Mastoid and Inner Ear Measurements in Patients With Meniere's Disease.

Objective: To determine the relationship between radiographic temporal bone anatomy of patients with Meniere's disease in medically and surgically managed populations versus controls. Study Design: Retrospective chart review. Setting: Two tertiary referral centers. Patients: Adults older than 18 years with Meniere's disease treated with endolymphatic sac decompression (ESD) or medical management (non-ESD) versus controls. Interventions: Magnetic resonance imaging and computed tomography imaging studies of the temporal bones were reviewed by blinded radiologists. Main Outcome Measures: Radiographic temporal bone dimensions were measured in Meniere's disease and control patients. Age, sex, symptoms, audiogram data, academy classification of Meniere's disease, and follow-up were recorded. Statistical analysis was performed to compare outcome measures across groups and demographics. Results: A total of 90 imaging studies were reviewed (ESD = 22; non-ESD = 30; control = 38). ESD and non-ESD groups had similar pure-tone averages (33.9 +/- 20.6 versus 41.6 +/- 22.6 dB HL; p = 0.21) and frequency of definite Meniere's disease (59.1% versus 53.3%; p = 0.68). There was no significant trend between groups for any measurement. One nonsignificant trend existed in mean vestibule length, increasing from the control (5.45 +/- 0.54 mm), non-ESD (5.80 +/- 0.97 mm), and ESD (5.94 +/- 0.81 mm) group. In a combined Meniere's group, mean vestibule length was significantly greater than controls (5.86 +/- 0.89 versus 5.45 +/- 0.54 mm; p = 0.008) and mean vestibule width significantly less (2.99 +/- 0.46 versus 3.19 +/- 0.39 mm; p = 0.024). Conclusion: Medical and surgical Meniere's patients were similar utilizing academy classification. There was no significant trend between medical and surgical Meniere's patients versus controls for any measurement. In a combined Meniere's group, the longer and narrower vestibule anatomy may suggest an anatomical basis for endolymphatic hydrops. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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