The ZB Mastoid Oscillation Protocol (ZBMOP) in Meniere[apos ]s disease and ductolithiasis

Endolymphatic hydrops and Ménière's disease: a lesion meta-analysis

“…The driving mechanism appears to be hydraulic. Potential aetiologies include barotraumas, 18 dark cell secretion, 19 aquaporin activity in the cochlear apex, 20 resorptive defects in the endolymphatic sac 21 and obstructive phenomena in the endolymphatic duct 22 . Membrane resistance to hydraulic pressure probably depends on structural characteristics such as configuration, composition and inherent strength.…”

Article Commentary: A unified hypothesis for vestibular dysfunction?

“…Progressive damage would initially be reversible but would ultimately result in irreversible harm to the auditory and vestibular apparatus. Becvarovski and coworkers have coined the term “ductolithiasis,” 6 but their explanations fall short by limiting the site of the disease to the endolymphatic sac, which is inconsistently associated with Ménière's disease. A descriptive term to encompass the entire endolymphatic tract would be more appropriate.…”

“…In patients with other forms of vestibular pathology, a particle-positioning maneuver would only transport the offending particles from one location in the labyrinth to another. Any positive effects would be of only a short-term benefit; this may explain the alleged success of mastoid oscillators 8 and middle ear pressure modulatory systems (Meniett device (Medtronic, Xomed Inc., Jacksonville, FL)) 9 for the treatment of Ménière's disease. The proposed benefits of both endolymphatic sac surgery and cortical mastoidectomy 10 may solely be the short-term result of oscillating the labyrinth with the burr of a drill.…”

A model design for the labyrinthine membranes in mammals

“…Guinea pig ears appear more susceptible in that they do develop hydrops readily when the endolymphatic duct is surgically obliterated, even though they are not known to exhibit the deformation naturally . Finally, human ears appear most susceptible and are known to exhibit this membrane deformation with some frequency even in the absence of ductal obstruction …”

“…6 Finally, human ears appear most susceptible and are known to exhibit this membrane deformation with some frequency even in the absence of ductal obstruction. 7 In the case of diving injuries, humans, whose endolymphatic systems are closed spaces, are prone to this disorder 8 and must take precautions to carefully control rate of descent and ascent. Yet, aquatic mammals, such as whales and dolphins, whose endolymphatic systems are also closed, are not known to be naturally susceptible to this disorder.…”