Comparative analysis of classic and delayed Ménière’s disease: clinical characteristics and endolymphatic hydrops manifestations in an Asian cohort

To investigate the clinical characteristics and endolymphatic hydrops (ELH) Manifestations in patients with delayed Ménière’s disease (DMD) compared to classic Ménière’s disease (CMD).

A prospective cohort study was conducted involving 523 patients diagnosed with MD. Clinical data, inner ear function, and ELH characteristics were analyzed and compared between CMD and DMD groups. Assessments included audiometry, VEMP, and MRI.

DMD prevalence was 6.1%. Bilateral MD was significantly more common in DMD (34.4% vs. 14.5%, P = 0.003). DMD patients had more severe hearing loss in the first involved ear and more deteriorated VEMP in the contralateral ear (P < 0.05). ELH was present in 100% of affected ears, with a higher contralateral ELH proportion in DMD (34.4% vs. 15.0%, P = 0.005).

DMD patients exhibit a higher prevalence of bilateral MD, more severe hearing loss, and greater contralateral ELH compared to CMD patients. Both subtypes share similar ELH characteristics, suggesting common underlying mechanisms.