Increased endolymph-to-perilymph ratios seen with imaging correlated with the degree of hearing loss
By Elana Gotkine HealthDay Reporter
WEDNESDAY, July 30, 2025 (HealthDay News) — Imaging the inner ear during surgical procedures is feasible and allows detection of endolymphatic hydrops, according to a study published online July 23 in Science Translational Medicine.
Wihan Kim, from the University of Southern California, Los Angeles, and colleagues imaged the lateral and posterior semicircular canals of patients undergoing ear surgery and measured the endolymph-to-perilymph ratio by peering through the otic capsule bone during mastoid surgery, translating the technology of optical coherence tomography (OCT) for use in the human inner ear. The authors analyzed 19 patients in three cohorts: six with normal inner function (control group), four with Ménière disease, and nine with vestibular schwannoma.
The researchers found that compared with the control group, both patient groups demonstrated increased endolymph and reduced perilymph compared with normal controls, known as endolymphatic hydrops. For measuring the endolymph-to-perilymph ratio, good repeatability was seen with OCT imaging. The data indicated a correlation of increased endolymph-to-perilymph ratios with the degree of hearing loss. Small but meaningful changes in the inner ear fluid balance can be detected with this approach, the authors note, with resolution better than the current gold standard clinical imaging modality of gadolinium enhanced 3 Tesla magnetic resonance imaging.
“These findings are exciting because hearing loss can happen very suddenly, and we often don’t know why. OCT offers a way to explore the underlying cause and potentially guide treatment,” senior author John Oghalai, M.D., also from the University of Southern California, said in a statement.
Two authors are founders of AO technologies, which has a goal of translating inner ear imaging technologies for clinical purposes.
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