ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Imaging meets function: radiological and vestibular predictors of long-term cochlear implant outcomes in patients with Ménière disease.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAlthough the proportion of Ménière disease (MD) patients who meet candidacy for CI remains relatively low, this subgroup has garnered increasing clinical interest. The main objective of this work is to evaluate the influence of preoperative vestibular function and radiological markers of endolymphatic hydrops (EH) on long-term auditory outcomes after cochlear implantation (CI) in patients with definite Ménière’s disease (MD).
methodsAll patients underwent CI and were assessed using a dedicated 3T MRI hydrops protocol. Audiological outcomes were measured using pure-tone audiometry (PTA) and speech recognition scores (SRS) at 65 dB, with a follow-up of up to five years. Preoperative vestibular assessment included video head impulse testing (vHIT), cervical and ocular vestibular evoked myogenic potentials (cVEMP, oVEMP), and caloric testing. MRI analysis evaluated cochlear and vestibular EH, perilymphatic enhancement, endolymphatic herniation (EHern), and the vestibular endolymphatic volume ratio (REL).
resultsThe 41 patients who underwent CI surgery resulted in significant and sustained improvements in PTA and SRS over five years (p < 0.001). Cochlear EH was associated with worse preoperative PTA but not with long-term speech outcomes. Patients undergoing simultaneous labyrinthectomy showed significant auditory gains but poorer five-year PTA compared with CI alone (p = 0.009). Abnormal cVEMP responses were associated with lower five-year SRS (p = 0.019). Higher REL correlated with poorer SRS at 65 dB (r = − 0.357, p = 0.039).
conclusionCI provides durable auditory benefits in patients with definite MD. Preoperative vestibular integrity, particularly cVEMP responses and vestibular endolymphatic volume, contributes to long-term speech recognition outcomes.
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