{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:55:41Z","timestamp":1791161741259,"version":"4.1.0"},"reference-count":40,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2013,1,8]]},"published-print":{"date-parts":[[2013]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the onset of vertigo, hearing loss and tinnitus in M\u00e9ni\u00e8re's disease and the associated endolymphatic hydrops (EH) of the inner ear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multicentre evaluation of three patient groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>Disease-specific symptoms were reviewed among referred patients in a tertiary referral hospital in Finland and in members of a Finnish M\u00e9ni\u00e8re Association in Finland. The MRI of a separate group of patients was undertaken in a tertiary referral centre in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>340 patients were reviewed in the referral hospital along with 740 members of the M\u00e9ni\u00e8re Association. MRI was undertaken in 224 patients in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Latency and symptom development in M\u00e9ni\u00e8re's disease, and the appearance of EH of the inner ear in monosymptomatic patients and in M\u00e9ni\u00e8re's disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean age of the first symptom was 43.8\u2005years, with 10% of the patients being older than 65\u2005years. The time delay between hearing loss and vertigo was more than 5\u2005years in 20% of the members and of the patients. Gadolinium-contrasted MRI demonstrated EH in 90% of the patients with M\u00e9ni\u00e8re's disease, in which 75% was bilateral among patients with unilateral symptoms. In monosymptomatic patients with vertigo, tinnitus or hearing loss; EH was demonstrated in 55\u201390% of the patients either in the cochlea and\/or the vestibulum of the symptomatic ear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>M\u00e9ni\u00e8re's disease often shows bilateral EH and comprises a continuum from a monosymptomatic disease to the typical symptom complex of the disease. We suggest that a 3T MRI measurement should be carried out in patients with sensory-neural hearing loss, vertigo and tinnitus, 4\u2005h after the intravenous injection of a gadolinium-contrast agent to verify the inner ear pathology. This may lead to a better management of the condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2012-001555","type":"journal-article","created":{"date-parts":[[2013,2,15]],"date-time":"2013-02-15T23:10:11Z","timestamp":1360969811000},"page":"e001555","source":"Crossref","is-referenced-by-count":189,"title":["M\u00e9ni\u00e8re's disease: a reappraisal supported by a variable latency of symptoms and the MRI visualisation of endolymphatic hydrops"],"prefix":"10.1136","volume":"3","author":[{"given":"Ilmari","family":"Pyykk\u00f6","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, University of Tampere, School of Medicine, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Nakashima","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Nagoya University School of Medicine, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadao","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Nagoya University School of Medicine, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Tampere, School of Medicine, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Naganawa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nagoya University School of Medicine, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,2,14]]},"reference":[{"key":"2025101810270700000_3.2.e001555.1","unstructured":"Atkinson M . Meniere's original papers reprinted with an English translation with commentaries and biographical sketch. 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