Endolymphatic Hydrops in Fluctuating Hearing Loss and Recurrent Vertigo

Area of Science:

• Otolaryngology
• Neurology
• Radiology

Background:

• Endolymphatic hydrops (EH) is a key finding in Ménière's disease (MD).
• EH is increasingly detected via MRI in various inner ear conditions.
• Its prevalence and significance in non-MD patients require further investigation.

Purpose of the Study:

• To assess EH prevalence and audiovestibular findings in patients with fluctuating symptoms but not meeting definite MD criteria.
• To compare these findings with definite MD and idiopathic sudden neurosensory hearing loss (ISSNHL) groups.
• To explore the relationship between EH and disease progression.

Main Methods:

• 170 patients were analyzed: 83 with definite MD, 38 with fluctuating hearing loss, 34 with recurrent vertigo, and 15 with ISSNHL.
• Clinical data, audiovestibular tests, and MRI-detected EH were evaluated.
• Logistic proportional hazard models analyzed odds ratios for hydrops development.

Main Results:

• Hearing loss differed significantly between groups; other clinical variables showed no statistical differences.
• EH prevalence varied significantly, with higher odds in definite MD patients compared to others (OR=11.43).
• EH presence was strongly associated with definite MD, recurrent vertigo, and fluctuating hearing loss, but minimal in ISSNHL.

Conclusions:

• EH detection rates correlate with the severity of audiovestibular symptoms.
• MRI-identified EH in patients with fluctuating symptoms may indicate a risk of progression to definite MD.
• Imaging for EH is recommended in patients presenting with fluctuating audiovestibular issues.