25791707
OBJECTIVE	To evaluate the applicability of magnetic resonance imaging ( MRI ) as a method for monitoring the activity of otospongiotic lesions before and after clinical treatment .
METHODS	Prospective , randomized , controlled , double-blind study .
METHODS	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 .
METHODS	If computed tomography ( CT ) demonstrated active lesions , these patients underwent MRI to detect otospongiotic foci , seen as areas of gadolinium enhancement .
METHODS	Patients were divided into 3 groups and received treatment with placebo , sodium alendronate , or sodium fluoride for 6 months .
METHODS	After this period , clinical and audiometric evaluations and a second MRI were performed .
METHODS	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 .
RESULTS	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 .
RESULTS	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 .
CONCLUSIONS	The objective MRI evaluation based on software analysis was the most accurate method of monitoring clinical treatment response in otospongiosis .

