{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:29:29Z","timestamp":1793716169391,"version":"4.6.1"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> The aim of this study is to evaluate the possible value of endolymphatic hydrops (EH) in patients with unilateral idiopathic sudden sensorineural hearing loss (UISSNHL) with four types according to audiometry.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Seventy-two patients (40 men and 32 women; age range, 28\u201378 years; mean age: 50.0 \u00b1 12.9 years) with UISSNHL were admitted retrospectively into this study. Based on the pure tone audiometry before treatment, the hearing loss of all these patients were categorized into four types: low-frequency group (LF-G), high-frequency group (HF-G), flat group (F-G), and total deafness group (TD-G). The average time from symptom onset to the first examination was 6.9 \u00b1 4.4 days (1\u201320 days). 3D-FLAIR MRI was performed 24 h after intratympanic injection of gadolinium (Gd) within 1 week after the UISSNHL onset. The incidence of EH in the affected ears based on four types of hearing loss were analyzed using the Chi-square test, and the possible relationship with vertigo and prognosis were also assessed.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Eleven of 21 patients (52.4%) in LF-G had the highest EH-positive rate, followed by 18.2% in HF-G, 11.8% in F-G, and 17.4% in TD-G. The significant difference was found in the four groups (<jats:italic>P<\/jats:italic> = 0.018). The EH rate of LF-G was statistically significantly higher than that of F-G and TD-G (<jats:italic>P<\/jats:italic> = 0.009, <jats:italic>P<\/jats:italic> =0.014), respectively. After being valued by the volume-referencing grading system (VR scores), the EH level was represented by the sum scores of EH. In LF-G, no statistically significant difference was found in the prognosis of ISSNHL patients between with the EH group and the no EH group (<jats:italic>P<\/jats:italic> = 0.586). The symptom \u201cvertigo\u201d did not correlate with EH and prognosis.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> EH was observed in UISSNHL patients by 3D-FLAIR MRI. EH may be responsible for the pathology of LF-G but not related to prognosis. It might be meaningless to assess EH in other hearing loss types, which might be more related to the blood-labyrinth dysfunction.<\/jats:p>","DOI":"10.3389\/fsurg.2021.682245","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T04:27:30Z","timestamp":1624249650000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Visualization of Endolymphatic Hydrops in Patients With Unilateral Idiopathic Sudden Sensorineural Hearing Loss With Four Types According to Chinese Criterion"],"prefix":"10.3389","volume":"8","author":[{"given":"Huan","family":"Qin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baihui","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianyong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maoli","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1177\/0194599819859883","article-title":"Clinical practice guideline: sudden hearing loss (update) executive summary","volume":"161","author":"Chandrasekhar","year":"2019","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e592","DOI":"10.3399\/bjgp13X670877","article-title":"Sudden sensorineural hearing loss: early diagnosis improves outcome","volume":"63","author":"Lloyd","year":"2013","journal-title":"Br J Gen Pract"},{"key":"B3","doi-asserted-by":"publisher","first-page":"198","DOI":"10.7874\/jao.2020.00157","article-title":"Anatomical and pathological findings of magnetic resonance imaging in idiopathic sudden sensorineural hearing loss","volume":"24","author":"Kim","year":"2020","journal-title":"J Audiol Otol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1159\/000057790s","article-title":"Endolymphatic deafness: a particular variety of cochlear disorder","volume":"64","author":"Tran","year":"2002","journal-title":"ORL J Otorhinolaryngol Relat Spec."