Skip to main content

Magnetic resonance imaging findings in Ménière's disease

  • V A Patel (a1), B S Oberman (a1), T T Zacharia (a2) and H Isildak (a1)
Abstract Objectives:

To identify and evaluate cranial magnetic resonance imaging findings associated with Ménière's disease.


Seventy-eight patients with a documented diagnosis of Ménière's disease and 35 controls underwent 1.5 T or 3 T magnetic resonance imaging of the brain. Patients also underwent otological, vestibular and audiometric examinations.


Lack of visualisation of the left and right vestibular aqueducts was identified as statistically significant amongst Ménière's disease patients (left, p = 0.0001, odds ratio = 0.02; right, p = 0.0004, odds ratio = 0.03). Both vestibular aqueducts were of abnormal size in the Ménière's disease group, albeit with left-sided significance (left, p = 0.008, odds ratio = 10.91; right, p = 0.49, odds ratio = 2.47).


Lack of vestibular aqueduct visualisation on magnetic resonance imaging was statistically significant in Ménière's disease patients compared to the general population. The study findings suggest that magnetic resonance imaging can be useful to rule out retrocochlear pathology and provide radiological data to support the clinical diagnosis of Ménière's disease.

Corresponding author
Address for correspondence: Dr Huseyin Isildak, Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, Pennsylvania State University, College of Medicine, 500 University Drive, MC H091, Hershey, PA 17033-0850, USA Fax: +1 717 531 6160 E-mail:
Hide All

Presented at the American Neurotology Society Scientific Session as part of the Combined Otolaryngology Spring Meetings, 24 April 2015, Boston, Massachusetts, USA.

