Evaluation Of Endolymphatic Hydrops In ISSHL Patients With Total Frequency Hearing Loss By 3.0-Tesla MRI

Objective Many researchers indicated that lots of low frequency ISSNL patients accompany with EH. But there are little reports about ISSNHL with total frequency hearing loss, and nobody kowns whether flat type ISSNHL patients accompany with EH. To confirm whether idiopathic sudden sensorineural hearing loss(ISSHL) accompany endolymphatic hydrops(EH) by three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging(3D-FLAIR MRI), then evaluate how a important role the EH plays in flat type ISSHL.Methods Gadolinium(Gd) was 8 times diluted in saline and injected intratympanically in 26 unilateral ISSHL patients of flat type. Then to evaluate the endolymphatic spacewith3-Tesla 3D-flair MRI at 24 hours after the intratympanic Gd injection. Compare the EH incidence rate in affected ears and normal ears,and analyze the relationship of EH and vertigo or the diagnosis.Results There are 33 patients(66 ears) who received 3D-FLAIR MRI scan. 30patients' affected ears(60 ears) show the high signals in their inner ears, indicate the positive rate is 90.9%(30/33ears)and we can detect there are 21 ears accompany with EH so that the percentage is 70.0%(21/30),in which have 13 mild EH(39.4%) and 8 significant EH(29.2%). Relatively, high signals can be detected in 29 normal ears(87.8%, 29/33), and9 of them accompany with EH, that with 5 mild EH(15.2%) and 4 significant EH(12.1%).The difference between affected ears and normal ears been proved through chi square test that the difference is significant(?2=9.689;P=0.008).we can conclude that the relationship between the existence of EH and vertigo is not significant like we thought before throughthe spearman test.(P=0.812)?Furthermore, the comparison of the existence of EH and the prognosis could indicate that there is little relationship between them. The patients accompany with EH have a effective percentage which is 66.7%(14/21 ears), and a recovery rate is 14.3%(3/21 ears), and the effective percentage of the patients without EH is44.4%(4/9 ears), the recovery rate is 11.1%(1/9 ears). With spearman test, we can confirm that(P=0.210).Conclusions Intra-tymanic Gd injection 3D-FLAIR MRI have a high positive rate to show the EH in flat type ISSHL patients, and it could be found in the normal ears as well.But it is necessary to have a further study of EH in ISSHL to reveal how a important role the EH plays in ISSHL.