Correlation Between The Site Of Endolymphatic Hydrops In Meniere’s Disease And The Degree Of Remission Of Clinical Manifestations After Surgical Treatment

Objective: Correlation between the site of endolymphatic hydrops detected by magnetic resonance after gadolinium contrast injection and the degree of remission of clinical manifestations after surgical treatment in patients with Ménière’s disease.Methods: Eighty-one patients with a definite diagnosis of unilateral Ménière’s disease were hospitalized for endolymphatic sac surgery or endolymphatic sac surgery and triple semicircular canal occlusion.The otolaryngologist checked the duration of vertigo,tinnitus,duration of vertigo and hearing level before surgery,and followed up the patients by telephone after surgery for the degree of vertigo and tinnitus relief.A three-dimensional rapid fluid attenuation inversion recovery magnetic resonance imaging(3D-FLAIR MRI)of the inner ear was performed via a double dose of intravenous gadolinium contrast over 4 hours to show the internal and external lymph and to classify the site of endolymphatic hydrops,allowing patients with Meniere’s disease to be divided into three groups: vestibular,cochlear and vestibular + cochlear;the degree of postoperative vertigo relief,the degree of tinnitus relief and the degree of tinnitus relief were assessed according to the degree of change in the postoperative degree score.The correlation between the degree of relief of tinnitus and the site of endolymphatic hydrops was assessed according to the degree of change in the postoperative degree score.The SPSS26.0 software was used to determine whether the site of endolymphatic hydrops in the same surgery was associated with the prognostic clinical performance of the patients after surgery by means of rank sum test analysis;the Spearman test was used to analyse whether the site of endolymphatic hydrops was associated with the prognostic clinical performance under the same surgery.Results:1.There was a significant correlation between the site of endolymphatic hydrops and the degree of relief of their postoperative vertigo in patients undergoing endolymphatic sac surgery(P<0.05),no correlation with the degree of tinnitus relief.2.There was a difference between the site of endolymphatic hydrops and the degree of vertigo relief in patients undergoing endolymphatic sac surgery(P<0.05),no correlation with the degree of tinnitus relief.3.There was a difference between the site of endolymphatic hydrops and the degree of vertigo relief and surgical staging in patients undergoing endolymphatic sac surgery and triple semicircular canal occlusion(P<0.05),no correlation with the degree of tinnitus relief.Conclusions:1.In patients undergoing endolymphatic sac surgery,the degree of vertigo relief was better in the vestibular group than in the vestibular + cochlear group;2.In patients undergoing endolymphatic sac surgery and triple semicircular canal occlusion,the degree of vertigo relief was better in the vestibular group than in the cochlear group,and patients in the vestibular group had lower staging than in the vestibular + cochlear group.3.In patients with Meniere’s disease stage Ⅲ,different sites of endolymphatic hydrops were associated with differential vertigo relief in patients with Meniere’s disease;patients in the vestibular group had better vertigo relief than those in the cochlear group.