Hydrops-MRT: Correlation of cochlear and vestibular hydrops with clinical symptoms in Ménière's disease

Ménière's disease is a disease of the inner ear with recurrent vertigo, tinnitus, fluctuating cochlear hearing loss and aural fullness. The pathologic hallmark of Ménière's disease is endolymphatic hydrops, which can be visualised by high resolution magnetic resonance imaging (MRI) after intravenous injection of contrast agent. This imaging technique allows the distinction between vestibular and cochlear endolymphatic hydrops. Whether there is a causal relation between endolymphatic hydrops and symptoms in Ménière's disease is not undisputed.

The aim of this study was to elucidate whether vestibular or cochlear hydrops correlated with clinical symptoms or the clinical tests applied in the diagnostic workup of Ménière's disease patients.

To this end, all patients with Ménière's disease that were admitted to the department of Head and Neck Surgery of the Hannover Medical School from January 2016 to October 2017 were included in a retrospective study, if results of a complete audiologic diagnostic workup, electrocochleography (ECochG), a glycerol test, and a vestibular diagnostic workup including an evaluation of caloric nystagmus and a hydrops-MRI could be retrieved.

First results show that the results of the hydrops MRI correlated with the results of the ECochG in 69% of cases but only in 56% with the results of the glycerol test. Interestingly, the results of the hydrops-MRI concerning cochlear hydrops showed a higher correlation with the results of ECochG and glycerol test than the results of the hydrops-MRI concerning vestibular hydrops (ECochG: 62% vs. 48%; glycerol test: 55% vs. 48%).

Thus, the results indicate a differential influence of vestibular and cochlear hydrops on the symptoms of Ménière's disease.

Publication History

Publication Date:
18 April 2018 (online)