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Does the intravenous administration of frusemide reduce endolymphatic hydrops?

Published online by Cambridge University Press:  14 January 2016

F Fiorino ,
B Mattellini ,
M Vento ,
L Mazzocchin ,
L Bianconi  and
F B Pizzini
F Fiorino*
Affiliation:
Department of Otolaryngology, Ospedale Mater Salutis – Azienda Unita Locale Socio Sanitaria 21, Legnago, Italy
B Mattellini
Affiliation:
Department of Otolaryngology, Ospedale di Fidenza, Azienda Unità Sanitaria Parma, Italy
M Vento
Affiliation:
Department of Otolaryngology, Ospedale di Fidenza, Azienda Unità Sanitaria Parma, Italy
L Mazzocchin
Affiliation:
Department of Otolaryngology, Ospedale Sacro Cuore, Negrar, Italy
L Bianconi
Affiliation:
Department of Otolaryngology, Ospedale Civile Maggiore – Azienda Ospedaliera Universitaria Integrata Verona, Italy
F B Pizzini
Affiliation:
Department of Neuroradiology, Ospedale Civile Maggiore – Azienda Ospedaliera Universitaria Integrata Verona, Italy
*
Address for correspondence: Dr Francesco Fiorino, Unità Operativa Complessa di Otorinolaringoiatria, Ospedale Mater Salutis, Via Gianella 1, 37045 Legnago (VR), Italy Fax: +39 0442 622357 E-mail: franco.fiorino@virgilio.it
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Abstract

Objective:

To verify the hypothesis that intravenous frusemide reduces endolymphatic hydrops, as evaluated by three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging following intratympanic gadolinium administration.

Methods:

The study comprised 12 patients (7 females and 5 males, aged 19–74 years) with Ménière's disease. Disease duration ranged from 0.5 to 8 years, with a frequency of 0.5 to 6 vertigo spells per month, as calculated in the last 6 months. Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging was performed 24 hours after intratympanic injection of gadobutrol diluted eight-fold. Frusemide 20 mg was given intravenously immediately after imaging. Magnetic resonance imaging was repeated after 1 hour, using the same parameters and sequence.

Results:

All patients showed enhancement defects, indicating endolymphatic hydrops of variable degrees. No modifications occurred at the second magnetic resonance imaging performed 1 hour after frusemide administration.

Conclusion:

There was no evidence of endolymphatic hydrops modification 1 hour after intravenously administered frusemide. Therefore, loop diuretics in Ménière's disease, which are today used on an empirical basis, must be reconsidered. Implications of these outcomes are discussed and related to the role of endolymphatic hydrops in the development of Ménière's disease.

Keywords

Endolymphatic HydropsMagnetic Resonance ImagingGadoliniumDiuretics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 3 , March 2016 , pp. 242 - 247
Copyright
Copyright © JLO (1984) Limited 2016 

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