Richard R. Gacek Meniere's Disease: Myth and Reality

Annotation

Of the most common recurrent vestibulopathies (Meniere's Disease, Vestibular Neuronitis, Benign Paroxysmal Positional Vertigo), Meniere's Disease has received the most attention because of the sensorineural hearing loss and tinnitus that is also present. Furthermore, the description of endolymphatic hydrops (EH) in the temporal of MD has provided some insight to its cause. Unfortunately, the various medical and surgical methods used to reduce this EH have failed to relieve the symptoms of MD. EH has come to be regarded as a marker of the pathophysiology result of a viral labyrinthitis. Close examination of human TB specimens from patients with MD, VN and BPPV by light and electron-microscopy has revealed changes in the 7th and 8th cranial nerves produced by neurotropic viral organisms of the herpes family. Re-activation of these viruses in the vestibular ganglion with release of toxic nucleic acids into the peri lymphatic space produces a serous labyrinthitis responsible for the symptoms of MD. We have documentation of recovery of hearing loss in almost half of the patients with MD.