Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min
Background: Intratympanic administration of gadolinium chelate allows for a better visualization of endolymphatic hydrops (EH) using MRI than intravenous injection and was recently further improved to facilitate high-quality imaging of EH in 7 min. The aim of the present study was to simplify the in...
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Tsinghua University Press
2022-07-01
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| Series: | Journal of Otology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1672293022000150 |
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| author | Jing Zou Zikai Zhao Hongbin Li Guoping Zhang Qing Zhang Jianping Lu Ilmari Pyykkö |
| author_facet | Jing Zou Zikai Zhao Hongbin Li Guoping Zhang Qing Zhang Jianping Lu Ilmari Pyykkö |
| author_sort | Jing Zou |
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| description | Background: Intratympanic administration of gadolinium chelate allows for a better visualization of endolymphatic hydrops (EH) using MRI than intravenous injection and was recently further improved to facilitate high-quality imaging of EH in 7 min. The aim of the present study was to simplify the intratympanic administration protocol by mixing gadolinium chelate with therapeutic dexamethasone and to evaluate the effects of this mixture on the visualization of EH in MRI. Materials and methods: In an in vitro study, the potential impact of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) on the stability of dexamethasone was evaluated by analyzing dynamic changes in dexamethasone with high-performance liquid chromatography (HPLC) after mixing with Gd-DTPA. Ten patients with definite Meniere's disease (MD) were recruited to study the potential interference of dexamethasone on MRI visualization of EH, and 49 patients with MD were recruited to evaluate the effect of intratympanic injection of Gd-DTPA mixed with dexamethasone on MRI of EH using a 3T MR machine and a novel heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed using a magnitude plus zero-filled interpolation (hT2FLAIR-MZFI) sequence. Results: The retention times and peak area of dexamethasone in HPLC were not modified by the addition of Gd-DTPA. EH grading in the cochlea and vestibule was not influenced in any ear by intratympanic injection of dexamethasone. Excellent inner ear images were obtained from all patients, and EHs with various grades were displayed. There were significant correlations between diagnosis and cochlear EH (p < 0.01, Spearman's Rho), between diagnosis and vestibular EH (p < 0.01, Spearman's Rho), and between cochlear and vestibular EH (p < 0.01, Spearman's Rho). The distribution of Gd-DTPA plus dexamethasone negatively correlated with the grade of vestibular EH. Injury of the endolymph-perilymph barrier was detected in one cochlea and three vestibules of 59 inner ears with MD. Conclusions: Intratympanic administration of Gd-DTPA plus dexamethasone yielded high-quality MRI images of EH in patients with MD using a novel 7-min protocol and simplified the clinical application. Intratympanic administration of Gd-DTPA plus dexamethasone might be used to test its therapeutic effect in future work. Level of evidence: 3. |
| format | Article |
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| institution | Kabale University |
| issn | 1672-2930 |
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| publishDate | 2022-07-01 |
| publisher | Tsinghua University Press |
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| series | Journal of Otology |
| spelling | doaj-art-a865dd0d4c3c4f1888252d5ade501ffa2025-08-20T03:48:35ZengTsinghua University PressJournal of Otology1672-29302022-07-0117316417410.1016/j.joto.2022.02.002Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 minJing Zou0Zikai Zhao1Hongbin Li2Guoping Zhang3Qing Zhang4Jianping Lu5Ilmari Pyykkö6Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China; Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland; Corresponding author. Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Changhai Road #168, Shanghai, 200433, China.Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, ChinaHearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, FinlandBackground: Intratympanic administration of gadolinium chelate allows for a better visualization of endolymphatic hydrops (EH) using MRI than intravenous injection and was recently further improved to facilitate high-quality imaging of EH in 7 min. The aim of the present study was to simplify the intratympanic administration protocol by mixing gadolinium chelate with therapeutic dexamethasone and to evaluate the effects of this mixture on the visualization of EH in MRI. Materials and methods: In an in vitro study, the potential impact of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) on the stability of dexamethasone was evaluated by analyzing dynamic changes in dexamethasone with high-performance liquid chromatography (HPLC) after mixing with Gd-DTPA. Ten patients with definite Meniere's disease (MD) were recruited to study the potential interference of dexamethasone on MRI visualization of EH, and 49 patients with MD were recruited to evaluate the effect of intratympanic injection of Gd-DTPA mixed with dexamethasone on MRI of EH using a 3T MR machine and a novel heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed using a magnitude plus zero-filled interpolation (hT2FLAIR-MZFI) sequence. Results: The retention times and peak area of dexamethasone in HPLC were not modified by the addition of Gd-DTPA. EH grading in the cochlea and vestibule was not influenced in any ear by intratympanic injection of dexamethasone. Excellent inner ear images were obtained from all patients, and EHs with various grades were displayed. There were significant correlations between diagnosis and cochlear EH (p < 0.01, Spearman's Rho), between diagnosis and vestibular EH (p < 0.01, Spearman's Rho), and between cochlear and vestibular EH (p < 0.01, Spearman's Rho). The distribution of Gd-DTPA plus dexamethasone negatively correlated with the grade of vestibular EH. Injury of the endolymph-perilymph barrier was detected in one cochlea and three vestibules of 59 inner ears with MD. Conclusions: Intratympanic administration of Gd-DTPA plus dexamethasone yielded high-quality MRI images of EH in patients with MD using a novel 7-min protocol and simplified the clinical application. Intratympanic administration of Gd-DTPA plus dexamethasone might be used to test its therapeutic effect in future work. Level of evidence: 3.http://www.sciencedirect.com/science/article/pii/S1672293022000150Meniere's diseaseEndolymphatic hydropsMRIContrast agentTherapeuticsTopical administration |
| spellingShingle | Jing Zou Zikai Zhao Hongbin Li Guoping Zhang Qing Zhang Jianping Lu Ilmari Pyykkö Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min Journal of Otology Meniere's disease Endolymphatic hydrops MRI Contrast agent Therapeutics Topical administration |
| title | Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min |
| title_full | Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min |
| title_fullStr | Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min |
| title_full_unstemmed | Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min |
| title_short | Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere's disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min |
| title_sort | dexamethasone does not affect endolymphatic hydrops eh in patients with meniere s disease within 24 h and intratympanic administration of gadolinium plus dexamethasone simplifies high quality imaging of eh using a novel protocol of 7 min |
| topic | Meniere's disease Endolymphatic hydrops MRI Contrast agent Therapeutics Topical administration |
| url | http://www.sciencedirect.com/science/article/pii/S1672293022000150 |
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