The long-term outcome of Meniere's disease patients following sac and shunt operation assessed by Hydrops MRI.

Abstract

Purpose: The aim of this study was to evaluate the long-term outcome of Meniere's disease (MD) patients who had previously undergone sac and shunt operation using Hydrops MRI for assessment.

Methods: A total of 17 unilateral MD patients who had previously undergone sac and shunt operation underwent an inner ear test battery, followed by Hydrops MRI. The 34 ears were classified into two groups. Group A consisted of 17 operated ears, which were further subdivided into Group A1 (with endolymphatic hydrops, EH), and Group A2 (without EH). In contrast, Group B comprised 17 non-operated (opposite) ears including Group B1 (with EH) and Group B2 (without EH).

Results: More than 70% MD patients continued to experience the Meniere's triad of symptoms, even long-term (20 years) after surgery. A significantly decreasing sequence in the abnormality rates of the inner ear test battery was noted in Group A1 + B1, whereas no such declining trend was noted in Group A2 or B2. The prevalence of EH on operated ears demonstrated EH at the cochlea (65%), saccule (53%), and utricle (53%). Additionally, EH was also identified on non-operated ears, with a prevalence of 24% at the cochlea, and 12% at the saccule and utricle.

Conclusion: Using Hydrops MRI, this study found a 65% prevalence of cochlear EH on operated ears over a long-term period after surgery. This, coupled with a 70% prevalence of episodic vertigo, suggests that sac and shunt operation may not effectively alleviate EH.