Masahiro Kato

Conclusion: Our study showed that patients with atypical Meniere's disease had endolymphatic hydrops (EH) in both the cochlea and the vestibule. Using an imaging method, we provide evidence that atypical Meniere's disease is a true variant of classic Meniere's disease. Objectives: The aim of present study was to investigate images of the endolymphatic space in patients with atypical Meniere's disease (cochlear and vestibular Meniere's disease). Methods: Sixty-four patients divided into two groups were enrolled in this study. The first group included 36 patients who had fluctuating hearing loss without vertigo, as candidates for cochlear Meniere's disease (CMD). The second group included 28 patients who had recurrent vertigo without hearing loss, as candidates for vestibular Meniere's disease (VMD). The patients underwent 3 T magnetic resonance imaging (MRI) after injection of gadolinium enhancement medium intratympanically or intravenously. We evaluated EH using MRI. Results: Of 56 ears (36 patients) with CMD, 38 showed EH in the cochlea and 44 showed EH in the vestibule. Of 56 ears (28 patients) with VMD, 29 showed EH in the cochlea and 47 showed EH in the vestibule. The VMD group had a significant vestibular predominance in EH distribution whereas the CMD group showed no significant regional predominance of EH.

Objective To investigate the association between the degree of endolymphatic hydrops (EH) revealed by magnetic resonance imaging (MRI) and a caloric response in the ear. Study Design Prospective diagnostic study. Setting University hospital. Patients Twenty-four patients with hearing loss and/or vertigo, who underwent MRI 1 day after an intratympanic gadolinium injection. Intervention MRI after intratympanic gadolinium injection and caloric testing with cool air stimulation (15°C, 6 l/min, 60 s). Main Outcome Measure Association between the degree of EH and caloric responses. The degree of EH in the vestibule, in the cochlea, and in the ampulla of the lateral semicircular canal (LSC) was evaluated using MRI. The ratio of the diameter of the endolymphatic space to the diameter of the perilymphatic space was measured in the LSC ampulla. Results Canal paresis (CP, >25%) was present in 15 patients and absent (CP, <25%) in 9 patients. There was no significant difference between caloric response and the degree of EH in the vestibule, the cochlea, or the LSC ampulla. The period between the onset of clinical symptoms and examination tended to be longer in the group with CP compared with the group without CP. Conclusion There was no significant association between the degree of EH and caloric response.