405-016-4418-2
Eliezer M, Poillon G, Gillibert A, Horion J, Cruypeninck Y, Gerardin E et al (2018) Comparison of enhancement of the vestibular perilymph between gadoterate meglumine and gadobutrol at 3-Tesla in Meniere’s disease. Diagn Interv Imaging 99:271–277. https://doi.org/10.1016/j.diii.2018.01.002
Kahn L, Hautefort C, Guichard J, Toupet M, Jourdaine C, Vitaux H et al (2019) Relationship between video head impulse test, ocular and cervical vestibular evoked myogenic potentials, and compartmental magnetic resonance imaging classification in Menière’s disease. The Laryngoscope. https://doi.org/10.1002/lary.28362
Niesten MEF, Hamberg LM, Silverman JB, Lou KV, McCall AA, Windsor A et al (2014) Superior canal dehiscence length and location influences clinical presentation and audiometric and cervical vestibular-evoked myogenic potential testing. Audiol Neurotol 19:97–105. https://doi.org/10.1159/000353920
Eliezer M, Maquet C, Horion J, Gillibert A, Toupet M, Bolognini B et al (2019) Detection of intralabyrinthine abnormalities using post-contrast delayed 3D-FLAIR MRI sequences in patients with acute vestibular syndrome. Eur Radiol 29:2760–2769. https://doi.org/10.1007/s00330-018-5825-0
Portney LG, Watkins MP (2009) Foundations of clinical research: applications to practice, 3rd edn. Pearson/Prentice Hall, Upper Saddle River
Nakashima T, Naganawa S, Pyykko I, Gibson WPR, Sone M, Nakata S et al (2009) Grading of endolymphatic hydrops using magnetic resonance imaging. Acta Oto-Laryngol Suppl. https://doi.org/10.1080/00016480902729827
Eliezer M, Gillibert A, Tropres I, Krainik A, Attyé A (2017) Influence of inversion time on endolymphatic hydrops evaluation in 3D-FLAIR imaging. J Neuroradiol J Neuroradiol 44:339–343. https://doi.org/10.1016/j.neurad.2017.06.002
Attyé A, Eliezer M, Boudiaf N, Tropres I, Chechin D, Schmerber S et al (2017) MRI of endolymphatic hydrops in patients with Meniere’s disease: a case-controlled study with a simplified classification based on saccular morphology. Eur Radiol 27:3138–3146. https://doi.org/10.1007/s00330-016-4701-z
Merchant SN, Rosowski JJ (2008) Conductive hearing loss caused by third-window lesions of the inner ear. Otol Neurotol Off Publ Am Otol Soc Am Neurotol Soc Eur Acad Otol Neurotol 29:282–289. https://doi.org/10.1097/mao.0b013e318161ab24
Maheu M, Alvarado-Umanzor JM, Delcenserie A, Champoux F (2017) The clinical utility of vestibular-evoked myogenic potentials in the diagnosis of Ménière’s disease. Front Neurol 8:415. https://doi.org/10.3389/fneur.2017.00415
Taylor RL, Bradshaw AP, Halmagyi GM, Welgampola MS (2012) Tuning characteristics of ocular and cervical vestibular evoked myogenic potentials in intact and dehiscent ears. Audiol Neurootol 17:207–218. https://doi.org/10.1159/000336959
Young Y-H, Huang T-W, Cheng P-W (2003) Assessing the stage of Meniere’s disease using vestibular evoked myogenic potentials. Arch Otolaryngol Head Neck Surg 129:815–818. https://doi.org/10.1001/archotol.129.8.815
Gioacchini FM, Alicandri-Ciufelli M, Kaleci S, Scarpa A, Cassandro E, Re M (2016) Outcomes and complications in superior semicircular canal dehiscence surgery: a systematic review. The Laryngoscope 126:1218–1224. https://doi.org/10.1002/lary.25662
Nogueira R, Verillaud B, Hautefort C, Fiaux-Camous D, Kania R, Herman P (2018) Minimally invasive surgery for superior semicircular canal dehiscence: results of a four fenestration technique in twenty-one adults. Clin Otolaryngol Off J ENT-UK Off J Neth Soc Oto-Rhino-Laryngol Cervico-Facial Surg 43:1368–1371. https://doi.org/10.1111/coa.13133
Sepahdari AR, Vorasubin N, Ishiyama G, Ishiyama A (2016) Endolymphatic hydrops reversal following acetazolamide therapy: demonstration with delayed intravenous contrast-enhanced 3D-FLAIR MRI. AJNR Am J Neuroradiol 37:151–154. https://doi.org/10.3174/ajnr.A4462
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Ray, A., Hautefort, C., Guichard, JP. et al. MRI contribution for the detection of endolymphatic hydrops in patients with superior canal dehiscence syndrome. Eur Arch Otorhinolaryngol 278, 2229–2238 (2021). https://doi.org/10.1007/s00405-020-06282-3
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DOI: https://doi.org/10.1007/s00405-020-06282-3