Correlation Between Enhanced Magnetic Resonance Exam and Pure-Tone Audiometry Tests of Patients With Meniere's Disease.

INTRODUCTION

Meniere's disease (MD) is a disease affecting the inner ear that is attributed to endolymphatic hydrops. Several electrophysiological tests and imaging techniques have been developed to improve the diagnosis of endolymphatic hydrops.

OBJECTIVE

This study aimed to correlate inner ear magnetic resonance findings after intravenous gadolinium injection with the results of pure-tone audiometry tests for the diagnosis of MD.

METHODS

Patients meeting the criteria for a diagnosis of MD were retrospectively included from January 2016 to May 2021 at Hospital IPO (Instituto Paranaense de Otorrinolaringologia)/Paraná Institute of Otolaryngology, a private hospital in Paraná, Brazil. The endolymphatic hydrops was graded in four degrees on the gadolinium-enhanced magnetic resonance of the inner ear based on the inversion of the saccule to utricle ratio, as indicated by Reissner's membrane distension. Correlations were made with pure-tone audiogram, using Spearman's coefficient, Fisher's exact test, and non-parametric tests.

RESULTS

Fifty-three patients were evaluated (totaling 106 ears). The most common symptoms reported by patients were tinnitus (86.8%), dizziness (83%), hearing loss (81.1%), and ear fullness (64.2%). Vestibular endolymphatic hydrops was observed in 77.4% of the affected ears, while cochlear endolymphatic hydrops was present in 50.9%. Differences in hearing thresholds were found between affected ears and controls at all frequencies analyzed, with statistical significance.

CONCLUSIONS

Our study demonstrated that endolymphatic hydrops can be identified through magnetic resonance contrast-enhanced with gadolinium, showing that the same patient may have different degrees of dilatation of the membranous labyrinth between their two ears. We observed significant differences in pure-tone thresholds in audiometry tests according to the progression of the degree of endolymphatic hydrops.