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

  • D J Pender (a1)



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.


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


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.


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.


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:


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



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