[Diagnostic value of color-coded Doppler sonography in neuro-otologic disorders].
OBJECTIVE
The successful introduction of Doppler and Color-Coded Doppler Sonography (CCDS) in the field of Otorhinolaryngology has improved the diagnostic sonographic value for several diseases of the head and neck region, e. g. in hemangiomas and vascular malformations. The diagnostic value of CCDS for examination of the extracranial brain supplying vessels in combination with neuro-otologic disorders is still under controversial discussion.


METHODS
We investigated the diagnostic CCDS findings for 215 patients suffering from different neuro-otologic disorders. All patients were classified into 4 groups according to the different disorder entity (sudden deafness, tinnitus, vestibular neuropathy, combined diagnosis). The frequency of pathologic CCDS findings was correlated with the different groups using sonographic parameters such as atherosclerosis, stenosis and intima-media thickness.


RESULTS
Classification of the disorder entities led to the following distribution: Sudden deafness group (85 patients; 40 %), Tinnitus group (44 patients; 20 %), Vestibular neuropathy group (41 patients; 19 %), Combined diagnosis group (45 patients; 21 %). Sonographic evaluation of atherosclerosis was possible in 76 cases (35 %), changes of the intima-media thickness were observed in 43 cases (20 %) while proof of stenoses was identified in 15 cases (7 %). The evaluation of plaque formation (atherosclerosis) in the sudden deafness group was significantly higher (p < 0.01) than in all other groups although the combined diagnosis group demonstrated certain tendencies (p < 0.08) without significant correlation.


CONCLUSIONS
Our results reinforce the hypothesis of a vascular genesis of sudden deafness and seem to offer the possibility of sonographic differentiation between neuro-otologic disorder entities by use of CCDS. In contrast, it seems that the role of CCDS is negligible for individual diagnostic purposes.
Offergeld
C
C
Univ.-HNO-Klinik, Universitätsklinik Freiburg, Freiburg. Offergeld@hno.ukl.unifreiburg.de
Schellong
S
S
Schmidt
A
A
Pfaar
O
O
Steigerwald
C
C
Zahnert
T
T
D050197:Atherosclerosis / Q000000981:diagnostic imaging; D001932:Brain Neoplasms / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D003638:Deafness / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging; D006391:Hemangioma / Q000000981:diagnostic imaging; D006801:Humans; D015203:Reproducibility of Results; D014012:Tinnitus / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*; D020338:Vestibular Neuronitis / Q000000981:diagnostic imaging