Endolymphatic hydrops in the unaffected ear of patients with unilateral Ménière’s disease

Abstract

Purpose Current studies show that frequency tuning modification is a good marker for the detection of endolymphatic hydrops (EH) employing magnetic resonance imaging (MRI) in patients with Ménière’s disease (MD). The purpose of the present study is to analyze the auditory and vestibular function with audiometric and vestibular-evoked myogenic potentials (VEMP) responses, respectively, in both the affected and unaffected ears of patients with unilateral MD using MRI as diagnostic support for the degree of EH. Methods We retrospectively reviewed the medical records of 76 consecutive patients with unilateral definite MD (age 55 (28–75); 39 women, 37 men). MRI was used through intravenous gadolinium administration, audiometry, and VEMPs. Functional tests were performed up to a week after the MRI. All were followed up one year after imaging utilizing clinical, auditory, and vestibular testing to rule out bilateral involvement. Results In the unaffected ear, the mean pure-tone average is normal even in cases with hydrops and, for a similar severity of hydrops is significantly lower than in the affected ear. Significant differences for the amplitude of the response at 0.5 kHz, at 1 kHz between the affected and unaffected ears were found to be lower in the affected ears. The relative amplitude ratio (1 Kz–0.5 kHz) was significantly lower in the affected ear and in the case of the oVEMP response depends on the degree of EH. The response in the unaffected ear was not modified by the presence or the degree of hydrops. Conclusion In the unaffected ear, hydrops is not associated with hearing deterioration. For a similar degree of hydrops, hearing loss is significantly greater in the affected ear. The endolymphatic hydrops in the vestibule induces a frequency bias in the VEMP response only in the affected ear and not in the unaffected ear. Because of these findings we consider that hydrops does not represent an active disorder in the unaffected ear.

Endolymphatic Hydrops Magnet Resonance Imaging in Ménière’s Disease Patients after Cochlea Implantation

“…It is known that ELH can also be present on ears. This can be in cases of the uni- and bilateral occurrence of MD [ 5 , 32 , 33 , 34 ].…”

“…It is known that ELH can also be present on ears. This can be in cases of the uni-and bilateral occurrence of MD [5,[32][33][34]. There is also an artifact on the implanted left side, which is denoted with a white star.…”

Measurement of Ocular Vestibular Evoked Myogenic Potentials: Nasion Reference Montage as an Alternative to the Clinical Standard Montage

“…Besides latencies, other standard parameters describing the oVEMP reflex pathway include amplitudes (in microvolts) and asymmetry ratio (AR; dimensionless) (3,14,15). These parameters and their alteration, alone or in conjunction with results from complementary methods such as cervical VEMP or video head impulse test, can help assess the function of the equilibrium system and diagnose various disorders of the vestibular organ and beyond (12,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25).…”

Central Representation of Cervical Vestibular Evoked Myogenic Potentials

“…Pathologies that involve the inner ear cochlea, also cause damage to the saccule. Then, the most susceptibility of the vestibular organs to impairment is related to the saccule, in cases of sensorineural hearing loss [ 15 , 16 ], Meniere's disease [ 17 ], sudden sensorineural hearing loss [ 18 , 19 ], auditory-neuropathy [ 20 ], noise induced hearing loss [ 21 ], destructive effects of musical sounds [ 22 ], aging [ 23 ], ototoxic drugs [ 24 ], and covid-19 [ 25 ]. Also, continuous loudly singing, which lasts longer than duration time of the stapedius reflex of the middle ear can cause saccular damage [ 26 ].…”