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.
