Skip to main content Accessibility help
×
Home

Endolymphatic hydrops and Ménière's disease: a lesion meta-analysis

  • D J Pender (a1)

Abstract

Objective:

To determine whether the distribution of membrane lesions associated with Ménière's disease is random, as might be expected from a pervasive process such as hydrops, or orderly, as might be expected if membrane resistance is graded.

Method:

A meta-analysis of temporal bone reports on 184 specimens demonstrating endolymphatic hydrops was undertaken to determine membrane lesion evolution and distribution.

Results:

Lesion distribution was found to be orderly and cochleocentric. No random scattershot lesions were reported in any study. Disease always started in the cochlear apex, even in non-symptomatic cases, and then involved the saccule, utricle, ampullae and canal system in that precise sequence as the disease progressed.

Conclusion:

The orderly lesion progression in the otopathology associated with Ménière's disease suggests that the hydropic process has a graded non-random effect on the labyrinth. These findings suggest a pathological staging system that may be useful in temporal bone evaluation.

Copyright

Corresponding author

Address for correspondence: Dr Daniel J Pender, 145 West 86th Street Suite 1C, New York City, New York 10024, USA Fax: +1-212-249-0474 E-mail: djp2@columbia.edu

Footnotes

Hide All

Presented at the International Otopathology Society Meeting held at Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, 10–11 June 2013

Footnotes

References

Hide All
1Ménière, P. Report on lesions of the inner ear causing symptoms of apolectiform cerebral congestion [in French]. Gazzette Medicale de Paris 1861;16:597601
2Duplay, S. Some diseases of the inner ear [in French]. Arch Gen Med 1872:711–22
3Hallpike, CS, Cairns, H. Observations on the pathology of Ménière's syndrome. J Laryngol Otol 1938;53:625–55
4Witmaack, K. In: Henke, F, Lubarsch, O eds. Handbook of Special Pathological Anatomy and Histology [in German]. 1926;12:290
5Lindsay, JR. Labyrinthine dropsy and Ménière's disease. Arch Otolaryngol 1942;35:853–67
6Williams, HL. The syndrome of physical or intrinsic allergy of the head. Proc Staff Meet Mayo Clin 1946;21:5864
7Schuknecht, HA, Benitez, JT, Beekhuis, J. Further observations on the pathology of Ménière's disease. Ann Otol Rhinol Laryngol 1962;71:1039–53
8Schuknecht, HF, Gulya, AJ. Endolymphatic hydrops. An overview and classification. Ann Otol Rhinol Laryngol Suppl 1983;106:120
9Antoli-Candela, F. The histopathology of Ménière's disease. Acta Otolaryngol 1976;340:142
10Yamashita, T, Schuknecht, HF. Apical endolymphatic hydrops. Arch Otolaryngol 1982;108:463–6
11Altmann, F, Kornfeld, M. Histological studies of Ménière's disease. Ann Otol Rhinol Laryngol 1965;74:915–43
12Merchant, SN, Adams, JC, Nadol, JB Jr.Pathophysiology of Ménière's syndrome: are symptoms caused by endolymphatic hydrops? Otol Neurotol 2005;26:7481
13Fraysse, BG, Alonso, A, House, WF. Ménière's disease and endolymphatic hydrops: clinical-histopathological correlations. Ann Otol Rhinol Laryngol 1980;89:222
14Sperling, NM, Paparella, MM, Yoon, TH, Zelterman, D. Symptomatic versus asymptomatic endolymphatic hydrops: a histological comparison. Laryngoscope 1993;103:277–85
15Perlman, HB. The saccule: Observations on a differentiated re-enforced area of the saccular wall in man. Arch Otolaryngol 1940;32:678–91
16Machiavelli, N. The Prince [in Italian]. Florence: Antonio Blado d'Asola, 1532
17Nakashima, T, Naganawa, S, Pyykko, I. Grading of endolymphatic hydrops using magnetic resonance imaging. Acta Otolaryngol 2009;129:58
18Antonelli, PJ, Parell, GJ, Becker, GD, Paparella, MM. Temporal bone pathology in scuba diving deaths. Otolaryngol Head Neck Surg 1993;109:514–21
19Kimura, RS. Distribution, structure and function of the dark cells of the vestibular labyrinth. Ann Otol Rhinol Laryngol 1969;78:542–61
20Eckhard, A, Gleiser, C, Arnold, H, Rask-Andersen, H, Kumagami, H, Muller, H et al. Water channel proteins in the inner ear and their link to hearing impairment and deafness. Mol Aspects Med 2012;33:612–37
21Guild, SR. The circulation of the endolymph. Am J Anat 1927;39:5781
22Becvarovski, Z, Zappia, JJ. The ZB mastoid oscillation protocol (ZBMOP) in Ménière's disease and ductolithiasis. Otolaryngol Head Neck Surg 2002;127:491–2

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed