Inner Ear Disorders: Exploring Possible Links between the Endolymphatic Sac, Gall Bladder and Small Intestine

Abstract

Introduction: In Traditional Chinese Medicine (TCM), the gall-bladder (GB) and small intestine (SI) systems are closely associated with the ear. Acupuncture involving these meridians has been used with success in Meniere's disease where the endolymphatic sac of the inner ear plays a key role. This paper aimed to find out if the endolymphatic sac of the ear shared certain anatomical, physiological and pathological similarities with those of the GB and SI.Methods: A Medline search of the English literature with each of the words "endolymphatic sac", "gall bladder" and "small intestine", was carried out. Relevant English literature detailing the anatomy and physiology of the 3 structures were also reviewed. Results:The GB, SI & ES are found to share common anatomical features facilitating the absorption of fluid and electrolytes. In addition, physiological and pathological processes involving allergy, immune-defense, hormonal action and active transport of solutes are involved in all the 3 structures. Conclusion:If the GB, SI and ES are indeed linked functionally and/or pathologically by one or more of the common themes relating to immunity, the endocrine system as well as fluid and electrolyte homeostasis, plausible medical explanations could possibly be offered for the pathogenesis and treatment of ear disorders as perceived by TCM.

Study of incidence of sensorineural hearing loss in allergic rhinitis

“…Epithelium of human endolymphatic sac has mucin molecules which make it the primary immunological structure of inner ear like MALT in other organs and also co-react with nasal-associated lymphoid tissue (NALT or Waldeyer's ring). 5,6 It has many antigen presenting cells and CD4+T cells and is the main site of antigen-specific immune responses after intranasal immunization. Therefore, allergic rhinitis can lead to sensorineural hearing loss by affecting the connection between the nasal mucosa and inner ears.…”