LAUSR

In their article, Wu et al. [1] present clinical data and results from hydrops MR imaging in patients with hydropic ear disease (Menière’s) with or without drop attacks. Drop attacks are sudden and unexpected fall/near-fall events due to paroxysmal vestibular dysfunction and loss of postural tone and are associated with serious fall-associated comorbidity. Wu et al. [1] found that patients with drop attacks had a higher degree of endolymphatic hydrops than those without drop attacks. Furthermore, they state that “In our previous study [20], we demonstrated that MD patients suffered from gradual deterioration of EH with disease progression (...)”. They refer to a publication from the year 2016 from their group [2], but, unfortunately fail to acknowledge our work which demonstrated for the first time among the published literature the positive correlation between endolymphatic hydrops severity and disease duration in patients with hydropic ear disease (Menière’s), which was published 4 years earlier in 2012 [3]. Wu et al. [1] state that “Although previous studies revealed that the incidence of drop attacks was lower than 10% in MD patients (...)”. In their own study, the prevalence was 16 of 177 patients (9%). In the meantime, in 2018, we reported for the first time among the published literature a description of the clinical features of 249 patients with proven endolymphatic hydrops [4] and reported a prevalence of drop attacks of 13.5%. Hence, the prevalence of drop attacks appears even higher than previously reported, and, therefore, merits the attention of every physician involved in the management of patients with hydropic ear disease (Menière’s).