In Meniere's disease, hydrops grade on MRI tracks hearing loss; age matters most in milder disease

Design

Retrospective single-centre cross-sectional study

Population

455 patients (910 ears) with Meniere's disease on gadolinium inner ear MRI

Primary outcome

Association of hydrops grade and age with hearing thresholds

Effect

Higher hydrops grade associated with worse thresholds; age effect strongest at grades I–III

This Chinese tertiary-centre study, published 24 September, included 455 patients (910 ears) with Meniere's disease confirmed on gadolinium-enhanced inner ear MRI between 2020 and 2025, and related endolymphatic hydrops grade and age to pure-tone thresholds.

Age was not associated with the presence or severity of hydrops. Higher hydrops grades were consistently associated with greater hearing loss in both unilateral and bilateral disease. The effect of age on hearing was most evident at lower hydrops grades (I–III) and faded at higher grades (IV–V).

Where gadolinium inner ear MRI is available, hydrops grade adds to the audiogram in explaining a patient's hearing. In older patients with mild hydrops, some of the hearing loss is likely age-related rather than Meniere's itself.

• Higher hydrops grade on inner ear MRI was associated with worse hearing thresholds.
• Age did not predict hydrops severity in Meniere's disease.
• In older patients with mild hydrops, consider age-related loss as a contributor.
• Use hydrops grading where available to support counselling on hearing prognosis.

Why it matters

Helps separate the hearing loss Meniere's causes from the loss ageing adds.

Don't overread it

Cross-sectional associations; they do not show how hearing changes over time or with treatment.

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