Journal
OTOLOGY & NEUROTOLOGY
Volume 28, Issue 8, Pages 1029-1033Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MAO.0b013e3181587d95
Keywords
3D FLAIR; blood-labyrinth barrier; cholesteatoma; inner ear; disturbance; labyrinthine fistula
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Objective: To investigate the cause of inner oar disturbances in cases of middle ear cholesteatoma with labyrinthine fistula. Setting: University hospital. Study Design: Prospective case study. Patients: Eight patients who were scheduled to undergo surgery for middle ear cholesteatoma with labyrinthine fistula were included in this study. Intervention: Imaging analysis was performed using a 3-dimensional fluid-anenuated inversion recovery (FLAIR) magnetic resonance imaging sequence. Main Outcome Measures: Three-dimensional FLAIR findings were compared with clinical symptoms associated with inner ear disturbance and surgical observations of the fistula. Results: Three-dimensional FLAIR in 6 patients affected sides and areas with increased signal after the administration of gadolinium, especially in cases accompanied by acute sensorineural hearing loss. These images were considered to be indicative of breakdown of the blood-labyrinth barrier due to middle ear cholesteatoma. This finding was also present in a patient with no clinical symptoms of inner ear disturbances. Conclusion: Three-dimensional FLAIR images of the. inner ear are valuable in evaluating labyrinthine fistula in patients with cholesteatoma Future studies are needed to better understand the role, of 3-dimensional FLAIR in predicting the severity of inner ear disturbance.
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