Endolymphatic hydrops severity shows no significant association with cochlear or vestibular nerve volumes in 108 patients.
This cohort study included 108 patients with clinically and radiologically confirmed endolymphatic hydrops. The primary objective was to investigate the relationship between EH severity, defined by EH grades, and volumetric changes in the cochlear and vestibular nerves using high-resolution MRI. Unaffected ears served as the internal comparator for assessing nerve volume differences.
The analysis of cochlear nerve volumes across EH grades demonstrated no significant difference, with a p-value of 0.057. A nonsignificant tendency toward larger volumes in mild EH was noted but did not survive correction for multiple testing. Similarly, vestibular nerve volumes across vestibular EH grades showed no significant difference (p = 0.64). In patients with unilateral hearing loss, cochlear nerve volume between affected and unaffected ears also showed no significant difference (p = 0.56).
The study found no significant association between EH severity and the prevalence of clinical symptoms, including hearing loss, vertigo, tinnitus, and aural fullness. No safety data, adverse events, or tolerability issues were reported as the study focused on imaging biomarkers rather than therapeutic interventions. A key limitation identified is that volumetric MRI may have limited sensitivity as an imaging biomarker for endolymphatic hydrops.
Given these limitations, the practice relevance suggests that volumetric MRI may not be a reliable marker for EH severity in this context. Clinicians should explore alternative MRI-based structural or functional markers to better understand the pathophysiology of endolymphatic hydrops. The evidence indicates that current imaging techniques may not capture subtle volumetric changes associated with varying degrees of hydrops.
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