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Updated: Nov 15, 2025
Surgical Induction of Endolymphatic Hydrops by Obliteration of the Endolymphatic Duct
Published on: January 22, 2010
Imaging of endolymphatic hydrops: A comprehensive update in primary and secondary hydropic ear disease
Michael Eliezer1, Arnaud Attyé1,2, Michel Toupet3
1Department of Neuroradiology, Lariboisière University Hospital, Paris, France.
Insights
Endolymphatic hydrops (EH), excess inner ear fluid, is key in Meniere's disease. Delayed inner ear MRI now reliably detects EH in primary and secondary hydropic ear disease, correlating with hearing loss.
Area of Science:
- Otolaryngology
- Radiology
- Inner Ear Disorders
Background:
- Endolymphatic hydrops (EH) is a key biomarker in Meniere's disease.
- Primary hydropic ear disease (PHED) is Meniere's disease; secondary hydropic ear disease (SHED) involves EH with pre-existing inner ear conditions.
Purpose of the Study:
- To review MRI methods for hydrops detection.
- To summarize radiological findings in PHED and SHED patients.
Main Methods:
- Delayed inner ear MRI techniques.
- Radiological assessment of EH.
Main Results:
- Inner ear MRI is crucial for in vivo EH identification in PHED and SHED.
- EH presence on MRI correlates with sensorineural hearing loss.
- Absence of EH on MRI in patients without hearing loss.
Conclusions:
- Advanced inner ear MRI is vital for diagnosing EH in PHED and SHED.
- MRI aids in understanding the relationship between EH and hearing loss.
Background:
Since the first description by Hallpike and Cairns, the excess of endolymphatic fluid, also known as endolymphatic hydrops (EH), has been established as being the main biomarker in patients with Menière's disease. Recently, the concept of primary (PHED) and secondary hydropic ear disease (SHED) has been introduced. PHED corresponded to Menière's disease while SHED was defined as the presence of EH in patients with pre-existing inner ear disease.
Objective:
In this article, we would like to summarize the methodology of hydrops exploration using MRI and the previously published radiological findings in patients with PHED and SHED.
Results:
Before the emergence of delayed inner ear MRI, the presence of EH was assumed based on clinical symptoms. However, because of the recent technical developments, inner ear MRI became an important tool in clinical settings for identifying EH in vivo, in patients with PHED and SHED. The presence of EH on MRI is related with the degree of sensorineural hearing loss whether in patients with PHED or SHED. By contrast, in PHED or SHED patients without sensorineural hearing loss, MRI showed no sign of EH.
Conclusions:
Thanks to the recent technical developments, inner ear MRI became an important tool in clinical settings for identifying EH in vivo, in patients with PHED and SHED.
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