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Updated: Aug 15, 2025
Surgical Induction of Endolymphatic Hydrops by Obliteration of the Endolymphatic Duct
Published on: January 22, 2010
Temporal changes in endolymphatic hydrops on MRI with or without intervention: A systematic review
Maria A Mavrommatis1, Vivian F Kaul2, Kevin Chow3
1Department of Otolaryngology - Head & Neck Surgery, Mount Sinai, New York, NY, USA.
Objective:
The pathophysiology of Meniere's Disease (MD) involves endolymphatic hydrops (ELH) of the inner ear. Magnetic Resonance Imaging (MRI) has been shown to detect ELH, but changes in ELH have been poorly described using this modality. Our objective was to review MRI-measured changes in ELH over time and after medical and/or surgical intervention in patients with MD. We secondarily aim to associate changes in ELH with changes in MD symptomatology.
Databases Reviewed:
Medline, Web of Science, and Embase databases.
Methods:
A systematic review of articles was performed to identify studies utilizing MRI to measure ELH changes over time, and after medical or surgical treatment. Articles on non-human subjects and without direct measurement of ELH were excluded.
Results:
Of 532 studies identified, 12 were included, involving 170 patients (mean age 56.3 years). Ten studies were prospective; two were retrospective. Five studies strictly utilized medical means of intervention, four utilized surgical treatments, one utilized both, and two observed temporal changes without treatment. Across all interventions, 72.1 % of patients exhibited the same or worsening ELH on imaging. In studies reporting vertigo outcomes, 95.9 % of patients exhibited improvement after the treatment period.
Conclusion:
Medical and surgical interventions often yield symptomatic relief of vertigo in MD patients despite stable or increasing ELH volume. MRI may have greater clinical utility in diagnosing ELH as opposed to assessing treatment response.
Insights
Meniere's Disease treatments often improve vertigo symptoms, even when MRI shows no change or worsening of inner ear fluid buildup (endolymphatic hydrops). MRI is better for diagnosis than tracking treatment effectiveness.
Area of Science:
- Otolaryngology
- Neurology
- Radiology
Background:
- Meniere's Disease (MD) is characterized by endolymphatic hydrops (ELH), an excess of inner ear fluid.
- Magnetic Resonance Imaging (MRI) can detect ELH, but its utility in monitoring changes over time and post-treatment is less understood.
Conclusions:
- Symptomatic relief in MD patients can occur despite persistent or increased ELH volume.
- MRI is valuable for diagnosing ELH but may be less effective for assessing treatment response in Meniere's Disease.
