Longitudinal study of changes in endolymphatic hydrops assessed by intravenous gadolinium-enhanced inner-ear magnetic resonance imaging following medical treatment in patients with Ménière’s disease: a preliminary study

Abstract

Abstract Ménière’s disease (MD) is characterized by episodic vertigo, tinnitus, and hearing loss. Endolymphatic hydrops (EH) is a histologic marker of MD. We aimed to investigate whether symptom improvement following medical treatment would decrease the hydrops ratio calculated by intravenous gadolinium-enhanced inner-ear magnetic resonance imaging (IV Gd MRI) in the cochlea and vestibule. This prospective study included 9 patients diagnosed with unilateral definite MD. All patients were treated medically. Patients underwent IV Gd MRI at diagnosis and follow-up MRI at 6 months after the last vertigo attack. Differences in cochlear hydrops (CH) and vestibular hydrops (VH) ratios of the affected ear before and after medical treatment were measured. Nine patients were enrolled in this study. The hearing level was not significantly (p = 0.759) altered after treatment. Moreover, there was no significant difference in CH ratio (p = 0.083) or VH ratio (p = 0.556) between the initial and follow-up MRI scans. The hydrops ratio did not change in patients after medical control of MD was attained. Because EH did not recover even after symptoms resolved, we conclude that there is no relationship between presenting symptoms and EH.