Comparison of furosemide-loading cervical vestibular-evoked myogenic potentials with magnetic resonance imaging for the evaluation of endolymphatic hydrops

Abstract

Background

Furosemide-loading cervical vestibular-evoked myogenic potential (FVEMP), in which vestibular function is improved via diuretics-induced dehydration, can be used to estimate the presence of endolymphatic hydrops, one characteristic of Menière’s disease. Inner ear magnetic resonance imaging (MRI) can also reveal endolymphatic hydrops.

Aims/Objective: This study aimed to compare and confirm the usefulness of these two examination methods for the diagnosis of Menière’s disease.

Methods

Twenty patients with definite unilateral Menière’s disease were included. All subjects underwent both, FVEMP and inner ear MRI examinations. The results were then compared statistically between the affected and contralateral ears and among the methods.

Results

FVEMP and inner ear MRI of the cochlea, saccules, and utricles yielded positive results indicative of endolymphatic hydrops in 55.0%, 60.0%, 45.0%, and 45.0% of cases, respectively. The results of FVEMP were more consistent with those of the cochlea (κ = 0.8) than with those of the saccules or utricles by inner ear MRI (κ = 0.6).

Conclusions

FVEMP appears to be a good and minimally invasive option for evaluating endolymphatic hydrops. However, the combination of FVEMP and inner ear MRI may yield even more accurate evaluations of endolymphatic hydrops.

Chinese abstract

背景：呋塞米加载的颈部前庭诱发的肌源性潜力（FVEMP）, 是通过利尿剂引起的脱水来改善前庭功能的过程, 它可用于评估内膜淋巴积液的存在。内膜淋巴积液是美尼尔综合症的特征之一。内耳磁共振影像学检查（MRI）也可显示淋巴内积液。

目的：本研究旨在比较并确认这两种诊断美尼尔综合症的方法的有效性。

方法：包括20例确诊的单侧美尼尔综合症患者。所有受试者均接受FVEMP和内耳MRI检查。然后将结果进行患侧耳和对侧耳之间以及两种方法之间的统计学比较。

结果：耳蜗、球囊和囊的FVEMP和内耳MRI产生阳性结果, 分别有55.0％、60.0％、45.0％和45.0％的病例发生了淋巴内积液。FVEMP的结果与耳蜗结果（j¼0.8）比囊或尿囊的内耳MRI扫描（j¼0.6）结果更一致。

结论：FVEMP似乎是评估内淋巴积水的好方法, 且创伤性低。然而, FVEMP和内耳MRI的结合可能会产生更准确的内淋巴积水评估结果。

Keywords:

• Endolymphatic hydrops
• furosemide-loading vestibular-evoked myogenic potential
• magnetic resonance imaging
• Menière’s disease

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by JSPS KAKENHI Grant-in Aid for Young Scientists 19K18750.