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

OBJECTIVE

To determine the relationship between radiographic temporal bone anatomy of patients with Menière'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 Menière'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 Menière's disease and control patients. Age, sex, symptoms, audiogram data, academy classification of Menière'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 Menière'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 Menière'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 Menière's patients were similar utilizing academy classification. There was no significant trend between medical and surgical Menière's patients versus controls for any measurement. In a combined Menière's group, the longer and narrower vestibule anatomy may suggest an anatomical basis for endolymphatic hydrops.