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Pathology of Meniere's disease
Abstract:
From review of recent findings, the pathology of Meniere's disease is described and correlated with clinical signs. Since Meniere's disease can be seen only in humans, assessing its natural history is important. A recent survey of 500 patients demonstrated the three major symptoms to be vestibular, auditory, and aural pressure. Meniere's disease (idiopathic) is distinguished from Meniere's syndrome (symptoms with likely cause), which accounted for approximately one fourth of the patients. Atypical forms include vestibular and cochlear Meniere's disease. A recent review of our temporal bone collection and detailed study of the pathological conditions of 134 temporal bones described in the literature revealed characteristic pathological findings. Patients with clear-cut histories of Meniere's disease may demonstrate little or no endolymphatic hydrops at death. Nevertheless, hydrops of the pars inferior remains the most significant pathological correlate of Meniere's disease. On the basis of these findings, the pathogenesis of the disease (malabsorption of endolymph) and the pathophysiology of the symptoms (physical and chemical) are discussed.
Insights
Meniere
Area of Science:
- Otolaryngology
- Neurology
- Pathology
Background:
- Meniere's disease is a human-specific inner ear disorder.
- Key symptoms include vestibular, auditory, and aural pressure disturbances.
- Distinguishing idiopathic Meniere's disease from Meniere's syndrome is crucial for diagnosis.
Purpose of the Study:
- To correlate pathological findings with clinical manifestations of Meniere's disease.
- To investigate the natural history and pathogenesis of Meniere's disease.
- To discuss the pathophysiology underlying Meniere's disease symptoms.
Main Methods:
- Review of recent scientific findings on Meniere's disease pathology.
- Analysis of a survey of 500 Meniere's disease patients.
- Examination of 134 temporal bones from literature and a dedicated collection.
Main Results:
- Endolymphatic hydrops, particularly in the pars inferior, is the primary pathological correlate.
- Some patients with clear Meniere's disease histories showed minimal or no hydrops post-mortem.
- Meniere's syndrome (secondary causes) comprised approximately 25% of cases.
Conclusions:
- Endolymphatic hydrops is the most significant pathological finding in Meniere's disease.
- Proposed pathogenesis involves endolymph malabsorption.
- Symptom pathophysiology is linked to physical and chemical changes within the inner ear.