Magnetic resonance-based volumetric measurement of the endolymphatic space in patients with Meniere’s disease and other endolymphatic hydrops-related diseases

Publication date: Available online 30 November 2018

Source: Auris Nasus Larynx

Author(s): Hiroshi Inui, Tsuyoshi Sakamoto, Taeko Ito, Tadashi Kitahara

Abstract

Objective

To employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere's disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis.

Methods

Forty-one patients with ALHL, 82 with SD, 48 with cMD, 72 with uMD, and 47 CS participated in the study. With the exception of all uMD patients, none of the subjects had vertigo. Images of the inner ear fluid space, positive perilymph signal, and positive endolymph signal were acquired using a 3-T MRI scanner. Three-dimensional images were reconstructed semi-automatically by using anatomical and tissue information to fuse the inner ear fluid space images and the ELS images.

Results

The cochlear ELS/total fluid space (TFS) volume ratio was 10.2 ± 6.7% (mean ± standard deviation) in the CS group, 12.1 ± 5.7% in ALHL patients, 15.2 ± 8.7% in SD patients, 18.1 ± 8.2% in cMD patients, and 21.9 ± 16.4% in uMD patients. The vestibular ELS/TFS volume ratio was 17.7 ± 10.2% in the CS group, 18.9 ± 8.3% in ALHL patients, 19.9 ± 11.3% in SD patients, 22.5 ± 13.7% in cMD patients, and 35.7 ± 24.1% in uMD patients. The cochlear ELS/TFS volume ratio in patients with uMD was similar to that in the cMD group and significantly higher than that in the CS, ALHL, and SD groups (CS = ALHL < SD < cMD = uMD: p < 0.05 for CS vs. SD and p < 0.01 for CS vs. cMD). The vestibular ELS/TFS volume ratio in patients with uMD was significantly higher than that in the CS and all other patient groups (CS = ALHL = SD = cMD < uMD: p < 0.01 for uMD vs. all other groups).

Conclusion

The cochlear ELS volume of patients with MD and other endolymphatic hydrops-related diseases differed from that of CS. Our results suggest that ALHL may not be caused by endolymphatic hydrops. We confirmed the presence of extended ELS in patients with SD.

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