},{"key":"B5","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1007\/s00330-005-0046-8","article-title":"Observation of contrast enhancement in the cochlear fluid space of healthy subjects using a 3D-FLAIR sequence at 3 Tesla","volume":"16","author":"Naganawa","year":"2006","journal-title":"Eur Radiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1097\/MLG.0b013e31802c300c","article-title":"Visualization of endolymphatic hydrops in patients with Meniere's disease","volume":"117","author":"Nakashima","year":"2007","journal-title":"Laryngoscope"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1097\/MAO.0b013e31829e83df","article-title":"Endolymphatic hydrops in M\u00e9ni\u00e8re's disease: cause, consequence, or epiphenomenon?","volume":"34","author":"Foster","year":"2013","journal-title":"Otol Neurotol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1111\/coa.12947","article-title":"Idiopathic sudden sensorineural hearing loss and m\u00e9ni\u00e8re syndrome: the role of cerebral venous drainage","volume":"43","author":"Ciccone","year":"2018","journal-title":"Clin Otolaryngol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2265","DOI":"10.1002\/lary.23452","article-title":"Endolymphatic space imaging in idiopathic sudden sensorineural hearing loss with vertigo","volume":"122","author":"Chen","year":"2012","journal-title":"Laryngoscope"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1097\/MAO.0000000000001499s","article-title":"Significance of endolymphatic hydrops in ears with unilateral sensorineural hearing loss. Otol","volume":"38","author":"Okazaki","year":"2017","journal-title":"Neurotol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1007\/s11596-019-2130-3","article-title":"The role of endolymphatic hydrops in patients with pantonal idiopathic sudden sensorineural hearing loss: a cause or secondary reaction","volume":"39","author":"Zheng","year":"2019","journal-title":"Curr Med Sci"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.3389\/fneur.2020.595038","article-title":"The correlation of a 2D volume-referencing endolymphatic-hydrops grading system with extra-tympanic electrocochleography in patients with definite m\u00e9ni\u00e8re's disease","volume":"11","author":"He","year":"2021","journal-title":"Front Neurol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"443","DOI":"10.3760\/cma.j.issn.1673-0860.2015.06.002","article-title":"EBoCJoOHaN, society of otorhinolaryngology head and neck surgery CMA. Guideline of diagnosis and treatment of sudden deafness (2015)","volume":"50","year":"2015","journal-title":"Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi."},{"key":"B14","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1288\/00005537-196007000-00002","article-title":"Vasodilator therapy in sensory-neural hearing loss","volume":"70","author":"Sheehy","year":"1960","journal-title":"Laryngoscope"},{"key":"B15","doi-asserted-by":"publisher","first-page":"355","DOI":"10.3760\/cma.j.issn.1673-0860.2013.05.002","article-title":"Prospective clinical multi-center study on the treatment of sudden deafness with different typings in China","volume":"48","author":"Group","year":"2013","journal-title":"Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi"},{"key":"B16","doi-asserted-by":"publisher","first-page":"Cd004739","DOI":"10.1002\/14651858.CD004739.pub4","article-title":"Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus","volume":"10","author":"Bennett","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1097\/mao.0000000000000450","article-title":"A prospective, multi-centered study of the treatment of idiopathic sudden sensorineural hearing loss with combination therapy versus high-dose prednisone alone: a 139 patient follow-up","volume":"35","author":"Battaglia","year":"2014","journal-title":"Otol Neurotol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1055\/s-0031-1273721","article-title":"Deutsche Gesellschaft fur Hals-Nasen-Ohren-Heilkunde K-uH-C. The revised version of the german guidelines \u201csudden idiopathic sensorineural hearing loss\u201d","volume":"90","author":"Michel","year":"2011","journal-title":"Laryngorhinootologie"},{"key":"B19","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1288\/00005537-199007000-00006s","article-title":"Histopathology of sudden hearing loss","volume":"100","author":"Yoon","year":"1990","journal-title":"Laryngoscope"},{"key":"B20","doi-asserted-by":"publisher","first-page":"21","DOI":"10.3109\/00016489709124015","article-title":"Electrocochleographic findings: Meniere's disease versus sudden sensorineural hearing loss","volume":"526","author":"Filipo","year":"1997","journal-title":"Acta Otolaryngol Suppl"},{"key":"B21","doi-asserted-by":"publisher","first-page":"3979","DOI":"10.1097\/00001756-200012180-00015","article-title":"Magnetic resonance imaging of the membranous labyrinth during in vivo gadolinium (Gd-DTPA-BMA) uptake in the normal and lesioned cochlea","volume":"11","author":"Counter","year":"2000","journal-title":"Neuroreport."