On the Nature of Hearing Loss in Méniere's Disease.

OBJECTIVE

To explain the pathophysiology of the hearing loss in Ménière's disease (MD).

BACKGROUND

In a previous report, we described a dramatic recovery of hearing in 12/31 patients with MD using antiviral (AV) drugs. The hearing loss in the remaining 19 patients with a longer history of MD remained unchanged or else worsened. Vertigo control was complete in the group with improved hearing but poorer in the group with greater hearing loss (and a longer MD history). Since achieving the recovery of hearing and control of the vertigo using AV drugs in these patients with a shorter history (≤2 years) of MD, we have continued to record dramatic hearing recovery in MD when patients have a shorter history of symptoms. We describe this here in 5 representative MD patients. We feel that the most likely explanation for the outcome is the removal of viral nucleic acids (NA) from the organ of Corti.

SUMMARY: A likely explanation for the sensorineural hearing loss in MD is paralysis of the cochlear amplifier function of the outer hair cells due to the toxicity ofNA. These NA are released from neurotropic viruses located in the vestibular nerve ganglion. Key Messages: (1) Viruses (Herpes family) are the cause of the symptoms in MD. (2) Hearing loss is the result of viral NA in the organ of Corti. (3) A short history of MD symptoms (<2 years) favors hearing recovery.