Related Experiment Video
Updated: May 30, 2026
In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears
Published on: February 21, 2018
Progression of endolymphatic hydrops in Ménière's disease as evaluated by magnetic resonance imaging
Francesco Fiorino1, Francesca B Pizzini, Alberto Beltramello
1Department of Otolaryngology, Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy. franco.fiorino@virgilio.it
Objective:
To evaluate the presence and the degree of endolymphatic hydrops (EHs) in patients with unilateral Ménière's disease (MD), as a function of duration of the disease, estimated using a 3-dimensional fluid-attenuated inversion recovery sequence in a 3-Tesla magnetic resonance imaging unit, after intratympanic gadolinium administration.
Patients:
A total of 32 patients (21 male and 11 female subjects, aged 25-78 yr; median, 56 yr) participated in the investigation. The duration of the disease ranged from 2 months to 10 years (median, 3 yr), with a prevalence of vertigo spells in the last 6 months ranging from 0.5 to 8 per month (median, 2.5).
Intervention:
A 0.6-ml solution of gadobutrol (1 mmol/ml) diluted 1:7 in saline was injected in the affected ear through the inferior-posterior quadrant of the tympanic membrane, using a 22-gauge spinal needle. The patient was kept with the head rotated 45 degrees contralaterally for 30 minutes after each injection. Twenty-four hours later, a 3-dimensional fluid-attenuated inversion recovery magnetic resonance imaging was performed.
Main Outcome Measure:
Perilymphatic enhancement was evaluated in different portions of the labyrinth as a function of MD duration.
Results:
Reduced or absence of enhancement of the vestibule occurred precociously and occurred in all subjects at long term. The prevalence of enhancement abnormalities in the cochlea and the semicircular canals was directly proportional to MD duration. At long term, the vestibule and the cochlea showed a more severe hydropic involvement compared with semicircular canals. A statistical significant correlation between enhancement abnormalities and MD duration was observed for most inner ear sites.
Conclusion:
The increased prevalence and severity of EH with the duration of MD indicates that hydrops is a progressive degenerative phenomenon. The frequent abnormality in the vestibule and, secondarily, in the cochlea is in line with some histopathologic investigations. It remains to be clarified whether hydropic changes are related to specific signs and symptoms of MD.
Insights
Endolymphatic hydrops (EH) in Ménière
Area of Science:
- Otolaryngology
- Neuroimaging
- Inner Ear Disorders
Background:
- Ménière's disease (MD) is characterized by endolymphatic hydrops (EH), a buildup of fluid in the inner ear.
- The relationship between EH severity and MD duration requires further investigation.
- Advanced MRI techniques can visualize EH after gadolinium administration.
Purpose of the Study:
- To assess the presence and degree of EH in unilateral MD patients.
- To correlate EH findings with the duration of the disease.
- To utilize 3D FLAIR 3T MRI with intratympanic gadolinium.
Main Methods:
- 32 patients with unilateral MD underwent intratympanic gadolinium injection.
- A 3D FLAIR sequence on a 3T MRI was performed 24 hours post-injection.
- Perilymphatic enhancement was evaluated in the labyrinth relative to MD duration.
Main Results:
- Vestibular enhancement abnormalities were observed early and universally in long-term cases.
- Cochlear and semicircular canal enhancement abnormalities correlated positively with MD duration.
- The vestibule and cochlea showed more severe hydropic changes than semicircular canals.
Conclusions:
- EH in MD is a progressive degenerative condition, increasing in prevalence and severity with disease duration.
- Observed hydropic changes in the vestibule and cochlea align with histopathological findings.
- Further research is needed to link EH progression to specific MD signs and symptoms.
Related Concept Videos
01:23Mitral Regurgitation II: Clinical Features and Diagnostic Tests
01:24Magnetic Resonance Imaging
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests