Pathophysiology of M??ni??re's Syndrome: Are Symptoms Caused by Endolymphatic Hydrops?
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- 1 January 2005
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Otology & Neurotology
- Vol. 26 (1), 74-81
- https://doi.org/10.1097/00129492-200501000-00013
Abstract
Background: The association of Ménière's syndrome with endolymphatic hydrops has led to the formation of a central hypothesis: many possible etiologic factors lead to hydrops, and hydrops in turn generates the symptoms. However, this hypothesis of hydrops as being the final common pathway has not been proven conclusively. Specific Aim: To examine human temporal bones with respect to the role of hydrops in causing symptoms in Ménière's syndrome. If the central hypothesis were true, every case of Ménière's syndrome should have hydrops and every case of hydrops should show the typical symptoms. Methods: Review of archival temporal bone cases with a clinical diagnosis of Ménière's syndrome (28 cases) or a histopathologic diagnosis of hydrops (79 cases). Results: All 28 cases with classical symptoms of Ménière's syndrome showed hydrops in at least one ear. However, the reverse was not true. There were 9 cases with idiopathic hydrops and 10 cases with secondary hydrops, but the patients did not exhibit the classic symptoms of Ménière's syndrome. A review of the literature revealed cases with asymptomatic hydrops (similar to the current study), as well as cases where symptoms of Ménière's syndrome existed during life but no hydrops was observed on histology. We also review recent experimental data where obstruction of the endolymphatic duct in guinea pigs resulted in cytochemical abnormalities within fibrocytes of the spiral ligament before development of hydrops. This result is consistent with the hypothesis that hydrops resulted from disordered fluid homeostasis caused by disruption of regulatory elements within the spiral ligament. Conclusion: Endolymphatic hydrops should be considered as a histologic marker for Ménière's syndrome rather than being directly responsible for its symptoms.Keywords
This publication has 36 references indexed in Scilit:
- Ménière's diseaseEuropean Archives of Oto-Rhino-Laryngology, 1995
- Degenerative Changes in the Organ of Corti and Lateral Cochlear Wall in Experimental Endolymphatic Hydrops and Human Meniere's DiseaseActa Oto-Laryngologica, 1995
- Changes in Immunostaining of Cochleas with Experimentally Induced Endolymphatic HydropsAnnals of Otology, Rhinology & Laryngology, 1994
- Functional changes associated with experimentally induced endolymphatic hydropsHearing Research, 1993
- Meniere's Syndrome and Endolymphatic HydropsAnnals of Otology, Rhinology & Laryngology, 1989
- Direct measurement of longitudinal endolymph flow rate in the guinea pig cochleaHearing Research, 1986
- Animal models of endolymphatic hydropsAmerican Journal of Otolaryngology, 1982
- Hydrops of the labyrinth. Case report. Coagulation operation, clinical course and histopathologyThe Laryngoscope, 1949
- LABYRINTHINE DROPSY AND MENIERE'S DISEASEJAMA Otolaryngology–Head & Neck Surgery, 1942
- Observations on the Pathology of Ménière's SyndromeThe Journal of Laryngology & Otology, 1938