Vestibular Endolymphatic Hydrops Visualized by Magnetic Resonance Imaging and Its Correlation With Vestibular Functional Test in Patients With Unilateral Meniere's Disease.

Yupeng Liu,Qing Zhang,Baihui He,Fan Zhang,Jun Yang,Maoli Duan,Jingchun He

doi:10.3389/fsurg.2021.673811

Abstract

Background: Currently, 3 Tesla-MRI following intratympanic gadolinium injection has made it possible to assess the existence and the severity of hydrops in each compartment of the endolymphatic spaces in vivo. However, the relationship between vestibular endolymphatic hydrops (EH) visualized by MRI and vestibular functional tests, especially the correlation between caloric test, video-head impulse test, and semicircular canal hydrops, has not been well-investigated.Objective: The purpose of this study is to investigate the relationship between the severity of EH in each compartment of otoliths and semicircular canal and the results of vestibular functional tests.Methods: In this retrospective study, we performed three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequences following intratympanic gadolinium injection in 69 unilateral patients with definite Menière's disease. Vestibular and lateral semicircular canal hydrops was graded on MRI using a four grade criterion. All patients underwent pure-tone audiometry, cervical vestibular evoked myogenic potential (cVEMP), ocular vestibular evoked myogenic potential (oVEMP), caloric test and video head impulse test (vHIT). The latency, amplitude and asymmetry ratio of VEMP, canal paresis (CP) and vestibulo-ocular reflex (VOR) gain of lateral semicircular canal of vHIT were collected. The correlation analysis were performed between the parameters of function test and EH.Results: Vestibular EH showed correlations with the duration of disease (r = 0.360) and pure tone average (r = 0.326). AR of cVEMP showed correlations with Vestibular EH (r = 0.407). CP (r = 0.367) and VOR gain of lateral semicircular canal at 60 ms (r = 0.311) showed correlations with lateral semicircular canal hydrops.Conclusion: EH in different compartments is readily visualized by using 3D-FLAIR MRI techniques. The degree of vestibular EH correlated with AR of cVEMP and EH in the semicircular canal ampullar affects the caloric and vHIT response in patients with unilateral Meniere‘s disease.

Highlights

Ménière’s disease (MD) is an idiopathic inner ear, which is characterized by recurrent attacks of vertigo, fluctuating hearing loss, tinnitus, and ear fullness
We retrospectively reviewed the medical records of 69 patients diagnosed with definite unilateral MD who were admitted to Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine from March, 2018 to December, 2020
The study population consisted of 34 men and 35 women (40 right-sided, 29 left-sided), with ages ranging from 28 to 75 years

Summary

Introduction

Ménière’s disease (MD) is an idiopathic inner ear, which is characterized by recurrent attacks of vertigo, fluctuating hearing loss, tinnitus, and ear fullness. Since 2007, the morphological assessment of EH in MD patients on magnetic resonance imaging (MRI) has been realized by the application of 3dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence following the intratympanic injection of gadolinium (Gd) by Nakashima et al [5]. 3 Tesla-MRI following intratympanic gadolinium injection has made it possible to assess the existence and the severity of hydrops in each compartment of the endolymphatic spaces in vivo. The relationship between vestibular endolymphatic hydrops (EH) visualized by MRI and vestibular functional tests, especially the correlation between caloric test, video-head impulse test, and semicircular canal hydrops, has not been well-investigated

Methods

Results

Conclusion