Download MBBS Menieres Disease Lecture PPT

MENIERE'S DISEASE

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DEFINITION
? Disorder of inner ear where endolymphatic system is distended with endolymph

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? Other name : endolymphatic hydrops
? Characterised by
1.
Vertigo
2.

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Tinnitus
3.
Sensorineural hearing loss
4.
Aural fullness

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PATHOLOGY
? Distension of the endolymphatic system
? Affects
1. Cochlear ducts

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2. Saccule
3. Utricle
4. Semicircular canals

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The dilatation of cochlear duct is such that it may completely fil

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the scala vestibuli and there is marked bulging of reissners
membrane,which may herniate through the helicotrema into
apical part of scala tympani

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AETIOLOGY

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? Either due to increased production (stria
vascularis) of endolymph or faulty
absorption(endolymphatic sac)

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THEORY

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? Defective absorption by endolymphatic sac
? Vasomotor disturbance
? Al ergy
? Sodium and water retention(excess fluid retained)
? Hypothyroidism

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? Autoimmune and viral aetiology

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DEFECTIVE ABSORPTIONS BY ENDOLYMPHATIC SAC
? Normal y endolymphatic sac to endolymphatic duct
? Experimental obstruction of endolymphatic sac and its duct

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produce hydrops
? Distension of membranous labyrinth leads to rupture of
reissner's membrane and thus mixing of perilymph and
endolymph which brings vertigo

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VASOMOTOR DISTURBANCE
? Sympathetic overactivity resulting in spasm of internal auditory
artery /its branches thus interfering the function of cochlear or
vestibular sensorineural epithelium
? Anoxia of capil aries of stria vascularis also causes increased

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permeability with transudation of fluid and increased
production of endolymph

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ALLERGY
? In cases of offending al ergen , inner ear acts as a shock organ

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producing excess endolymph
? 50 percent patients with Meniers disease hav concomitant
inhalant/food al ergy

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THANK YOU

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