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1097\/00001756-200408260-00019","article-title":"Imaging of the guinea pig cochlea following round window gadolinium application","volume":"15","author":"Duan","year":"2004","journal-title":"Neuroreport."},{"key":"B23","doi-asserted-by":"publisher","first-page":"665","DOI":"10.3109\/00016480903384176","article-title":"3 Tesla magnetic resonance imaging obtained 4 hours after intravenous gadolinium injection in patients with sudden deafness","volume":"130","author":"Tagaya","year":"2010","journal-title":"Acta Otolaryngol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"602","DOI":"10.3109\/00016489.2010.548403","article-title":"Endolymphatic hydrops in Meniere's disease detected by MRI after intratympanic administration of gadolinium: comparison with sudden deafness","volume":"131","author":"Horii","year":"2011","journal-title":"Acta Oto-Laryngol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"773","DOI":"10.3174\/ajnr.A2821","article-title":"Comparison of contrast effect on the cochlear perilymph after intratympanic and intravenous gadolinium injection","volume":"33","author":"Yamazaki","year":"2012","journal-title":"Am J Neuroradiol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"213","DOI":"10.2463\/mrms.11.213","article-title":"Imaging of Meniere's disease after intravenous administration of single-dose gadodiamide: utility of subtraction images with different inversion time","volume":"11","author":"Naganawa","year":"2012","journal-title":"Magn Reson Med Sci"},{"key":"B27","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1001\/jamaoto.2013.2659","article-title":"Analysis of the 3-dimensional fluid-attenuated inversion-recovery (3D-FLAIR) sequence in idiopathic sudden sensorineural hearing loss","volume":"139","author":"Berrettini","year":"2013","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"B28","doi-asserted-by":"publisher","first-page":"724","DOI":"10.3174\/ajnr.A0894","article-title":"imaging of endolymphatic and perilymphatic fluid at 3T after intratympanic administration of gadolinium-diethylene-triamine pentaacetic acid","volume":"29","author":"Naganawa","year":"2008","journal-title":"Am J Neuroradiol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1097\/01.mlg.0000228005.78187.23","article-title":"Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging findings in patients with sudden sensorineural hearing loss","volume":"116","author":"Sugiura","year":"2006","journal-title":"Laryngoscope"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.3109\/00016489.2010.496461","article-title":"3D-FLAIR MRI findings in patients with low-tone sudden deafness","volume":"130","author":"Tanigawa","year":"2010","journal-title":"Acta Otolaryngol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.1007\/s00405-011-1834-1","article-title":"Feasibility of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging as a prognostic factor in patients with sudden hearing loss","volume":"269","author":"Lee","year":"2012","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1017\/s0022215114003028","article-title":"Usefulness of three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging to detect inner-ear abnormalities in patients with sudden sensorineural hearing loss","volume":"129","author":"Tanigawa","year":"2015","journal-title":"J Laryngol Otol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"2659","DOI":"10.1007\/s00405-014-3187-z","article-title":"A comparison of inner ear imaging features at different time points of sudden sensorineural hearing loss with three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging","volume":"272","author":"Zhu","year":"2015","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.3174\/ajnr.A4901","article-title":"Prognostic value of labyrinthine 3D-flair abnormalities in idiopathic sudden sensorineural hearing loss","volume":"37","author":"Lee","year":"2016"},{"key":"B35","doi-asserted-by":"publisher","first-page":"31","DOI":"10.7874\/jao.2016.20.1.31","article-title":"Clinical features and prognosis of sudden sensorineural hearing loss secondary to intralabyrinthine hemorrhage","volume":"20","author":"Lee","year":"2016","journal-title":"J Audiol Otol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.3174\/ajnr.A4439","article-title":"Comparison of inner ear contrast