Endolymphatic hydrops in patients with tinnitus as the major symptom

Tinnitus is one of the symptoms of Meniere's disease. The relationship between a clinical presentation of subjective tinnitus or ear fullness and endolymphatic hydrops (EH) has not yet been explored. We studied 15 patients with symptoms of tinnitus as their major complaint, with or without hearing loss, who were evaluated using magnetic resonance imaging (MRI). The mean age of the subjects was 59 years (range 35-79 years). Nine were women and six were men. Patients were divided into two groups based on whether they had fluctuating or stable tinnitus. These groups were subdivided in the presence or absence of accompanying sensation of ear fullness. MRI was performed 4 h after intravenous gadolinium administration. Overall, 30 ears were evaluated. EH in the cochlea was present in 14 of 25 symptomatic ears (56 %) in patients with tinnitus as the major complaint. Significant hydrops was present in 7 of 14 ears and mild hydrops in the other ears. Patients with fluctuating tinnitus had EH more frequently than patients with stable tinnitus. Furthermore, the presence of ear fullness also correlated with the presence of EH in the cochlea. However, there was no significant relationship between EH in the cochlea and age, sex, duration of tinnitus, hearing level or the configuration of the audiogram. Our study revealed that patients who had tinnitus as their major symptom often had EH. Using MRI to identify this covert early EH in patients who have tinnitus as their major symptom may broaden the treatment options for tinnitus.