In 2 patients with severe Meniere's disease (MD), there was histologic evidence of occlusion of the vein of the vestibular aqueduct (VVA). This finding coincided with total or partial occlusion of numerous small vessels around the endolymphatic sac (ES), flattening of epithelium, extensive perisaccular fibrosis, and signs of new bone formation. Ultrastructural analysis of the occluding material showed foci with dense connective tissue, calcification, lipid deposits, and layers of basement membrane, sometimes concentrically arranged. The exact nature of the occluding material was unknown. In another 2 MD patients, the VVA was not visualized, and the ES vessels showed no signs of occlusion. Seven controls with acoustic schwannoma or meningioma had normal vasculature. The presence of vascular impairment in the ES in MD patients indicated that altered hemodynamics may contribute to the pathogenesis of endolymphatic hydrops and MD.
Rask-AndersenHErwallCSteelKPFribergU. The endolymphatic sac in a mouse mutant with cochleo-saccular degeneration. Electrophysiological and ultrastructural correlations. Hear Res1987;26:177–90.
2.
ErwallCFribergUBagger-SjöbäckDRask-AndersenH. Degradation of the homogeneous substance in the endolymphatic sac. Acta Otolaryngol (Stockh)1988;105:209–17.
3.
JanssonBFribergURask-AndersenH. Effects of glycerol on the endolymphatic sac. A time sequence study. ORL J Otorhinolaryngol Relat Spec1992;54:201–10.
4.
Rask-AndersenHDeMottJEBagger-SjöbäckDSaltAN. Morphological changes of the endolymphatic sac induced by microinjection of artificial endolymph into the cochlea. Hear Res1999;138:81–90.
5.
KoburgEHaubrichJKembachB. Autoradiographische Untersuchungen zum Stoffwechsel des Ductus und Saccus endolymphaticus. Acta Otolaryngol (Stockh)1967;64:146–56.
6.
Rask-AndersenH. The vascular supply of the endolymphatic sac. Acta Otolaryngol (Stockh)1979;88:315–27.
7.
OppenheimerH. Lehrbuch der Nervenkrankheiten. Part II. Berlin: S Karger, 1923:1880–82.
8.
HilgerJA. Vasomotor labyrinthine ischemia. Ann Otol Rhinol Laryngol1950;59:1102–16.
9.
FowlerEPJrZeckelA. Psychosomatic aspects of Meniere's disease. J Am Med Assoc1952;148:1265–8.
JenknerFLVojacekE. Vascular studies in Meniere's syndrome and disease. Acta Otolaryngol (Stockh)1967;64:427–35.
12.
BomholtA. Hypofibrinolysis in Meniere's disease. Preliminary report. Arch Otorhinolaryngol1980;226:101–5.
13.
GussenR. Vascular mechanisms in Meniere's disease. Theoretical considerations. Arch Otolaryngol1982;108:544–9.
14.
LeeKSKimuraRS. Ischemia of the endolymphatic sac. Acta Otolaryngol (Stockh)1992;112:658–66.
15.
Danckwardt-LillieströmNFribergUKinneforsARask-AndersenH. “Endolymphatic sacitis” in a case of active Meniere's disease. An ultrastructural histopathologic investigation. Ann Otol Rhinol Laryngol1997;106:190–8.
16.
KimuraRSTreheyJAHuttaJ. Vein of the vestibular aqueduct in the gerbil. Acta Otolaryngol (Stockh)1996;116:44–51.
17.
ShambaughGEJr. Surgery of the endolymphatic sac. Arch Otolaryngol1966;83:305–15.
18.
MazzoniA. Vein of the vestibular aqueduct. Ann Otol Rhinol Laryngol1979;88:759–67.
19.
GussenR. Endolymphatic hydrops with absence of vein in paravestibular canaliculus. Ann Otol Rhinol Laryngol1980;89:157–61.
20.
IkedaMSandoI. Paravestibular canaliculus in Meniere's disease. A histopathological study. Ann Otol Rhinol Laryngol Suppl1985;94(suppl 118):11–6.
21.
IkedaMSandoI. Vascularity of endolymphatic sac in Meniere's disease. A histopathological study. Ann Otol Rhinol Laryngol Suppl1985;94(suppl 118):6–10.
22.
WadinKThomanderLWilbrandH. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation. Acta Radiol Diagn (Stockh)1986;27:629–36.
23.
SanciprianoJAGarciaFJSantacruzSGutierrezRBeltranL. Cochleovestibular hypofunction syndrome of infrequent origin. Thrombosis of venous endotracheal sinuses [in Spanish]. Acta Otorrinolaringol Esp1995;46:137–9.
24.
BuiHTGaleyFRLinthicumFHJr. Electron microscopy of hyalin bodies in the human intraosseous endolymphatic sac. Am J Otol1989;10:285–8.
25.
RossRWightTNStrandnessEThieleB. Human atherosclerosis. I. Cell constitution and characteristics of advanced lesions of the superficial femoral artery. Am J Pathol1984;114:79–93.
26.
LundquistPGSchindlerRAStahleJ. Ultrasonic irradiation of the guinea pig labyrinth. Correlation of morphology and intralabyrinthine temperature. Acta Otolaryngol (Stockh)1978;85:85–95.
27.
LundquistPGWersällJIgarashiMGuilfordFRWrightWK. The acute effect of ultrasonic irradiation upon ampullar sensory epithelia of the guinea pig. Acta Otolaryngol (Stockh)1971;72:68–79.
28.
ConwayBPTabatabayCACampochiaroPAD'AmicoDJHanninenLAKenyonKR. Gentamicin toxicity in the primate retina. Arch Ophthalmol1989;107:107–12.
29.
BangKSampramEFundingMChristensenTMBaandrupUHjortdalVE. Gentacoll hampers epithelialisation and neovascularisation in excisional wounds in hairless mice. Scand J Plast Reconstr Surg Hand Surg1998;32:129–33.
30.
HofferMEBaloughBJKopkeRD. Morphologic changes in the inner ear of Chinchilla laniger after middle ear administration of gentamicin in a sustained-release vehicle. Otolaryngol Head Neck Surg1999;120:643–8.
31.
WanamakerHHSlepeckyNBCefarattiLKOgataY. Comparison of vestibular and cochlear ototoxicity from transtympanic streptomycin administration. Am J Otol1999, 20:457–64.
32.
BaloughBJHofferMEWesterDO'LearyMJBrookerCRGotoM. Kinetics of gentamicin uptake in the inner ear of Chinchilla laniger after middle-ear administration in a sustained-release vehicle. Otolaryngol Head Neck Surg1998;119:427–31.
33.
Ba HuyP TranManuelCMeulemansASterkersOAmielC. Pharmacokinetics of gentamicin in perilymph and endolymph of the rat as determined by radioimmunoassay. J Infect Dis1981;143:476–86.
34.
WrightCGMeyerhoffWL. Ototoxicity of otic drops applied to the middle ear in the chinchilla. Am J Otolaryngol1984;5:166–76.
35.
YazawaYKitaharaM. Immunofluorescent study of the endolymphatic sac in Meniere's disease. Acta Otolaryngol Suppl (Stockh)1989(suppl 468):71–6.
36.
BarbaraMHultcrantzM. Vascular supply of the endolymphatic sac. A gross and ultrastructural study in the Mongolian gerbil under normal and experimental conditions. Acta Otolaryngol (Stockh)1991;111:728–37.
