Change in endolymphatic hydrops 2 years after endolymphatic sac surgery evaluated by MRI

Publication date: Available online 27 November 2018

Source: Auris Nasus Larynx

Author(s): Kayoko Higashi-Shingai, Takao Imai, Tomoko Okumura, Atsuhiko Uno, Tadashi Kitahara, Arata Horii, Yumi Ohta, Yasuhiro Osaki, Takashi Sato, Suzuyo Okazaki, Takefumi Kamakura, Yasumitsu Takimoto, Yoshiyuki Ozono, Yoshiyuki Watanabe, Ryusuke Imai, Yukiko Hanada, Kazuya Ohata, Ryohei Oya, Hidenori Inohara

Abstract

Objective

This study was performed to determine whether endolymphatic sac surgery improves vestibular and cochlear endolymphatic hydrops 2 years after sac surgery and to elucidate the relationship between the degree of improvement of endolymphatic hydrops and the changes in vertigo symptoms, the hearing level, and the summating potential/action potential ratio (−SP/AP ratio) by electrocochleography (ECochG) in patients with Ménière's disease (MD).

Methods

Twenty-one patients with unilateral MD who underwent sac surgery were included in this study. All patients underwent gadolinium-enhanced magnetic resonance imaging (Gd-MRI) before and 2 years after sac surgery. We evaluated the difference in vestibular and cochlear endolymphatic hydrops between before and after surgery in both ears and compared these findings with the frequency of vertigo attacks, hearing level, and ECochG findings.

Results

In affected ears, the presence of vestibular endolymphatic hydrops and the frequency of vertigo attacks significantly decreased after surgery. However, affected ears showed no significant improvement in the presence of cochlear endolymphatic hydrops or the −SP/AP ratio by ECochG; there was also no significant improvement or deterioration in the hearing level.

Conclusion

The present findings suggest that sac surgery reduces vestibular endolymphatic hydrops and prevents aggravation of cochlear endolymphatic hydrops, and these changes lead to a reduction of vertigo attacks and suppress the progression of hearing impairment associated with vertigo attacks.

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