Meniere Syndrome: Compensatory Collateral Venous Drainage With Endolymphatic Sac Fibrosis

Validation of inner ear MRI in patients with Ménière’s disease by comparing endolymphatic hydrops from histopathologic specimens

“…Because EH has been known as a histopathological marker since the 1930s 19 , 20 , histopathologic analysis has long been applied to MD patients. However, the pathologic mechanisms underlying the development of EH are not clear 21 .…”

Histopathologic findings in meniere's disease

“…This accumulation of endolymph may be caused by impaired resorption of endolymph in the ED and ES. These hypotheses are based on (1) histopathologic evidence of endolymphatic hydrops in patients with the signs and symptoms of Meniere's disease, 1 , 2 (2) reported histopathologic evidence of a reduced vascularization and fibrosis in the perisaccular tissue reducing the resorptive capacity of the ES, 3‐9 and (3) experimental evidence showing that obliteration of the ED and ES will induce endolymphatic hydrops 10 …”

“…By excluding from their study half of the perisaccular tissue from each ES, the statistical analysis may be biased. Second, the data may be further biased by inclusion of the contralateral ES in the hydrops group in those cases of bilateral hydrops because several authors have noted marked similarity in the perisaccular tissue between temporal bones of individuals, regardless of the presence of otologic disease 1,5,17‐19,28,29 …”

“…By excluding from their study half of the perisaccular tissue from each ES, the statistical analysis may be biased. Second, the data may be further biased by inclusion of the contralateral ES in the hydrops group in those cases of bilateral hydrops because several authors have noted marked similarity in the perisaccular tissue between temporal bones of individuals, regardless of the presence of otologic disease, 1,5,17,19,28,29 Only in the last decade have reports of the ultrastructural pathology of the human ES in Meniere's disease been published. 6-9' 17 The majority of the TEM studies of the ES in Meniere's disease published to date have been based on biopsy material taken from the extraosseous (intradural) ES during ES surgery.…”

Human endolymphatic sac: possible mechanisms of pressure regulation

“…tion, has been attributed to venous congestion (Gussen, 1974(Gussen, , 1982, decreased size of the vestibular aqueduct (Sando and Ikeda, 1984), type II collagen autoimmunity (Yoo et al, 1983), and ES fibrosis (Gussen, 1974;Schindleref a/., 1979). Most interestingly, the distribution of the dense connective tissue observed in the subepithelial tissue of these patients ( Fig.…”