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Objective: We used volumetric three-dimensional (3D) analysis to quantitatively evaluate the extent of endolymphatic hydrops (EH) in the entire inner ear. We tested for correlations between the planimetric and volumetric measurements, to identify their advantages and disadvantages.Methods: HYDROPS2-Mi2 EH images were acquired for 32 ears (16 patients): 16 ipsilateral ears of MD patients (MD-ears) and 16 contralateral ears. Three-T MR unit with a 32-channel phased-array coil/the contrast agent to fill the perilymphatic space and the HYDROPS2-Mi2 sequence. We calculated the EH% [(endolymph)/(endolymph+perilymph)] ratio and analyzed the entire inner ear in terms of the volumetric EH% value, but only single cochlear and vestibular slices were subjected to planimetric EH% evaluation. The EH% values were compared between MD ears and non-MD ears, to evaluate the diagnostic accuracy of the two methods.Results: The volumetric EH% was significantly higher for MD vestibules (50.76 ± 13.78%) than non-MD vestibules (39.50 ± 8.99%). The planimetric EH% was also significantly higher for MD vestibules (61.98 ± 20.65%) than non-MD vestibules (37.22 ± 12.95%). The vestibular and cochlear volumetric EH% values correlated significantly with the planimetric EH% values of the MD ear.Conclusion: Volumetric and planimetric EH measurements facilitate diagnosis of MD ears compared to non-MD ears. Both methods seem to be reliable and consistent; the measurements were significantly correlated in this study. However, the planimetric EH% overestimates the extent of vestibular hydrops by 26.26%. Also, planimetric data may not correlate with volumetric data for non-MD cochleae with normal EH% values.

Objective: We used volumetric three-dimensional (3D) analysis to quantitatively evaluate the extent of endolymphatic hydrops (EH) in the entire inner ear. We tested for correlations between the planimetric and volumetric measurements, to identify their advantages and disadvantages. Methods: HYDROPS2-Mi2 EH images were acquired for 32 ears (16 patients): 16 ipsilateral ears of MD patients (MD-ears) and 16 contralateral ears. Three-T MR unit with a 32-channel phased-array coil/the contrast agent to fill the perilymphatic space and the HYDROPS2-Mi2 sequence. We calculated the EH% [(endolymph)/(endolymph+perilymph)] ratio and analyzed the entire inner ear in terms of the volumetric EH% value, but only single cochlear and vestibular slices were subjected to planimetric EH% evaluation. The EH% values were compared between MD ears and non-MD ears, to evaluate the diagnostic accuracy of the two methods. Results: The volumetric EH% was significantly higher for MD vestibules (50.76 ± 13.78%) than non-MD vestibules (39.50 ± 8.99%). The planimetric EH% was also significantly higher for MD vestibules (61.98 ± 20.65%) than non-MD vestibules (37.22 ± 12.95%). The vestibular and cochlear volumetric EH% values correlated significantly with the planimetric EH% values of the MD ear. Conclusion: Volumetric and planimetric EH measurements facilitate diagnosis of MD ears compared to non-MD ears. Both methods seem to be reliable and consistent; the measurements were significantly correlated in this study. However, the planimetric EH% overestimates the extent of vestibular hydrops by 26.26%. Also, planimetric data may not correlate with volumetric data for non-MD cochleae with normal EH% values. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To measure the auditory (pure tone audiometry and word recognition scores) and vestibular (video head impulse test and vestibular myogenic potentials) outcomes in patients diagnosed with Meniere's disease (MD) who underwent cochlear implantation. MATERIAL AND METHODS: This prospective study included 23 cochlear implant users with MD and 29 patients diagnosed with far-advanced otosclerosis (the control group). RESULTS: The preoperative mean pure tone average thresholds were 99 and 122.5 dB for the Meniere's and control groups, respectively. Word recognition scores after cochlear implant yielded a median of 80% and 72% for the Meniere's and control groups, respectively. Semicircular canal gain was not observed to vary post implantation (mean variation for lateral, posterior, and anterior plane was 0, 0.03, and 0, respectively). The mean ocular and cervical myogenic potentials asymmetry varied as 9.65% and 18.39%, respectively. CONCLUSIONS: The auditory performance improved in patients with MD similar to the general cochlear implant population. No major dysfunction of otolithic or semicircular canal function was demonstrated after the implantation surgery. [ABSTRACT FROM AUTHOR]

