The relationship between cochleovestibular function tests and endolymphatic hydrops grading on MRI in patients with Menière’s disease

Sluydts, Morgana; Bernaerts, Anja; Foer, Bert De; Blaivie, Cathérine; Zarowski, Andrzej; Dinther, Joost van; Offeciers, Erwin; Wuyts, Floris L.; Vanspauwen, Robby

doi:10.1007/s00405-021-06610-1

Cited by 14 publications

(21 citation statements)

References 19 publications

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“…However, there may be some controversy regarding this point, so our choice of the 1995 AAO-HNS diagnostic scale (1) instead of the criteria of the 2015 Barany Society guidelines (27) as the main guidelines may represent a limitation of this study. The size of the study population consisting of 123 (246 ears) in our study was much larger than the sample sizes in previous studies of the associations between clinical parameters of MD and EH visualized by MRI (19,20,(28)(29)(30)(31)(32)(33).…”

Section: Discussionmentioning

confidence: 86%

“…Several recent studies analyzed MRI findings of EH and clinical data (19,20,(28)(29)(30)(31). Two Korean studies calculated the mean hydrops ratios in study populations of 29 and 16 patients with unilateral definite MD (19,20).…”

Section: Discussionmentioning

confidence: 99%

“…In these studies, EH on MRI was present in 10 of 14 ears (29) and 12 of 20 ears (28), and hydrops grade (28) was correlated with the amplitude of cervical VEMP. In another study, in a population of 78 patients with unilateral definite MD, there were 57 cases of cochlear EH and 60 of vestibular EH, and these were related to the results of audiometry and caloric tests (30). In a study in which MRI was performed before the endolymphatic duct blockage procedure for unilateral definite MD, all affected ears had cochlear and vestibular EH (31).…”

Section: Discussionmentioning

confidence: 99%

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Correlation of clinical parameters with endolymphatic hydrops on MRI in Meniere's disease

Han

Kim

et al. 2022

Front. Neurol.

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A clinical diagnosis of Ménière's disease (MD) is made based on medical history and audiometry findings. The 1995 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines requires histopathological confirmation of endolymphatic hydrops (EH) for a diagnosis of “certain” MD. Symptoms such as dizziness and ear fullness are important diagnostic features; however, the descriptions provided by patients are frequently vague and non-specific. A recently developed magnetic resonance imaging (MRI) protocol to document EH is, therefore, useful for the evaluation of inner ear status in patients with MD. In this study, patients with MD were assessed using MRI and the HYDROPS (HYbriD of Reversed image Of Positive endolymph signal and native image of positive perilymph Signal) protocol to investigate the effectiveness of MRI for visualization of the endolymphatic space in the diagnosis of MD by correlating clinical laboratory parameters with the grade of EH. Of the 123 patients with MD recruited in this study, 80 had definite MD, 11 had probable MD, and 32 had possible MD based on the 1995 AAO-HNS guidelines. The EH grade based on HYDROPS MRI was determined independently by two otorhinolaryngologists and compared with several clinical parameters, including the diagnostic scale of MD (1995 AAO-HNS guidelines), pure tone average (PTA), low tone average (LTA), canal paresis (CP) on the caloric test, and disease duration. Cochlear hydrops and vestibular hydrops were detected in 58 and 80% of 80 definite MD ears, in 33 and 58% of 12 probable MD ears, and in 5 and 27% of 37 possible MD ears, respectively. The proportion of higher hydrops grades increased significantly with grade according to the MD diagnostic scale (p < 0.0001). Both PTA and LTA were significantly higher in patients with hydrops grade 2 than hydrops grade 0 in both the cochlea and the vestibule. CP was significantly higher in patients with grade 2 than grade 0 vestibular hydrops. Disease duration was not associated with hydrops grade. Radiological evaluation of MD using the HYDROPS protocol is useful for evaluation of the extent and severity of EH in the diagnosis of MD based on its pathophysiological mechanism.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Correlation of clinical parameters with endolymphatic hydrops on MRI in Meniere's disease

Han

Kim

et al. 2022

Front. Neurol.

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“…Kato et al (9) presented that there was no significant correlation between the caloric test results and the degree of EH in the vestibule, or the lateral semicircular canal ampulla. While, Sluydts et al (10) and Guo et al (6) reported that the abnormal caloric tests was correlated with the severity of vestibular. Moreover, few studies have focused on the relationships between semicircular canal hydrops and vestibularocular reflex (VOR) recorded by video head impulse test (vHIT) (11,12).…”

Section: Introductionmentioning

confidence: 98%

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

Liu

Zhang

et al. 2021

Front. Surg.

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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.

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“…Despite their strong association, the relationship between EH and MD remains unclear. In the last decade, the application of delayed gadolinium (Gd)-enhanced MRI has provided novel insights in the clinical effect of EH (22)(23)(24)(25)(26)(27)(28)(29)(30). The degree of EH is reported to correspond with disease duration and the degree of sensorineural hearing loss in MD patients (27,28,31,32).…”

Section: Introductionmentioning

confidence: 99%

Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment

et al. 2021

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Research Objective: To investigate the correlation between clinical features and MRI-confirmed endolymphatic hydrops (EH) and blood-labyrinth barrier (BLB) impairment.Study Design: Retrospective cross-sectional study.Setting: Vertigo referral center (Haga Teaching Hospital, The Hague, the Netherlands).Methods: We retrospectively analyzed all patients that underwent 4 h-delayed Gd-enhanced 3D FLAIR MRI at our institution from February 2017 to March 2019. Perilymphatic enhancement and the degree of cochlear and vestibular hydrops were assessed. The signal intensity ratio (SIR) was calculated by region of interest analysis. Correlations between MRI findings and clinical features were evaluated.Results: Two hundred and fifteen patients with MRI-proven endolymphatic hydrops (EH) were included (179 unilateral, 36 bilateral) with a mean age of 55.9 yrs and median disease duration of 4.3 yrs. Hydrops grade is significantly correlated with disease duration (P < 0.001), the severity of low- and high-frequency hearing loss (both P < 0.001), and the incidence of drop attacks (P = 0.001). Visually increased perilymphatic enhancement was present in 157 (87.7%) subjects with unilateral EH. SIR increases in correlation with hydrops grade (P < 0.001), but is not significantly correlated with the low or high Fletcher index (P = 0.344 and P = 0.178 respectively). No significant differences were found between the degree of EH or BLB impairment and vertigo, tinnitus or aural fullness.Conclusion: The degree of EH positively correlates with disease duration, hearing loss and the incidence of drop attacks. The BLB is impaired in association with EH grade, but without clear contribution to the severity of audiovestibular symptoms.

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The relationship between cochleovestibular function tests and endolymphatic hydrops grading on MRI in patients with Menière’s disease

Cited by 14 publications

References 19 publications

Correlation of clinical parameters with endolymphatic hydrops on MRI in Meniere's disease

Correlation of clinical parameters with endolymphatic hydrops on MRI in Meniere's disease

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

Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment

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