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Magnetic resonance imaging in the evaluation of clinical treatment of otospongiosis : a pilot study . OBJECTIVES To evaluate the applicability of magnetic resonance imaging ( MRI ) as a method for monitoring the activity of otospongiotic lesions before and after clinical treatment . STUDY DESIGN Prospective , randomized , controlled , double-blind study . SETTING One single tertiary care institution in a large , cosmopolitan city . METHODS Twenty-six patients ( n = 42 ears ) with clinical , audiometric , and tomographic diagnosis of otosclerosis were enrolled . If computed tomography ( CT ) demonstrated active lesions , these patients underwent MRI to detect otospongiotic foci , seen as areas of gadolinium enhancement . Patients were divided into 3 groups and received treatment with placebo , sodium alendronate , or sodium fluoride for 6 months . After this period , clinical and audiometric evaluations and a second MRI were performed . Each MRI was evaluated by both a neuroradiologist and an otolaryngologist in a subjective ( visual ) and objective ( using specific eFilm Workstation software ) manner . RESULTS Otospongiosis was most predominantly identified in the region anterior to the oval window , and this site was reliable for comparing pre- and posttreatment scans . The patients in the alendronate and sodium fluoride groups had MRI findings that suggested a decrease in activity of otospongiotic lesions , more relevant in the alendronate group . These findings were statistically significant for both subjective and objective MRI evaluations . CONCLUSIONS MRI shows higher sensitivity than clinical or audiometric assessment for detecting reduction in activity of otospongiosis . The objective MRI evaluation based on software analysis was the most accurate method of monitoring clinical treatment response in otospongiosis .
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Intervention_Physical
Magnetic resonance imaging
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Intervention_Physical
magnetic resonance imaging ( MRI )
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Intervention_Physical
computed tomography
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Intervention_Physical
MRI
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Intervention_Control
placebo
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Intervention_Pharmacological
sodium alendronate
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Intervention_Pharmacological
sodium fluoride
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Intervention_Physical
MRI
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Intervention_Physical
MRI
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Intervention_Physical
MRI
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Intervention_Physical
MRI
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Intervention_Physical
MRI
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Participant_Condition
otospongiosis :
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Participant_Sample-size
Twenty-six
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Participant_Sample-size
n = 42 ears
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Participant_Condition
otosclerosis