The correlation between symptoms of definite Meniere's disease and endolymphatic hydrops visualized by magnetic resonance imaging.
OBJECTIVE
This study aimed at investigating the correlation between a battery of diagnostic symptoms of definite Meniere's disease (MD) and the degree of endolymphatic hydrops (EH) in the inner ear.


METHODS
Prospective study.


METHODS
Fifty-four patients diagnosed with unilateral definite MD were enrolled in the study. The hearing levels of all patients at the low, middle, and high frequencies were evaluated. Three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) and three-dimensional real inversion recovery (3D-real IR) magnetic resonance imaging (MRI) were performed 24 hours after bilateral intratympanic injection of gadolinium to assess the presence and grading of EH.


RESULTS
Various degrees of EH were observed in the vestibule and/or each turn of the cochlea in the affected ears of all patients. The duration of MD disease and low-tone and middle-tone hearing thresholds were proportional to the extent of EH in the vestibule and cochlear. However, no significant correlation was demonstrated between EH and other aspects of symptoms such as high-tone hearing loss, tinnitus, and aural fullness. Of all subjects, 16.7% exhibited bilateral EH on MRI exam who were diagnosed with unilateral MD based on diagnostic criteria.


CONCLUSIONS
EH in the inner ear of MD patients exhibits a progressive deteriorative trend over time. Low-tone and middle-tone hearing thresholds can indirectly reflect the severity of EH in the cochlea. EH may not be the primary cause of tinnitus and aural fullness in patients with MD. Patients diagnosed with unilateral MD should maintain long-term regular follow-ups for the possibility of developing bilateral EH.


METHODS
4.
Department of Otology and Skull Base Surgery, Hearing Research Key Lab of Health Ministry of China, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai.
Qianru
Q
Wu
Department of Otology and Skull Base Surgery, Hearing Research Key Lab of Health Ministry of China, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai.
Chunfu
C
Dai
Department of Radiology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.
Menglong
M
Zhao
Department of Radiology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.
Yan
Y
Sha
D000328:Adult; D000368:Aged; D003287:Contrast Media; D018159:Endolymphatic Hydrops / Q000473:pathology*; D005260:Female; D005682:Gadolinium; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008575:Meniere Disease / Q000473:pathology*; D008875:Middle Aged; D011446:Prospective Studies; D014012:Tinnitus / Q000473:pathology
D003287:Contrast Media; D005682:Gadolinium
Meniere's disease; endolymphatic hydrops; magnetic resonance imaging; symptom