Correlations Between the Degree of Endolymphatic Hydrops and Symptoms and Audiological Test Results in Patients With Menière's Disease: A Reevaluation

Objective: This study was performed to reevaluate the diagnostic significance of clinically well-accepted audiological tests in indicating endolymphatic hydrops (EH) in Menière's disease (MD). Study Design: Retrospective case review. Settings: Hospital. Patients: Fifty patients (52 affected ears) diagnosed with MD were enrolled. Intervention: Diagnostic. Main Outcome Measure: To analyze the correlations between endolymphatic hydrops and results of audiological test including the pure-tone audiometry threshold, suprathreshold function tests, electrocochleogram, and glycerol test. Results: Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging demonstrated EH in either the vestibule or cochlea to various degrees in all of the MD patients, 24 hours after intratympanic gadolinium chelate injection. Both vestibular and cochlear EH were significantly correlated with PTA threshold. However, EH was not associated with alternate binaural loudness balance or the tone decay test, although a correlation was observed with the short-increment sensitivity index. There was also a correlation between vestibular EH, but not cochlear EH, and the negative summating potential/action potential (–SP/AP) ratio. Neither vestibular EH nor cochlear EH was correlated with the glycerol test results. In addition, the frequency of vertigo attacks, the existence of tinnitus, and aural fullness did not correlate with EH. Conclusions: Disrupted ionic homeostasis in the inner ear, but not the EH, may contribute to changes in the –SP/AP ratio. The relevance of glycerol test in identifying EH through detection of hearing changes needs further investigation in the future. Address correspondence and reprint requests to Haibo Shi, M.D., Ph.D., Department of Otolaryngology–Head and Neck Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Yishan Road #600, Shanghai 200233, China; E-mail: haibo99@hotmail.com; Yuehua Li, M.D., Ph.D., Department of Radiology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Yishan Road #600, Shanghai 200233, China; E-mail: liyuehua312@163.com; Jing Zou, M.D., Ph.D., Department of Otolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Changhai Road #168, Shanghai 200433, China; E-mail: zoujinghb@hotmail.com S.Y. and H.Z. have contributed equally to this work. This work was supported by grants from the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (No. 20152233), the Key Project of Shanghai Jiao Tong University Medicine Science and Engineering Interdisciplinary Foundation (No.YG2016ZD02), the research program of the Shanghai Science and Technology Committee (No.124119b0300), Clinical Research Plan of Shanghai Shen Kang Hospital Development Center (16CR4022A, 16CR3041A), and the National Natural Science Foundation of China (81771006/H1304). The authors disclose no conflicts of interest. Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

from #Audiology via xlomafota13 on Inoreader http://ift.tt/2EeaPbg
via IFTTT