Ménière's disease is associated with hydrops of the inner ear endolymphatic 
space, and histopathologically, the cochlea and vestibule are usually involved. 
We used gadolinium-enhanced magnetic resonance imaging and measured cervical and 
ocular vestibular evoked myogenic potentials and the gain in the utricular 
induced linear vestibulo-ocular reflex to test the hypothesis that vestibular 
hydrops in Ménière's disease patients is associated with otolith organ 
dysfunction. We evaluated 21 patients diagnosed with unilateral definitive 
Ménière's disease using gadolinium magnetic resonance imaging to detect 
endolymphatic hydrops in the cochlea and vestibule. Cervical and ocular 
vestibular evoked myogenic potentials and the gain in utricular induced linear 
vestibulo-ocular reflex during eccentric rotation were measured to assess 
otolith organ function. For eccentric rotation, patients were rotated while 
displaced from the axis of rotation, while linear acceleration stimulated the 
utricle and induced the vestibulo-ocular reflex. Magnetic resonance imaging 
revealed vestibular hydrops in 14 of 20 patients (70%). Among the 14 patients, 
ten (71%) had abnormal cervical and three (21%) had abnormal ocular vestibular 
evoked myogenic potentials. Four patients (4/21, 19%) had abnormal linear 
vestibulo-ocular reflexes, three of whom also had abnormal ocular vestibular 
evoked myogenic potentials. Overall, 16 of 17 patients had normal linear 
vestibulo-ocular reflexes and normal ocular vestibular evoked myogenic 
potentials. Vestibular endolymphatic hydrops in Ménière's disease patients 
caused otolith organ dysfunction, mainly in the saccule. The number of Ménière's 
disease patients with abnormal ocular vestibular evoked myogenic potentials was 
low (19%), and they also had abnormal utricular induced linear vestibulo-ocular 
reflexes.