Observation of MRI-Based Endolymphatic Hydrops and Clinical Symptoms in Patients With Definite Meniere's Disease Over Time: A Case Series.

PURPOSE: The assessment of endolymphatic hydrops (ELH) with specific MRI sequences underlines the ability to evaluate intralabyrinthine changes objectively and radiologically. The visualization of ELH by MRI allows correlations to be made with clinical patterns and supports the diagnosis of Ménière's disease (MD). Because MD cannot be assumed to be a static clinical condition, follow-up observations are of particular clinical interest. Our examination aimed to compare the grading of MRI-based ELH in patients over time, considering clinical symptoms and possible interventions. MATERIAL AND METHODS: Two MRI hydrops examinations and their gradings, from 11 patients with clinically definite MD, were compared in each case. The clinical pattern before and after conservative therapy or endolymphatic sac surgery was assessed over time using linear mixed regression. RESULTS: In 9 out of 11 patients, we observed an aligned trend in the MRI-based grading and hearing loss during an attack of MD. There was an increase in both parameters in eight patients. In one patient, an unchanged grading was observed. In one case, decrease was noted. In three cases there was a change of ELH, although the average hearing loss did not change. CONCLUSION: The MRI-based ELH may change during MD. Influencing variables and the correlation with clinical symptoms might be of great clinical interest regarding the success of therapy and the subjective complaints of patients. The different treatment options contribute to varying degrees to slowing the progression of MD.