title: Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging investigation of inner ear disturbances in cases of middle ear cholesteatoma with labyrinthine fistula.
abstract: OBJECTIVE
  To investigate the cause of inner ear disturbances in cases of middle ear cholesteatoma with labyrinthine fistula.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Prospective case study.
  
  
  METHODS
  Eight patients who were scheduled to undergo surgery for middle ear cholesteatoma with labyrinthine fistula were included in this study.
  
  
  METHODS
  Imaging analysis was performed using a 3-dimensional fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging sequence.
  
  
  METHODS
  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 revealed areas of high signal intensity in the inner ears on the 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan. michsone@med.nagoya-u.ac.jp
authors.forename: Michihiko
authors.initials: M
authors.lastname: Sone
authors.forename: Terukazu
authors.initials: T
authors.lastname: Mizuno
authors.forename: Makoto
authors.initials: M
authors.lastname: Sugiura
authors.forename: Shinji
authors.initials: S
authors.lastname: Naganawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakashima
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000150:complications* / Q000601:surgery; D007758:Ear, Inner / Q000473:pathology*; D005260:Female; D005402:Fistula / Q000150:complications / Q000473:pathology*; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D007759:Labyrinth Diseases / Q000150:complications / Q000209:etiology* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D011446:Prospective Studies