Clinical Significance Of Endolymphatic Hydrops Visualized By Magnetic Resonance Imaging In Patients With Meniere's Disease

Objective: This study aimed at exploring whether diagnostic symptoms and common audiological examinations of Meniere's disease(MD)correlate with the degree of endolymphatic hydrops(EH)in the inner ear.Methods: Fifty patients(52 affected ears)diagnosed with MD were enrolled in the study.Three-dimensional fluid-attenuated inversion recover(3D-FLAIR)magnetic resonance imaging(MRI)were performed about 24 hours after intratympanic injection of gadolinium to assess the presence and grading of EH.The pure tone hearing threshold,suprathreshold function test,electrocochleogram(EcochG)and glycerol test were conducted on all patients.Symptoms and the result of audiological examinations were analyzed whether correlate with EH.Results: Various degrees of EH were observed in the vestibule and cochlea in the affected ears of all patients.The vestibular EH was proportional to the cochlear EH(p<0.001).Pure-tone audiometry(PTA)thresholds were significantly correlated with both vestibular(p<0.001)and cochlear EH(p=0.001).EH significantly correlate with short increment sensitivity index(SISI)both in vestibule(p<0.001)and cochlea(p=0.008).EcochG correlates with vestibular EH(p=0.024).However,no correlation was demonstrated between EH and other audiological examinations we performed,such as alternate binaural loudness balance(ABLB),tone decay test(TDT)and glycerol test(p>0.05).Age,duration,frequency of vertigo,tinnitus and aural fullness also showed correlation with EH(p>0.05).Conclusions: EH can be observed in almost all MD patients.The degree of EH can reflect impairment of inner ear function.Therefore,EH showed by 3D-FLAIR MRI after intratympanic injection of gadolinium can not only be applied to the diagnosis of MD,but also be helpful to evaluate state of illness.