The intravestibular source of the vestibular aqueduct. III: Osseous pathology of Ménière's disease, clarified by a developmental study of the intraskeletal channels of the otic capsule.

CONCLUSION: Review of the histopathological changes in the vestibular arch in Ménière's disease, after a study of development of the otic capsule, indicated a severe apoptotic loss of osteoblasts with consequent denudation of these cells from and damage to the osseous canal structure of the arch.

OBJECTIVE: To review previously reported histological findings in the inner layer of the vestibular aqueduct and its intravestibular source in Ménière's disease, using newer knowledge of otic capsule development.

METHODS: Temporal bone histological sections from the vestibular arch region of eight patients with Ménière's disease were reviewed in our London-based material.

RESULTS: Minute granules suggesting apoptotic bodies were found in the arch in the majority of cases, giving support for the concept of an apoptotic loss of osteoblasts. Explanation for the previously described appearance of proliferation of atypical channels and of small, finely outlined empty areas in the bone was provided by the observation of denudation of osteoblasts from Volkmann's canals and microcanals. These canals had been recently described in a developmental study of the otic capsule. Dislocation of dead microcanals into blood vessels of Volkmann's canals was seen in two of the cases.