Mastoid and inner ear measurements in patients with Menière's disease

OBJECTIVE: To determine the relationship between radiographic temporal bone anatomy of patients with Meniere's disease in medically and surgically managed populations versus controls. STUDY DESIGN: Retrospective chart review. SETTING: Two tertiary referral centers. PATIENTS: Adults older than 18 years with Meniere's disease treated with endolymphatic sac decompression (ESD) or medical management (non-ESD) versus controls. INTERVENTIONS: Magnetic resonance imaging and computed tomography imaging studies of the temporal bones were reviewed by blinded radiologists. MAIN OUTCOME MEASURES: Radiographic temporal bone dimensions were measured in Meniere's disease and control patients. Age, sex, symptoms, audiogram data, academy classification of Meniere's disease, and follow-up were recorded. Statistical analysis was performed to compare outcome measures across groups and demographics. RESULTS: A total of 90 imaging studies were reviewed (ESD = 22; non-ESD = 30; control = 38). ESD and non-ESD groups had similar pure-tone averages (33.9 ± 20.6 versus 41.6 ± 22.6 dB HL; p = 0.21) and frequency of definite Meniere's disease (59.1% versus 53.3%; p = 0.68). There was no significant trend between groups for any measurement. One nonsignificant trend existed in mean vestibule length, increasing from the control (5.45 ± 0.54 mm), non-ESD (5.80 ± 0.97 mm), and ESD (5.94 ± 0.81 mm) group. In a combined Meniere's group, mean vestibule length was significantly greater than controls (5.86 ± 0.89 versus 5.45 ± 0.54 mm; p = 0.008) and mean vestibule width significantly less (2.99 ± 0.46 versus 3.19 ± 0.39 mm; p = 0.024). CONCLUSION: Medical and surgical Meniere's patients were similar utilizing academy classification. There was no significant trend between medical and surgical Meniere's patients versus controls for any measurement. In a combined Meniere's group, the longer and narrower vestibule anatomy may suggest an anatomical basis for endolymphatic hydrops.