Enfermedad inmunomediada del oído interno: contribución de nuevas herramientas diagnósticas para su caracterización

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Cirugía. Fecha de lectura: 09-03-2018Esta tesis tiene embargado el acceso al texto completo hasta el 09-09-2019The main goal of this investigation is to provide a new insight towards possible diagnostic tools such as Magnetic Resonance Imaging (MRI) and PET scan (Positron Emission Tomography) to characterize immune-mediated inner ear disease (IMIED). A retrospective case review study design, analyzing patients with IMIED was carried out. Sixty-seven patients suspected of having an IMIED (primary or secondary) were studied. Twenty-eight patients referred a sudden hearing loss as form of presentation and 39 a fluctuating hearing loss. Twenty-seven patients underwent an MRI of the temporal bone with previous intratympanic Gadolinium observing endolymphatic hydrops (EH) in 13 patients. A PET scan was performed on 30 patients being altered in 17 of them. Initial and treatment for recurrences included mainly corticosteroids: intratympanic, intravenous, oral or the combination of two or three of them. IMIED lacks a specific serological marker and it may show different clinical presentations, mimicking diverse inner ear disorders. Fluctuating hearing loss has been the most frequent presentation in the present study. Intratympanic gadolinium (IT Gd) MRI has reported EH in a group of patients mainly affected by primary IMIED. PET has provided the diagnosis of unknown or underestimated secondary IMIED. In conclusion, both IT Gd MRI and PET have shown to be diagnostic tools that can facilitate the characterization of this entity