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

Acta Otolaryngol. 2020 Sep;140(9):723-727. doi: 10.1080/00016489.2020.1769863. Epub 2020 Jul 23.

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.

Keywords: Endolymphatic hydrops; Menière’s disease; furosemide-loading vestibular-evoked myogenic potential; magnetic resonance imaging.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Contrast Media / administration & dosage
  • Endolymphatic Hydrops / diagnostic imaging*
  • Endolymphatic Hydrops / physiopathology*
  • Furosemide / administration & dosage
  • Gadolinium / administration & dosage
  • Humans
  • Magnetic Resonance Imaging*
  • Meniere Disease / diagnosis*
  • Meniere Disease / diagnostic imaging
  • Middle Aged
  • Retrospective Studies
  • Vestibular Evoked Myogenic Potentials*

Substances

  • Contrast Media
  • Furosemide
  • Gadolinium