enhancement among patients with unilateral inner ear symptoms in MR images obtained 10 minutes and 4 hours after gadolinium injection","volume":"36","author":"Kim","year":"2015","journal-title":"Am J Neuroradiol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1111\/coa.13305","article-title":"The clinical value of 4-hour delayed-enhanced 3D-FLAIR MR images in sudden hearing loss","volume":"44","author":"Byun","year":"2019","journal-title":"Clin Otolaryngol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"429","DOI":"10.5152\/dir.2020.19229","article-title":"Clinical value of abnormal MRI findings in patients with unilateral sudden sensorineural hearing loss","volume":"26","author":"Min","year":"2020","journal-title":"Diagn Interv Radiol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1097\/MAO.0b013e31819bda66","article-title":"Individual differences in the permeability of the round window: evaluating the movement of intratympanic gadolinium into the inner ear","volume":"30","author":"Yoshioka","year":"2009","journal-title":"Otol Neurotol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"S38","DOI":"10.1080\/00016489.2017.1297539","article-title":"Idiopathic sudden sensorineural hearing loss and acute low-tone sensorineural hearing loss: a comparison of the results of a nationwide epidemiological survey in Japan","volume":"137","author":"Yoshida","year":"2017","journal-title":"Acta Otolaryngol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1177\/0194599819859885","article-title":"Clinical practice guideline: sudden hearing loss (update)","volume":"161","author":"Chandrasekhar","year":"2019","journal-title":"Otolaryngol Head Neck Surg."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.2165\/00003495-200161080-00005","article-title":"Meni\u00e8re's disease: pathophysiology and treatment","volume":"61","author":"Thai-Van","year":"2001","journal-title":"Drugs"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1097\/MAO.0b013e3182990e81","article-title":"Endolymphatic hydrops revealed by magnetic resonance imaging in patients with acute low-tone sensorineural hearing loss","volume":"34","author":"Shimono","year":"2013","journal-title":"Otol Neurotol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"102856","DOI":"10.1016\/j.amjoto.2020.102856","article-title":"High level of IgE in acute low-tone sensorineural hearing loss: a predictor for recurrence and Meniere Disease transformation","volume":"42","author":"Ma","year":"2021","journal-title":"Am J Otolaryngol"},{"key":"B45","doi-asserted-by":"publisher","first-page":"884","DOI":"10.3389\/fneur.2018.00884","article-title":"Comorbid symptoms occurring during acute low-tone hearing loss (AHLH) as potential predictors of Meni\u00e8re's disease","volume":"9","author":"St\u00f6lzel","year":"2018","journal-title":"Front Neurol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1080\/00016480601002096","article-title":"Prognosis of low-tone sudden deafness - does it inevitably progress to Meniere's disease?","volume":"128","author":"Junicho","year":"2008","journal-title":"Acta Otolaryngol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/0194599820909438","article-title":"Clinical practice guideline: M\u00e9ni\u00e8re's disease","volume":"162","author":"Basura","year":"2020","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B48","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1001\/jamaoto.2018.0648","article-title":"Association of vertigo with hearing outcomes in patients with sudden sensorineural hearing loss: a systematic review and meta-analysis","volume":"144","author":"Yu","year":"2018","journal-title":"JAMA Otolaryngol Head Neck Surg."},{"key":"B49","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1159\/000314695","article-title":"A comparison of the short-term outcome in patients with acute low-tone sensorineural hearing loss","volume":"72","author":"Morita","year":"2010","journal-title":"ORL J Otorhinolaryngol Relat Spec"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2021.682245\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T04:27:34Z","timestamp":1624249654000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2021.682245\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,21]]},"references-count":49,"alternative-id":["10.3389\/fsurg.2021.682245"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2021.682245","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,21]]},"article-number":"682245"}}