The utility of cervical vestibular evoked myogenic potentials (cVEMPs) of Ménière´s disease has been demonstrated by both, early diagnosis and the monitoring of the efficacy of the intratympanic Gentamicin therapy used for chemical vestibular ablation in patients whose in spite of the conventional medication, persist with incapacitating dizziness, preferring this treatment over other options of more invasive ones. Nevertheless the inherent risk of ablative gentamicin therapy is the hearing loss even when it is used on a weekly administration basis or very low doses of aminoglukoside. There are also other schemes of complete vestibular ablation and partial vestibular ablation, for which, in both cases, the main objective is the satisfactory control of dizziness in short and long term. We presented the case of a man with definitive unilateral Ménière disease, incapacitating dizziness and useful hearing function without response to the medical treatment, in which a complete chemical vestibular ablation with intratympanic gentamicin was realized, achieving an adequate control of vestibular symptoms and preservation of the hearing function through the six years follow up. The scheme used in our hospital is a complete chemical vestibular ablation, equivalent to a vestibular neurectomy when is monitored by means of cVEMPs, where recurrence is rare, the weekly basis administration in low doses offers a lower risk of hypoacusia [ABSTRACT FROM AUTHOR]

Conclusion: We suggest that 1/0.5 kHz FPA would be clinically useful in the diagnosis of Meniere's disease. Objective: To determine whether clinically useful VEMP parameters could be identified using different tone burst stimuli for the diagnosis of Meniere's disease. Subjects and methods: The Meniere's group included 24 affected ears from definite Meniere's disease and 26 affected ears from probable Meniere's disease. The control group included 20 normal ears. Using tone bursts of 0.5 and 1 kHz, two parameters were examined: 1) the frequency peak amplitude ratio (1/0.5 kHz FPA), where the peak amplitude was determined by the difference in amplitude between peak p13 and peak n23 ipsilaterally; and 2) the interaural amplitude difference (IAD) ratio, defined as the difference in amplitude between peaks p13 and n23 (p13-n23) in the right and left ears divided by the sum of p13-p23 in both ears. Results: Data showed that the 1/0.5 kHz FPA ratios in the Meniere's group were significantly elevated compared with those of the control group (p<0.001) and the recommendable cut-off value for the diagnosis of Meniere's symptoms using 1/0.5 kHz FPA was > 0.7. However, the IAD ratio did not show significant differences in either the 0.5 or 1 kHz stimulus conditions. [ABSTRACT FROM AUTHOR]

Different medical and surgical methods have been tried in attempting to reduce endolymphatic pressure in Meniere's disease. Pressure treatment has a role on the treatment staircase, after pharmacological treatment and before destructive methods. Pressure chamber treatment has shown that some patients respond well to the treatment with diminishing inner ear symptoms and also some hearing improvement. Earlier studies have shown that electrocochlear measurements improve after local pressure treatment in the ear. The present study was a prospective randomized placebo controlled, multicentre clinical trial. 56 patients with active Meniere's disease, age 20-65 years, with a hearing loss of 20-65 dB PTA participated. A total of 31 patients completed 2 weeks use with an active apparatus (Meniett) and 25 patients completed the 2 weeks with the placebo gadget. Both machines were produced by Pascal Medical, Halmstad, Sweden. Two weeks before the start of treatment a grommet was placed in the tympanic membrane. A significant improvement concerning frequency and intensity of vertigo, dizziness, aural pressure and tinnitus was reported by the active group on the visual analogue scales (VAS) questionnaire. In the placebo group no change was the most common finding, followed by worsening of the symptoms and a few improvements. The function in professional and family life improved during active treatment and did not during placebo treatment. Pure-tone audiometry did not improve after placebo treatment, but improved at the frequencies 500 Hz and 1,000 Hz after active treatment. The study showed an improvement in the inner ear symptoms after Meniett treatment. The mechanism may be explained by the influence on the round window membrane pressure receptors or an endolymphatic flow out through the pressure release points, such as the endolymphatic duct and sac, thus activating the longitudinal flow. Other mechanisms are also possible. [ABSTRACT FROM AUTHOR]