Temporal changes in endolymphatic hydrops on MRI with or without intervention: A systematic review

Objective: The pathophysiology of Meniere's Disease (MD) involves endolymphatic hydrops (ELH) of the inner ear. Magnetic Resonance Imaging (MRI) has been shown to detect ELH, but changes in ELH have been poorly described using this modality. Our objective was to review MRI-measured changes in ELH over time and after medical and/or surgical intervention in patients with MD. We secondarily aim to associate changes in ELH with changes in MD symptomatology. Databases reviewed: Medline, Web of Science, and Embase databases.Methods: A systematic review of articles was performed to identify studies utilizing MRI to measure ELH changes over time, and after medical or surgical treatment. Articles on non-human subjects and without direct mea-surement of ELH were excluded. Results: Of 532 studies identified, 12 were included, involving 170 patients (mean age 56.3 years). Ten studies were prospective; two were retrospective. Five studies strictly utilized medical means of intervention, four uti-lized surgical treatments, one utilized both, and two observed temporal changes without treatment. Across all interventions, 72.1 % of patients exhibited the same or worsening ELH on imaging. In studies reporting vertigo outcomes, 95.9 % of patients exhibited improvement after the treatment period. Conclusion: Medical and surgical interventions often yield symptomatic relief of vertigo in MD patients despite stable or increasing ELH volume. MRI may have greater clinical utility in diagnosing ELH as opposed to assessing treatment response.

Automated summary

This study aimed to review the MRI-measured changes in endolymphatic hydrops (ELH) over time and after medical or surgical intervention in patients with Meniere's Disease (MD), as well as the association between ELH changes and MD symptomatology. The results showed that medical and surgical interventions often relieved vertigo symptoms in MD patients despite stable or increasing ELH volume. MRI may have greater clinical utility in diagnosing ELH rather than assessing treatment response.