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

Published online by Cambridge University Press:  19 September 2014

D J Pender
D J Pender*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Columbia University Medical Center, New York, New York, USA
*
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
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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.

Keywords

Meniere's DiseaseLabyrinthEndolymphatic HydropsHistopathology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 10 , October 2014 , pp. 859 - 865
Copyright
Copyright © JLO (1984) Limited 2014 

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Footnotes

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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