The authors have no funding, financial relationships, or conflicts of interest to disclose.
Variability in the perilymphatic diffusion of gadolinium does not predict the outcome of intratympanic gentamicin in patients with ménière's disease†
Article first published online: 28 FEB 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 4, pages 907–911, April 2012
How to Cite
Fiorino, F., Pizzini, F. B., Barbieri, F. and Beltramello, A. (2012), Variability in the perilymphatic diffusion of gadolinium does not predict the outcome of intratympanic gentamicin in patients with ménière's disease. The Laryngoscope, 122: 907–911. doi: 10.1002/lary.23211
- Issue published online: 20 MAR 2012
- Article first published online: 28 FEB 2012
- Manuscript Accepted: 27 DEC 2011
- Manuscript Revised: 10 DEC 2011
- Manuscript Received: 14 NOV 2011
- Endolymphatic hydrops;
- magnetic resonance imaging;
- 3 Tesla;
- Level of Evidence: 4.
To assess the utility of imaging in planning intratympanic (IT) gentamicin (Gent) treatment in Ménière's disease (MD), we compared the dosage and outcomes of ITGent with the severity and extent of endolymphatic hydrops (EH), as evaluated by three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence in a 3-T magnetic resonance imaging (MRI) unit, after IT gadolinium administration.
A total of 18 patients (10 males and 8 females; age, 28–78 years; median age, 53.2 years) with definite MD participated in the investigation. The duration of the disease ranged from 8 months to 9 years (median, 2 years), with a prevalence of vertigo spells ranging from 0.8 to 8 per month (median, 2.2), as calculated in the last 6 months. A 3D-FLAIR MRI was performed 24 hours after IT injection of diluted gadobutrol. ITGent injection was performed within a variable period of time, from 1 week to 3 weeks after 3D-FLAIR MRI. The degree and extension of EH as evaluated by 3D-FLAIR MRI were compared with the number of injections necessary to cure vertigo attacks. Vertigo results, functional level scale modifications, variations in caloric excitability, and pure-tone average modifications.
No statistically significant correlation was observed between severity of EH and outcomes of ITGent administration.
The hypothesis of a reduced effect of Gent administered intratympanically in the presence of severe EH, owing to obstacled diffusion along the perilymphatic compartments, has not been confirmed in the present investigation. Laryngoscope, 2012