Endolymphatic hydrops in contralateral ear of patients with unilateral Meniere’s disease

Background: Endolymphatic hydrops (EH) detected by MRI following intratympanic injection of gadolinium is identified in the contralateral ears to the affected side of some patients with clinically unilateral Ménière’s disease (MD).Objective To investigate the prevalence and clinical relevance of endolymphatic hydrops in the contralateral ear of patients with unilateral Meniere’s disease.Material and Methods We analyzed 66 patients with definite unilateral MD. Participants underwent audiological examinations and clinical assessments, including the Tinnitus Handicap Inventory (THI), Dizziness Handicap Inventory (DHI), disease duration, and vertigo characteristics. Besides, bilateral intratympanic gadolinium-enhanced 3D-Real IR magnetic resonance imaging (MRI) was performed.Results EH was detected in 24.2% of contralateral ears, predominantly presenting as isolated vestibular or cochlear hydrops. Cochlear hydrops in the contralateral ear showed a positive correlation with hearing loss severity (χ²= 3.95, p < 0.05) and disease duration (t = 3.5, p < 0.001). Conversely, vestibular hydrops in the contralateral ear exhibited no significant associations with hearing loss or disease duration (p > 0.05). Furthermore, no correlations were found between contralateral EH and THI, DHI, or vertigo duration.Conclusion and significance Our study confirms that contralateral EH is a prevalent imaging finding in unilateral MD, highlighting the disease’s potential for subclinical bilateral involvement.