The Relationship between Clinical Characteristics and Magnetic Resonance Imaging Findings in Meniere's Disease: Analysis of Own Observations

Background. The relationship between endolymphatic hydrops (EH) — the key pathological substrate of Meniere's disease (MD) — and the data from comprehensive audiological and vestibulometric examination at different disease severity levels remains insufficiently studied. Clear diagnostic criteria based on the correlation of functional hearing changes and neuroimaging data are lacking.
Objective. To conduct a comprehensive assessment of the auditory function and neuroimaging characteristics of the inner ear in patients with MD of varying severity.
Methods. The study included 74 patients with MD according to the 2015 Barany Society criteria, divided into three subgroups based on disease severity. A comprehensive examination was performed: pure-tone audiometry (PTA), auditory brainstem response (ABR), transient evoked otoacoustic emissions (TEOAE), and magnetic resonance imaging (MRI) of the inner ear with contrast for EH detection.
Results. Progressive hearing deterioration was revealed with increasing MD severity. The median PTA thresholds on the affected side increased from 46.25 dB (mild degree) to 60.00 dB (severe degree) (p=0.010). The proportion of patients with sensorineural hearing loss also significantly increased from 56% to 95% (p=0.010). In the severe group, prolonged latency of wave V was recorded — 6.13 ms (p<0.050) — and TEOAE amplitudes at medium and high frequencies were reduced (5-21% vs 55-60% in the mild group, p<0.010). The frequency and degree of EH on MRI increased with disease severity (p=0.070 and p<0.050, respectively). A moderate negative correlation was found between the degree of EH and the time elapsed since the last attack (rₛ=-0.531; p<0.05). Cluster analysis identified three clinical phenotypes of MD (p<0.010).
Conclusion. A statistically significant relationship was established between the severity of MD and the nature of auditory function impairments, as well as the frequency and severity of EH on MRI. EH visualization is most informative within 6 months after an attack.