Journal of the American Medical Association · 1959 · 126 citations · 4 references
MedicineOtolaryngologySurgeryHearing ScienceOtolaryngologic SurgeryOtologyCochlear DisordersHearing ImpairmentHearing LossInner Ear DisordersInner Ear FunctionMeniere DiseaseCochlear HydropsCochlear SymptomsEndolymphatic SystemInner Ear PhysiologyInner Ear SurgeryInner Ear TraumaMeniere Disease PhysiologyMeniere Disease Surgery
The study examined inner‑ear changes in a woman with four years of Ménière's syndrome who later died of unrelated causes. The authors sought to determine whether reducing cochlear endolymph—by cochlear destruction or other hydrops‑reducing methods—could treat Ménière's syndrome better than labyrinthotomy. They reasoned that cochlear destruction would eliminate excess endolymph, causing deafness but alleviating vertigo, the more disabling symptom. Histology revealed an overdistended ductus cochlearis that ruptured and partially repaired, accounting for the episodic symptoms and a two‑year remission.
Intensive study was made of the changes in the inner ear of a woman who died of other causes after suffering from Ménière's syndrome for four years. There was evidence that the ductus cochlearis had been overdistended by an excess of endolymph and that its rupture had been followed by partial repair. This would explain the fact that the symptoms had come in spells and that there had been a remission lasting two years. if the underlying process in Ménière's syndrome is overproduction of endolymph in the cochlea, then the logical remedy is either destruction of the cochlea or some other method of reducing the hydrops, rather than the destructive labyrinthotomy which had been contemplated. Destruction of the cochlea produces deafness but would relieve the vertigo, which is the more disabling of the two symptoms.
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