Meniere Disease

Endolymphatic hydrops (can only be diagnosed by postmortem histopathological examination of temporal bone) Immunological Mechanism Genetic Predisposition (AD inheritence) Viral Predisposition not proved Vascular Etiology (Migraine Association) (VIG viral vascular, immunological, genetic) RUPTURE THEORY Periodic ruptures of the membranous labyrinth, which result in leakage of the potassium-rich endolymph into the perilymph, are thought to be responsible for producing Meniere's attacks. 1. Initial Irritative Phase 2. Subsequent Paretic Phase 3. Recovery Phase Initial excitation of the hair cells as a result of the increased potassium concentration around their basal surfaces is thought to result in the initial irritative phase of an attack. The subsequent paretic phase is thought to result from a blockade of neurotransmitter release. Recovery phase – Healing of the rupture then allows restitution of the normal chemical composition of the endolymph and perilymph, resulting in termination of the attack and improvement in vestibular and auditory function. The gradual deterioration in inner ear function probably results from the effects of repeated ionic insults leading to degeneration of Hair cells.