title: Magnetic resonance imaging in the evaluation of clinical treatment of otospongiosis: a pilot study.
abstract: OBJECTIVE
  To evaluate the applicability of magnetic resonance imaging (MRI) as a method for monitoring the activity of otospongiotic lesions before and after clinical treatment.
  
  
  METHODS
  Prospective, randomized, controlled, double-blind study.
  
  
  METHODS
  One single tertiary care institution in a large, cosmopolitan city.
  
  
  METHODS
  Twenty-six patients (n = 42 ears) with clinical, audiometric, and tomographic diagnosis of otosclerosis were enrolled. If computed tomography (CT) demonstrated active lesions, these patients underwent MRI to detect otospongiotic foci, seen as areas of gadolinium enhancement. Patients were divided into 3 groups and received treatment with placebo, sodium alendronate, or sodium fluoride for 6 months. After this period, clinical and audiometric evaluations and a second MRI were performed. Each MRI was evaluated by both a neuroradiologist and an otolaryngologist in a subjective (visual) and objective (using specific eFilm Workstation software) manner.
  
  
  RESULTS
  Otospongiosis was most predominantly identified in the region anterior to the oval window, and this site was reliable for comparing pre- and posttreatment scans. The patients in the alendronate and sodium fluoride groups had MRI findings that suggested a decrease in activity of otospongiotic lesions, more relevant in the alendronate group. These findings were statistically significant for both subjective and objective MRI evaluations.
  
  
  CONCLUSIONS
  MRI shows higher sensitivity than clinical or audiometric assessment for detecting reduction in activity of otospongiosis. The objective MRI evaluation based on software analysis was the most accurate method of monitoring clinical treatment response in otospongiosis.
authors: Department of Otorhinolaryngology and Head and Neck Surgery and the Department of Imaging Diagnosis, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil andyvicente@uol.com.br.
authors: Andy
authors: A
authors: de Oliveira Vicente
authors: New York Otology, New York Head and Neck Institute, New York, New York, USA.
authors: Sujana S
authors: SS
authors: Chandrasekhar
authors: Department of Otorhinolaryngology and Head and Neck Surgery and the Department of Imaging Diagnosis, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil.
authors: Helio K
authors: HK
authors: Yamashita
authors: Department of Otorhinolaryngology and Head and Neck Surgery and the Department of Imaging Diagnosis, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil.
authors: Oswaldo Laercio M
authors: OL
authors: Cruz
authors: Department of Otorhinolaryngology and Head and Neck Surgery and the Department of Imaging Diagnosis, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil.
authors: Flavia A
authors: FA
authors: Barros
authors: Department of Otorhinolaryngology and Head and Neck Surgery and the Department of Imaging Diagnosis, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil.
authors: Norma O
authors: NO
authors: Penido
mesh_terms: D000328:Adult; D000368:Aged; D019386:Alendronate / Q000008:administration & dosage*; D001299:Audiometry / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012016:Reference Values; D012969:Sodium Fluoride / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D012969:Sodium Fluoride; D019386:Alendronate
keywords: hearing loss; magnetic resonance imaging; otosclerosis; otospongiosis; sodium alendronate; sodium fluoride