Magnetic resonance imaging fails to show evidence of reduced endolymphatic hydrops in gentamicin treatment of Ménière's disease
To verify the hypothesis that intratympanic (IT) gentamicin (Gent) treatment in Ménière's disease (MD) is capable of reducing endolymphatic hydrops (EH), as evaluated by 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence in a 3-Tesla magnetic resonance imaging (MRI) unit, aft...
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| Veröffentlicht in: | Otology & neurotology Jg. 33; H. 4; S. 629 |
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01.06.2012
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| Abstract | To verify the hypothesis that intratympanic (IT) gentamicin (Gent) treatment in Ménière's disease (MD) is capable of reducing endolymphatic hydrops (EH), as evaluated by 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence in a 3-Tesla magnetic resonance imaging (MRI) unit, after IT gadolinium administration.
A total of 8 patients (5 men and 3 women; aged 40-78 yr; median, 60 yr) with definite MD participated in the investigation. The duration of the disease ranged from 1 to 10 years (median, 4 yr), with a prevalence of vertigo spells of 1 to 6 per month (median, 3.1), as calculated in the last 6 months.
A 3D-FLAIR MRI was performed 24 hours after IT injection of diluted gadobutrol. Intratympanic Gent injection was performed in a period variable from 1 to 3 weeks after 3D-FLAIR MRI. A single-shot administration protocol was attempted with additional injections administered on demand in the case of relapsing vertigo spells. MRI was repeated after 3 to 12 months (median, 8 mo) after treatment.
The degree and extension of EH as evaluated by 3D-FLAIR MRI was compared from images obtained pre- and post-ITGent administration.
After ITGent administration, 4 patients did not show any MRI modification, 3 patients showed a worsening of EH in one site, and 1 patient showed a worsening in two sites. No subjects presented reduction of EH.
No evidence of reduced EH following ITGent treatment has been shown in the present imaging investigation. |
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| AbstractList | To verify the hypothesis that intratympanic (IT) gentamicin (Gent) treatment in Ménière's disease (MD) is capable of reducing endolymphatic hydrops (EH), as evaluated by 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence in a 3-Tesla magnetic resonance imaging (MRI) unit, after IT gadolinium administration.OBJECTIVETo verify the hypothesis that intratympanic (IT) gentamicin (Gent) treatment in Ménière's disease (MD) is capable of reducing endolymphatic hydrops (EH), as evaluated by 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence in a 3-Tesla magnetic resonance imaging (MRI) unit, after IT gadolinium administration.A total of 8 patients (5 men and 3 women; aged 40-78 yr; median, 60 yr) with definite MD participated in the investigation. The duration of the disease ranged from 1 to 10 years (median, 4 yr), with a prevalence of vertigo spells of 1 to 6 per month (median, 3.1), as calculated in the last 6 months.PATIENTSA total of 8 patients (5 men and 3 women; aged 40-78 yr; median, 60 yr) with definite MD participated in the investigation. The duration of the disease ranged from 1 to 10 years (median, 4 yr), with a prevalence of vertigo spells of 1 to 6 per month (median, 3.1), as calculated in the last 6 months.A 3D-FLAIR MRI was performed 24 hours after IT injection of diluted gadobutrol. Intratympanic Gent injection was performed in a period variable from 1 to 3 weeks after 3D-FLAIR MRI. A single-shot administration protocol was attempted with additional injections administered on demand in the case of relapsing vertigo spells. MRI was repeated after 3 to 12 months (median, 8 mo) after treatment.INTERVENTIONA 3D-FLAIR MRI was performed 24 hours after IT injection of diluted gadobutrol. Intratympanic Gent injection was performed in a period variable from 1 to 3 weeks after 3D-FLAIR MRI. A single-shot administration protocol was attempted with additional injections administered on demand in the case of relapsing vertigo spells. MRI was repeated after 3 to 12 months (median, 8 mo) after treatment.The degree and extension of EH as evaluated by 3D-FLAIR MRI was compared from images obtained pre- and post-ITGent administration.MAIN OUTCOME MEASUREThe degree and extension of EH as evaluated by 3D-FLAIR MRI was compared from images obtained pre- and post-ITGent administration.After ITGent administration, 4 patients did not show any MRI modification, 3 patients showed a worsening of EH in one site, and 1 patient showed a worsening in two sites. No subjects presented reduction of EH.RESULTSAfter ITGent administration, 4 patients did not show any MRI modification, 3 patients showed a worsening of EH in one site, and 1 patient showed a worsening in two sites. No subjects presented reduction of EH.No evidence of reduced EH following ITGent treatment has been shown in the present imaging investigation.CONCLUSIONNo evidence of reduced EH following ITGent treatment has been shown in the present imaging investigation. To verify the hypothesis that intratympanic (IT) gentamicin (Gent) treatment in Ménière's disease (MD) is capable of reducing endolymphatic hydrops (EH), as evaluated by 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence in a 3-Tesla magnetic resonance imaging (MRI) unit, after IT gadolinium administration. A total of 8 patients (5 men and 3 women; aged 40-78 yr; median, 60 yr) with definite MD participated in the investigation. The duration of the disease ranged from 1 to 10 years (median, 4 yr), with a prevalence of vertigo spells of 1 to 6 per month (median, 3.1), as calculated in the last 6 months. A 3D-FLAIR MRI was performed 24 hours after IT injection of diluted gadobutrol. Intratympanic Gent injection was performed in a period variable from 1 to 3 weeks after 3D-FLAIR MRI. A single-shot administration protocol was attempted with additional injections administered on demand in the case of relapsing vertigo spells. MRI was repeated after 3 to 12 months (median, 8 mo) after treatment. The degree and extension of EH as evaluated by 3D-FLAIR MRI was compared from images obtained pre- and post-ITGent administration. After ITGent administration, 4 patients did not show any MRI modification, 3 patients showed a worsening of EH in one site, and 1 patient showed a worsening in two sites. No subjects presented reduction of EH. No evidence of reduced EH following ITGent treatment has been shown in the present imaging investigation. |
| Author | Fiorino, Francesco Barbieri, Franco Pizzini, Francesca B Beltramello, Alberto |
| Author_xml | – sequence: 1 givenname: Francesco surname: Fiorino fullname: Fiorino, Francesco email: franco.fiorino@virgilio.it organization: Department of Otolaryngology, Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy. franco.fiorino@virgilio.it – sequence: 2 givenname: Francesca B surname: Pizzini fullname: Pizzini, Francesca B – sequence: 3 givenname: Franco surname: Barbieri fullname: Barbieri, Franco – sequence: 4 givenname: Alberto surname: Beltramello fullname: Beltramello, Alberto |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/22314924$$D View this record in MEDLINE/PubMed |
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| Snippet | To verify the hypothesis that intratympanic (IT) gentamicin (Gent) treatment in Ménière's disease (MD) is capable of reducing endolymphatic hydrops (EH), as... |
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| SubjectTerms | Adult Aged Ear, Inner - pathology Endolymphatic Hydrops - etiology Endolymphatic Hydrops - pathology Female Gentamicins - therapeutic use Humans Image Processing, Computer-Assisted Imaging, Three-Dimensional Magnetic Resonance Imaging Male Meniere Disease - complications Meniere Disease - drug therapy Middle Aged |
| Title | Magnetic resonance imaging fails to show evidence of reduced endolymphatic hydrops in gentamicin treatment of Ménière's disease |
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