Menière's disease as a manifestation of vestibular ganglionitis.

OBJECTIVE

To present morphologic evidence of viral-induced vestibular nerve pathology in Menière's Disease (MD). MATERIAL STUDIED: Twelve temporal bones (TB) from 8 patients with the clinical symptoms of MD.

RESULTS

There was endolymphatic hydrops (EH) and perilymphatic fibrosis in 10 of the 12 TB from MD patients. Of the 10 TB with EH of the pars inferior, 3 also contained outpouchings in the pars superior (utricle and canals), and 3 showed apical spiral ganglion cell loss. Focal vestibular nerve axonal degeneration was observed in all but one TB.

CONCLUSION

Morphologic changes in TB of patients with MD, and clinical observations in patients with recurrent vestibulopathy, support the concept that the pathologic mechanism responsible for auditory and vestibular symptoms in MD may be reactivation of a latent viral vestibular ganglionitis.