[Correlation analysis between endolymphatic hydrops severity and high jugular bulb with vestibular function in refractory Ménière's disease patients].

Objective

To investigate the correlation between the degree of endolymphatic hydrops（EH） and high jugular bulb（HJB）, as well as the relationship between vestibular EH and vestibular function, and between cochlear EH and vestibular function, in patients with refractory Ménière's disease（MD）.

Methods

A retrospective analysis was conducted on patients with refractory Ménière's disease admitted to the department of Otorhinolaryngology of the Second Xiangya Hospital of Central South University from 2018 to 2022. All patients underwent video-head impulse test（vHIT） for vestibular function assessment, temporal bone CT to evaluate the the presence of HJB, and gadolinium enhanced inner ear MRI to assess cochlear and vestibular EH. Spearman's correlation analysis, Fisher's exact test, and McNemar's test were used to analyze the concordance between vHIT and caloric test results, the correlation between EH positivity and HJB, the relationship between cochlear and vestibular EH on the affected side, and the associations between cochlear EH grade and vestibular function.

Results

The overall abnormality rate for vHIT was 51.1% （48/94）, while the abnormality rate specifically for the horizontal semicircular canal on vHIT was 10.6% （10/94）. The caloric test abnormality rate was 56.4% （53/94）, which was significantly higher than that of the horizontal semicircular canal vHIT （P<0.01）. No significant correlation was found between the presence of HJB and EH positivity （P >0.999）. On the affected side, the detection rates for cochlear EH and vestibular EH were 79.8% （75/94） and 88.3% （83/94）, respectively. A significant correlation was observed between cochlear and vestibular EH （r= 0.504, P<0.01）. Furthermore, the grade of vestibular EH was significantly correlated with the proportion of abnormal caloric test results （P=0.027）. In contrast, the grade of cochlear EH showed no significant correlation with abnormality rates on either the caloric test or vHIT （P>0.05）.

Conclusion

This study reveals that caloric test and vHIT provide complementary information, and dissociation between caloric test and horizontal semicircular canal vHIT results may be suggestive of MD. The correlation between the detection rate of the affected cochlea and vestibular EH in patients with MD, and the degree of vestibular EH correlated with the rate of abnormality of caloric test, may provide a basis for the clinical diagnosis of MD and the assessment of its degree of EH.