Case Report
Copyright ©2013 Baishideng. All rights reserved.
World J Otorhinolaryngol. Feb 28, 2013; 3(1): 22-25
Published online Feb 28, 2013. doi: 10.5319/wjo.v3.i1.22
Endolymphatic hydrops in Meniere’s disease secondary to otitis media and visualized by gadolinium-enhanced magnetic resonance imaging
Jing Zou, Ilmari Pyykkö
Jing Zou, Ilmari Pyykkö, Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, 33520 Tampere, Finland
Author contributions: Zou J reviewed the case history, analyzed the magnetic resonance imaging and wrote the paper; Pyykkö I performed the clinic observation and magnetic resonance imaging.
Supported by The European Community 7th Framework Programme on Research, NanoValid (Contract: 263147)
Correspondence to: Jing Zou, MD, PhD, Associate Professor, Head of Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, Room C2165a, 33520 Tampere, Finland.
Telephone: +358-4-1901307 Fax: +358-3-3641482
Received: November 8, 2012
Revised: January 16, 2013
Accepted: February 2, 2013
Published online: February 28, 2013

Aimed to test the hypothesis that endolymphatic hydrops in Meniere’s disease (MD) may be secondary to otitis media, history of a patient who developed MD as a complication of otitis media was reviewed. The inner ear was imaged using a 3.0 Tesla MR system post-intravenous injection of gadolinium-tetraazacyclododecane-tetraacetic acid (Gd-DOTA) in a standard single dosage (0.1 mmol/kg). Both t2-spc-rst-tra-iso (T2-weighted) and heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery magnetic resonance imaging [hT(2)W-3D-FLAIR] sequences were applied. As a result, in the T2-weighted images, the perilymph and endolymph, cerebrospinal fluid surrounding the eighth nerve (N8), and middle ear granulation tissue showed intense signals. In the hT(2)W-3D-FLAIR images, evident enhancement by Gd-DOTA was observed in the middle ear cavity and the perilymphatic compartments of the cochlea. Cochlear endolymphatic hydrops was implicated by the enlarged scala media in the basal turn. In general, the Gd-DOTA uptake in the vestibule was weak, and signs of vestibular endolymphatic hydrops were obvious. The N8 on the diseased side was also significantly enhanced. To conclude, endolymphatic hydrops in MD may be induced by otitis media. Cochlear endolymphatic hydrops in MD secondary to otitis media may not follow the classical pattern.

Keywords: Endolymphatic hydrops, Otitis media, Meniere’s disease, Magnetic resonance imaging, Sensorineural hearing loss