Imaging of endolymphatic hydrops by MRI after cochlear implantation

Introduction In patients with Meniere’s disease (MM), cochlear implantation (CI) is the standard procedure when functional deafness occurs. In addition, monitoring vertigo symptoms is of great importance in these patients. The pathophysiological counterpart of MM is endolymphatic hydrops (ELH). This can be assessed with magnetic resonance imaging (MRI). MM appears in 10-33 % of affected patients bilaterally, making it a possible cause of dizziness both postoperatively persistent and as a new symptom. Advances in implant magnets and progression in MRI sequences offer the opportunity to assess the value of MRI in cochlear implantees. To evaluate the imaging of the ELH by MRI after CI was the aim of this study.

Material and methods Retrospectively 4 patients* (61-76 years, 2 females, 2 males) with postoperative vertigo events in Meniere-like form after CI for MM using MRI were studied. A 4h iv. delayed Gad 3D flair sequence was used for the MRI examination.

Results In all patients, there was ipsilateral signal extinction of the vestibule, the semicircular canals, and the cochlea due to the implant artifact. Contralaterally, the vestibule, the semicircular canals, and the cochlea could be visualized. Graduation of the ELH was possible.

Conclusion An ELH-MRI examination is a potential tool in the assessment of vertigo after cochlear implantation as it can provide evidence of ELH.

Publication History

Article published online:
12 May 2023