Qianru Wu1, Chunfu Dai1, Menglong Zhao2, Yan Sha2. 1. 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. 2. Department of Radiology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.
Abstract
OBJECTIVE/HYPOTHESIS: 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. STUDY DESIGN: 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. LEVEL OF EVIDENCE: 4.
OBJECTIVE/HYPOTHESIS: 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. STUDY DESIGN: 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. LEVEL OF EVIDENCE: 4.
Authors: Nils Kristian Prenzler; Eva Bültmann; Alexandros Giourgas; Melanie Steffens; Rolf Benedikt Salcher; Stefan Stolle; Anke Lesinski-Schiedat; Thomas Lenarz; Martin Durisin Journal: Eur Arch Otorhinolaryngol Date: 2016-10-25 Impact factor: 2.503
Authors: David Bächinger; Andreas H Eckhard; Christof Röösli; Dorothe Veraguth; Alexander Huber; Adrian Dalbert Journal: Eur Arch Otorhinolaryngol Date: 2020-06-24 Impact factor: 2.503