Change in endolymphatic hydrops 2 years after endolymphatic sac surgery evaluated by MRI Kayoko Higashi-Shingai a , Takao Imai b, *, Tomoko Okumura b , Atsuhiko Uno c , Tadashi Kitahara d , Arata Horii e , Yumi Ohta b , Yasuhiro Osaki f , Takashi Sato b , Suzuyo Okazaki g , Takefumi Kamakura h , Yasumitsu Takimoto i , Yoshiyuki Ozono b , Yoshiyuki Watanabe j , Ryusuke Imai b , Yukiko Hanada k , Kazuya Ohata b , Ryohei Oya b , Hidenori Inohara b a Department of Otolaryngology, Yao Municipal Hospital, Osaka, Japan b Department of Otorhinolaryngology — Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan c Department of Otorhinolaryngology — Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan d Department of Otorhinolaryngology — Head and Neck Surgery, Nara Medical University, Nara, Japan e Department of Otorhinolaryngology — Head and Neck Surgery, Niigata University Graduate School of Medicine and Dentistry, Niigata, Japan f Department of Otolaryngology, Kinki University Faculty of Medicine, Japan g Department of Otolaryngology, Osaka City General Hospital, Osaka, Japan h Department of Otorhinolaryngology, Otemae Hospital, Osaka, Japan i Department of Otolaryngology, Osaka Police Hospital, Osaka, Japan j Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan k Department of Otolaryngology, National Hospital Organization Osaka National Hospital, Osaka, Japan Auris Nasus Larynx xxx (2018) xxx–xxx * Corresponding author at: Department of Otorhinolaryngology — Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan. E-mail address: timai@ent.med.osaka-u.ac.jp (T. Imai). A R T I C L E I N F O Article history: Received 24 July 2018 Accepted 2 October 2018 Available online xxx Keywords: Ménière’s disease Endolymphatic hydrops Endolymphatic sac decompression surgery Gadolinium-enhanced magnetic resonance imaging Electrocochleography A B S T R A C T Objective: This study was performed to determine whether endolymphatic sac surgery improves vestibular and cochlear endolymphatic hydrops 2 years after sac surgery and to elucidate the relationship between the degree of improvement of endolymphatic hydrops and the changes in vertigo symptoms, the hearing level, and the summating potential/action potential ratio (SP/AP ratio) by electrocochleography (ECochG) in patients with Ménière’s disease (MD). Methods: Twenty-one patients with unilateral MD who underwent sac surgery were included in this study. All patients underwent gadolinium-enhanced magnetic resonance imaging (Gd-MRI) before and 2 years after sac surgery. We evaluated the difference in vestibular and cochlear endolymphatic hydrops between before and after surgery in both ears and compared these findings with the frequency of vertigo attacks, hearing level, and ECochG findings. Results: In affected ears, the presence of vestibular endolymphatic hydrops and the frequency of vertigo attacks significantly decreased after surgery. However, affected ears showed no significant improvement in the presence of cochlear endolymphatic hydrops or the SP/AP ratio by ECochG; there was also no significant improvement or deterioration in the hearing level. Conclusion: The present findings suggest that sac surgery reduces vestibular endolymphatic hydrops and prevents aggravation of cochlear endolymphatic hydrops, and these changes lead to a reduction of vertigo attacks and suppress the progression of hearing impairment associated with vertigo attacks. © 2018 Elsevier B.V. All rights reserved. G Model ANL-2524; No. of Pages 11 Please cite this article in press as: Higashi-Shingai K, et al. Change in endolymphatic hydrops 2 years after endolymphatic sac surgery evaluated by MRI. Auris Nasus Larynx (2018), https://doi.org/10.1016/j.anl.2018.10.011 Contents lists available at ScienceDirect Auris Nasus Larynx jo u rn al h om epag e: ww w.els evier.c o m/lo cat e/anl https://doi.org/10.1016/j.anl.2018.10.011 0385-8146/© 2018 Elsevier B.V. All rights reserved.