**Author details**

Shazia Mirza\* and Sankalp Gokhale

\*Address all correspondence to: shazia.mirza@utsouthwestern.edu

UT Southwestern Medical Center, Dallas, Texas, USA

#### **References**


[4] LB, C.B.S.D.N.J.M., *Peripheral vestibular disorders*. Otolaryngol Head Neck Surg, p.2328‐45.

administration and exploring the role of Latanoprost in MD therapy [50]. Technological advancements in inner ear imaging, histology, immunohistochemistry, genetic testing and functional measurements will allow a more molecular and refined examination of the patho‐

The pathophysiology of MD remains elusive despite intense research. It is likely that hydrops may not be the cause of MD symptoms, rather an epiphenomenon. Theories on the patho‐ physiology of MD thus leave several important gaps, mainly around the central theory of EH

• EH cannot comprehensively account for all the physiological changes seen in MD patients.

• Several differences exist in the physiological responses in hydropic animals versus MD patients. While this can be accounted for by innate differences between human and animal

• The central role played by the endolymphatic sac in the pathophysiology of MD is also challenged, due to the low proportion of hydrops that develops in most animal species fol‐ lowing obstruction of the sac and duct. Alternative mechanisms of endolymph production

However, given a 100% association of EH in at least one ear of patients with MD, it is likely that EH is more than just an epiphenomenon, rather it is a condition that is necessary but not

[1] Meniere P. Sur une forme de surdité grave dépendant d'une lésion de l'oreille interne.

[2] Merchant, S.N., Adams J.C. and Nadol, J.B., Jr., *Pathophysiology of Meniere's syndrome: are symptoms caused by endolymphatic hydrops?* Otol Neurotol, 2005. **26**(1): p. 74‐81.

[3] Morita, N., et al., *Membranous labyrinth volumes in normal ears and Meniere disease: a three‐*

*dimensional reconstruction study.* Laryngoscope, 2009. **119**(11): p. 2216‐20.

• EH need not be associated with the characteristic triad of symptoms of MD.

ears, it is likely related to alternate or additional processes involved in MD.

or resorption are likely to be in play in different regions of the labyrinth.

\*Address all correspondence to: shazia.mirza@utsouthwestern.edu

UT Southwestern Medical Center, Dallas, Texas, USA

physiological process.

64 Up to Date on Meniere's Disease

causing hydrops. They include the following:

sufficient for the clinical picture of MD.

Shazia Mirza\* and Sankalp Gokhale

*Gaz Méd de Paris* 1861;16:P29

**Author details**

**References**

**15. Summary**


[37] Silverstein, H., *The effects of perfusing the perilymphatic space with artificial endolymph.* Ann Otol Rhinol Laryngol, 1970. **79**(4): p. 754‐65.

[21] Keithley, E.M., Horowitz, S. and Ruckenstein, M.J., *Na,K‐ATPase in the cochlear lateral wall of human temporal bones with endolymphatic hydrops.* Ann Otol Rhinol Laryngol, 1995.

[22] Yoon, T.H., et al., *Cellular changes in Reissner's membrane in endolymphatic hydrops.* Ann

[23] Andrews, J.C., Bohmer, A. and Hoffman, L.F., *The measurement and manipulation of intra‐ labyrinthine pressure in experimental endolymphatic hydrops.* Laryngoscope, 1991. **101**(6 Pt

[24] Nakashima, T. and Ito, A., *Effect of increased perilymphatic pressure on endocochlear potential.*

[25] Rosingh, H.J., Wit, H.P. and Albers, F.W., *Perilymphatic pressure dynamics following posture change in patients with Meniere's disease and in normal hearing subjects.* Acta Otolaryngol,

[26] Warmerdam, T.J., et al., *Perilymphatic and endolymphatic pressures during endolymphatic* 

[27] Rosingh, H.J., Wit, H.P. and Albers, F.W., *Non‐invasive perilymphatic pressure measurement in patients with Meniere's disease.* Clin Otolaryngol Allied Sci, 1996. **21**(4): p. 335‐8. [28] Brown, D.J., et al., *Changes in cochlear function during acute endolymphatic hydrops develop‐*

[29] Nadol, J.B., Jr., *Positive Hennebert's sign in Meniere's disease.* Arch Otolaryngol, 1977.

[30] Rizvi, S.S., *Investigations into the cause of canal paresis in Meniere's disease.* Laryngoscope,

[31] Nadol, J.B., Jr. and Thornton, A.R., *Ultrastructural findings in a case of Meniere's disease.*

[32] Futaki, T., Kitahara, M. and Morimoto, M., *A comparison of the furosemide and glycerol tests for Meniere's disease. With special reference to the bilateral lesion.* Acta Otolaryngol, 1977.

[33] Brookes, G.B., Morrison, A.W. and Richard, R., *Otoadmittance changes following glycerol* 

[34] Di Girolamo, S., et al., *Postural control and glycerol test in Meniere's disease.* Acta Otolaryngol,

[35] Ferraro, J.A. and Krishnan, G., *Cochlear potentials in clinical audiology.* Audiol Neurotol,

[36] Sperling, N.M., et al., *Symptomatic versus asymptomatic endolymphatic hydrops: a histopatho‐*

*dehydration in Meniere's disease.* Acta Otolaryngol, 1984. **98**(1‐2): p. 30‐41.

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66 Up to Date on Meniere's Disease

1): p. 661‐8.

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*hydrops.* Eur Arch Otorhinolaryngol, 2003. **260**(1): p. 9‐11.

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*logic comparison.* Laryngoscope, 1993. **103**(3): p. 277‐85.


**Ménière's Disease - Audiological and Vestibular Evaluation**
