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Hemorrhage in the endolymphatic sac: a cause of hearing fluctuation in enlarged vestibular aqueduct

Authors
 Minbum Kim  ;  Jinna Kim  ;  Sung Huhn Kim  ;  Sang Cheol Kim  ;  Ju Hyun Jeon  ;  Won Sang Lee  ;  Un-Kyung Kim  ;  Hee Nam Kim  ;  Jae Young Choi 
Citation
 INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, Vol.75(12) : 1538-1544, 2011 
Journal Title
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY
ISSN
 0165-5876 
Issue Date
2011
MeSH
Adolescent ; Adult ; Child ; Child, Preschool ; Endolymph ; Endolymphatic Sac* ; Erythrocytes/pathology ; Female ; Hearing Loss, Sudden/etiology* ; Hemorrhage/complications* ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Vestibular Aqueduct/pathology*
Keywords
Enlarged vestibular aqueduct ; Hearing loss ; Magnetic resonance imaging
Abstract
OBJECTIVE: Most of the patients with enlarged vestibular aqueduct (EVA) experience sudden hearing deterioration, but the exact mechanism is unclear. We analyzed magnetic resonance (MR) images and the cellular components of endolymph obtained from the endolymphatic sac in patients with EVA, in order to demonstrate the cause of sudden hearing loss.

METHODS: A total of 25 patients (50 ears) with EVA, who had severe to profound hearing loss, were included in this retrospective clinical study. MR examinations were performed by a 3.0-T MR system using an 8-channel sensitivity-encoding head coil. We analyzed endolymphatic fluid harvested from the endolymphatic sac during cochlear implantations in four patients.

RESULTS: The area of low signal intensity in the endolymphatic sac was observed on T2-weighted MR images for 15 of 50 ears. This area was observed more frequently in patients who experienced recent sudden hearing loss (10/12, 83%) than those with stable hearing (5/38, 13%)(Fisher's exact test, p<0.001). In addition, this area showed high signal intensity on fluid attenuated inversion recovery images. Cytologic analysis of the aspirated endolymph from the endolymphatic sac in the patients with this area revealed many erythrocytes.

CONCLUSION: Our data suggests that hemorrhage in the endolymphatic sac could be a cause of sudden hearing deterioration in patients with EVA
Full Text
http://www.sciencedirect.com/science/article/pii/S0165587611004368
DOI
10.1016/j.ijporl.2011.09.002
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Cheol(김상철)
Kim, Sung Huhn(김성헌)
Kim, Jinna(김진아) ORCID logo https://orcid.org/0000-0002-9978-4356
Lee, Won Sang(이원상)
Jeon, Ju Hyun(전주현)
Choi, Jae Young(최재영) ORCID logo https://orcid.org/0000-0001-9493-3458
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/95068
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