| Objective: The purpose of this study was to investigate the toxicity of gadolini um contrast agent injected into the tympanum on patients' pure tone hearing Methods: A total of 63 patients with 126 ears diagnosed and suspected meniere's disease admitted to our hospital from 2010 to 2018 were selected.After pure tone audiometry,the average audiometric threshold(PTA)at four frequencies of 250 Hz,500hz,1K Hz and 2KHz in both ears were calculated.Then,gadolinium contrast magnetic resonance examination of inner ear was performed through tymbal injection.Conservative treatment and long-term follow-up were conducted for these patients.According to the results of each ear mirror imaging,divided into the ear membranous labyrinth water and no water,and then:(1),according to the follow-up time T(T 20 days or less,a month or less T < 24 months,T ? 24 months),according to the frequency(250 Hz and 500 Hz,1 k Hz,2 KHz,4 KHz,8 KHz)group,line design,repeated measurement variance and membranous labyrinth water,gadolinium agent whether there is influence on hearing;(2)clear developing ears were grouped according to the follow-up time T(T ?20 days,1 month? T<24 months,T?24 months),frequency(250Hz,500 Hz,1K Hz,2KHz,4KHz,and 8KHz),and the rank sum test was performed.(3)the patients with hydrocephalus in the inner ear indicated by positive contrast were grouped separately and the average value of the two pure tone audiometry was compared.Results: 1.Among the 63 patients with vertigo,imaging was performed in 54 cases and imaging results were poor in 9 cases.Clear imaging was performed in 115 ears,and positive gadolinium contrast in the inner ear indicated hydrocephalus in 36 patients with 39 ears.There were 17 cases of hydrocephalus and 1 case of bleeding in the inner ear when gadolinium contrast was negative.Hydrocephalus 39 ears;76 ears had no hydrocephalus and 11 ears had poor development.2.The repeated measurement variance design showed that:(1)at different follow-up times,the difference value of gadolinium and hydrocephalus on hearing was P > 0.05,which was not statistically significant.In the two groups of T ?20 days and T ?24 months,the difference values of the effect of contrast agent and hydrops on hearing were greater than 0,05,which was not statistically significant.At 1 month T?24 months,the difference value of hydrocephalus on hearing was P < 0.05.The difference value of contrast agent on hearing was P > 0.05.At different frequencies,the difference value of gadolinium and contrast agent on hearing was P > 0.05,which was not statistically significant.At 250 Hz and 500 Hz,the difference value of hydrocephalus on hearing was P < 0.05.The difference value of contrast agent on hearing was P > 0.05.At the other frequencies,the difference values of the effect of contrast media and hydrocephalus on hearing were all greater than 0.05;3.Rank-sum test showed that:(1)according to the follow-up time grouping,there was no statistical difference in PTA before and after angiography.(2)according to frequency grouping,there was no significant difference in hearing before and after frequency contrast.There was no significant difference in PTA between the two groups before and after treatment.5.Among the 36 cases of hydrocephalus,30 cases of meniere's disease were diagnosed,with an imaging diagnosis rate of 83.33%(30/36).The remaining 6 cases were confirmed with delayed hydrolabyrinth in 3 cases and sudden deafness in 3 cases.Conclusion: 1.After long-term follow-up,we found that it was safe to determine whether the internal auditory labyrinth was hydrocephalus by tympanostinium contrast injection,and gadolinium contrast agent had no ototoxicity on hearing function.2.Gadolinium contrast via tympanum injection has certain advantages in assisting in the judgment of internal labyrinthian hydrops,and it plays a better auxiliary role in the diagnosis of meniere's disease. |
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