External aperture of the vestibular aqueduct in Meniere's disease

Objective: To study the relationship of the length of the external aperture of the vestibular aqueduct and the ratio of the summating potential and ac tion potential (SP:AP) in patients with Meniere's disease. Study Design: Retrospective case study. Setting: Neurology referral center. Patients: Fifty-four patients with Meniere's disease and nine control subje cts without Meniere's disease. Intervention: The external aperture of the vestibular aqueduct was measured from a three-dimensional surface reconstruction computed tomography scan. Transtympanic electrocochleography was performed on patients with Meniere's disease. Main Outcome Measure: The length of the external aperture of the vestibular aqueduct in the Meniere's disease ears was related to the SP:AP ratio in t he Meniere's disease ears and compared with controls. Results: The average length of the external aperture was 3.79 +/- 2.92 mm i n Meniere's disease cars and 5.35 +/- 1.73 mm in the control ears (p < 0.05 ), An enlarged SP:AP ratio was found in 95% of ears in the group with nonvi sible external apertures of the vestibular aqueduct, 91% of ears in the <5 mm group, 58% of ears in the 5-7 mm group, and 29% of ears in the >7 mm gro up (chi-square = 24.814; p = 0.000). Conclusions: The length of the external aperture of the vestibular aqueduct in patients with Meniere's disease is significantly shorter than in those without Meniere's disease, Endolymphatic hydrops, evidenced by an enlarged SP:AP ratio, was related to the length of the external aperture of the vest ibular aqueduct, The shorter the external aperture, the more often the SP:A P ratio was enlarged. A short or nonvisible external aperture of the vestib ular aqueduct is a predisposing factor to the development of Meniere's dise ase.