Hide All
1 Thorp, MA, James, AL. Prosper Ménière. Lancet 2005;366:2137–9
2 Huppert, D, Strupp, M, Brandt, T. Long-term course of Menière's disease revisited. Acta Otolaryngol 2010;130:644–51
3 Alexander, TH, Harris, JP. Current epidemiology of Ménière's syndrome. Otolaryngol Clin North Am 2010;43:965–70
4 Zou, J, Zhang, W, Poe, D, Zhang, Y, Ramadan, UA, Pyykkö, I. Differential passage of gadolinium through the mouse inner ear barriers evaluated with 4.7 T MRI. Hear Res 2010;259:3643
5 Teranishi, M, Yoshida, T, Katayama, N, Hayashi, H, Otake, H, Nakata, S et al. 3D computerized model of endolymphatic hydrops from specimens of temporal bone. Acta Otolaryngol Suppl 2009;560:43–7
6 Carfrae, MJ, Holtzman, A, Eames, F, Parnes, SM, Lupinetti, A. 3 Tesla delayed contrast magnetic resonance imaging evaluation of Ménière's disease. Laryngoscope 2008;118:501–5
7 American Academy of Otolaryngology-Head and Neck Foundation. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière's disease. Otolaryngol Head Neck Surg 1995;113:181–5
8 Takeda, T, Sawada, S, Kakigi, A, Saito, H. Computed radiographic measurement of the dimensions of the vestibular aqueduct in Menière's disease. Acta Otolaryngol Suppl 1997;528:80–4
9 Ohmen, JD, White, CH, Li, X, Wang, J, Fisher, LM, Zhang, H et al. Genetic evidence for an ethnic diversity in the susceptibility to Ménière's disease. Otol Neurotol 2013;34:1336–41
10 Evans, KL, Baldwin, DL, Bainbridge, D, Morrison, AW. Immune status in patients with Menière's disease. Arch Otorhinolaryngol 1988;245:287–92
11 Nakayama, M, Kabaya, K. Obstructive sleep apnea syndrome as a novel cause for Ménière's disease. Curr Opin Otolaryngol Head Neck Surg 2013;21:503–8
12 Kimura, RS. Experimental blockage of the endolymphatic duct and sac and its effect on the inner ear of the guinea pig. A study on endolymphatic hydrops. Ann Otol Rhinol Laryngol 1967;76:664–87
13 Muzzi, E, Rinaldo, A, Ferlito, A. Ménière disease: diagnostic instrumental support. Am J Otolaryngol 2008;29:188–94
14 von Brevern, M, Neuhauser, H. Epidemiological evidence for a link between vertigo and migraine. J Vestib Res 2011;21:299304
15 Gopen, Q, Viirre, E, Anderson, J. Epidemiologic study to explore links between Ménière syndrome and migraine headache. Ear Nose Throat J 2009;88:1200–4
16 Swartz, RH, Kern, RZ. Migraine is associated with magnetic resonance imaging white matter abnormalities: a meta-analysis. Arch Neurol 2004;61:1366–8
17 Yamamoto, E, Mizukami, C, Isono, M, Ohmura, M, Hirono, Y. Observation of the external aperture of the vestibular aqueduct using three-dimensional surface reconstruction imaging. Laryngoscope 1991;101:480–3
18 Welling, DB, Clarkson, MW, Miles, BA, Schmalbrock, P, Williams, PM, Chakeres, DW et al. Submillimeter magnetic resonance imaging of the temporal bone in Meniere's disease. Laryngoscope 1996;106:1359–64
19 Milhorat, TH. Cerebrospinal fluid physiology. In: Milhorat, TH. Hydrocephalus and the Cerebrospinal Fluid. Baltimore: Williams & Wilkins, 1972;141
20 Guerra Jiménez, G, Mazón Gutiérrez, Á, Marco de Lucas, E, Valle San Román, N, Martín Laez, R, Morales Angulo, C. Audio-vestibular signs and symptoms in Chiari malformation type I. Case series and literature review. Acta Otorrinolaringol Esp 2015;66:2835
21 Otterstedde, CR, Tischendorf, M, Reisser, C. Megadolichobasilar artery as the etiology of sensorineural deafness in differential sudden deafness diagnosis [in German]. HNO 1999;47:494–6
22 Bovo, R, Ciorba, A, Martini, A. Vertigo and autoimmunity. Eur Arch Otorhinolaryngol 2010;267:1319
23 Ge, Y. Multiple sclerosis: the role of MR imaging. AJNR Am J Neuroradiol 2006;27:1165–76
24 Filipo, R, Ciciarello, F, Attanasio, G, Mancini, P, Covelli, E, Agati, L et al. Chronic cerebrospinal venous insufficiency in patients with Ménière's disease. Eur Arch Otorhinolaryngol 2015;272:7782
25 Di Berardino, F, Alpini, DC, Bavera, PM, Cecconi, P, Farabola, M, Mattei, V et al. Chronic cerebrospinal venous insufficiency in Menière disease. Phlebology 2014;30:274–9
26 Carlborg, BI, Farmer, JC. Transmission of cerebrospinal fluid pressure via the cochlear aqueduct and endolymphatic sac. Am J Otolaryngol 1983;4:273–82
27 George, U, Rathore, S, Pandian, JD, Singh, Y. Diffuse pachymeningeal enhancement and subdural and subarachnoid space opacification on delayed postcontrast fluid-attenuated inversion recovery imaging in spontaneous intracranial hypotension: visualizing the Monro-Kellie hypothesis. AJNR Am J Neuroradiol 2011;32:E16
28 Murphy, TP. Otologic manifestations of pseudotumor cerebri. J Otolaryngol 1991;20:258–61
29 Wakerley, B, Tan, M, Ting, E. Idiopathic intracranial hypertension. Cephalalgia 2015;35:248–61
30 Warninghoff, JC, Bayer, O, Ferrari, U, Straube, A. Co-morbidities of vertiginous diseases. BMC Neurol 2009;9:29
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 11
Total number of PDF views: 143 *
Loading metrics...

Abstract views

Total abstract views: 510 *
Loading metrics...

* Views captured on Cambridge Core between 6th June 2017 - 17th March 2018. This data will be updated every 24 hours.