gms | German Medical Science

76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

Acute vestibulo-cochlear dysfunction caused by hemorrhagic labyrinthitis?

Meeting Abstract

  • corresponding author Thoralf Stange - HNO-Klinik, Lukaskrankenhaus, Neuss
  • Rainer Köster - Institut für klinische Radiologie und Nuklearmedizin, Lukaskrankenhaus, Neuss
  • Hans-Jürgen Schultz-Coulon - HNO-Klinik, Lukaskrankenhaus, Neuss

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno284

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2005/05hno074.shtml

Published: September 22, 2005

© 2005 Stange et al.
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Outline

Text

The pathogenesis of the acute dysfunction of the inner ear has not yet been determined entirely. The real cause often remains unclear and subject to speculations as the diagnostic investigations usually do not return any specific findings. The majority of patients suffering from vestibular-cochlear dysfunction undergo diagnostic imaging by MRI in order to exclude an intracranial pathology.

In case of three examined patients the T1-weighted MRI showed a signal enhancement of the involved vestibular organ. The diagnostic imaging by MRI was hereby processed without enhancement by the application of contrast medium. All three patients showed different clinical symptoms and courses. A 5-year old girl complained about diffuse vertigo for a few days only without any nystagmus. With another girl a progressive labyrinthine hearing loss on both sides developed from a unilateral vestibular dysfunction. For the third patient we observed the classic course of a unilateral vestibular dysfunction with consecutive regression of symptoms within few weeks.

Still the clinical relevance of the diagnostic imaging by MRI has to be questioned. Evidently, a signal enhancement of the T1-weighted MRI – without contast medium - within the involved labyrinth system is caused by hemorrhage. A total of 23 patients showing symptoms of sudden sensorineural hearing loss and vestibular dysfunction as well as revealing the very same findings in the MRI have already been reported in the literature. Thereby the results obtained by MRI gave rise to various interpretations by the respective authors.

Therefore the variable clinical courses of our three patients very likely do conclude from a hemorrhagic labyrinthitis due to an influenzal viral infection.