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Relationship between video head impulse test, ocular and cervical vestibular evoked myogenic potentials, and compartmental magnetic resonance imaging classification in menière's disease
Author(s) -
Kahn Laureline,
Hautefort Charlotte,
Guichard JeanPierre,
Toupet Michel,
Jourdaine Clément,
Vitaux Hélène,
Herman Philippe,
Kania Romain,
Houdart Emmanuel,
Attyé Arnaud,
Eliezer Michael
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28362
Subject(s) - saccule , endolymphatic hydrops , utricle , vestibular evoked myogenic potential , medicine , meniere's disease , magnetic resonance imaging , vestibular system , audiology , ophthalmology , radiology , pathology , disease
Objectives/Hypothesis Currently, it is possible to assess in vivo the morphology of each compartment of the endolymphatic spaces 4 hours after an intravenous administration of gadolinium on magnetic resonance imaging (MRI). The aim of this study was to assess the correlation between otolithic and ampullar functions (cervical vestibular evoked myogenic potential [cVEMP], ocular vestibular evoked myogenic potential [oVEMP], video head impulse test [VHIT]) and delayed inner ear MRI based on a compartmental, anatomically based classification that included the cochlea, the saccule, the utricle, and the ampullas. Study Design Retrospective case–control study. Methods In this retrospective study, we performed three‐dimensional fluid‐attenuated inversion recovery sequences with delayed acquisition in 26 healthy subjects and 31 definite Menière's disease (MD) patients. Each subject was then graded on MRI on the basis on cochlear, saccular, utricular, and ampullar hydrops in MD patients. All patients underwent pure‐tone audiometry, VHIT, cVEMP, and oVEMP testing. Results Cochlear, saccular, utricular, and ampullar hydrops were found on MRI in 88%, 91%, 50%, and 8.5% respectively. We found no significant correlation between the presence of saccular hydrops versus cVEMP, utricular hydrops versus oVEMP, and ampullar hydrops versus VHIT. However, the severity of endolymphatic hydrops on MRI was correlated to the degree of hearing loss. Conclusions We proposed a compartmental, anatomically based classification for endolymphatic hydrops on MRI, which included the whole vestibular compartment. Using this classification, we observed increasing morphological changes as the disease evolved, affecting first the saccule, then the utricle, and finally the ampullas. The severity of vestibular endolymphatic hydrops is only correlated to hearing loss severity. Level of Evidence 3 Laryngoscope , 130:E444–E452, 2020