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PubMed1990

[Pathohistological study on active endolymphatic hydrops in guinea pig--with stress stimulations].

Recently Meniere's disease is believed to show a pathological features of endolymphatic hydrops, but the etiology of this disease has not yet been ascertained. Many investigators tried to create animal models with endolymphatic hydrops by obliterating endolymphatic sac and duct. However, these methods have not been adequate to explain the mechanism of development of Meniere's disease, because it gives mechanical damage to destroy endolymphatic sac and duct. On the other hand, Meniere's disease is thought to develop even as a result of stress. The present paper reported the conduction of an acute experiment, creating active endolymphatic hydrops by stress load, to study the occurrence rate of endolymphatic hydrops and the pathological findings of inner ears by a light microscope. This was followed by a light and electron microscopic study on the changes in permeability of the cochlear lateral wall with horseradish peroxidase and a study of the development mechanism of endolymphatic hydrops. Results obtained were as follows: 1. Although it was impossible to cause endolymphatic hydrops with a single stimulation, four kinds of stress stimulations could cause endolymphatic hydrops with the rate of 37.8%. 2. Judging from the different pathological findings between the group with four kinds of stress stimulations and the untreated control group, vessel permeability in the stria vascularis was highly changeable, while that in the spiral ligament was not. 3. It was found out that increased permeability of the stria vascularis vessels was by increased pinocytotic vesicular transport and through tight junctions from vessel lumen to basal lamina and that it was presumably only by increased pinocytotic vesicular transport beyond basal lamina. 4. It was assumed that increased permeability of the stria vascularis vessels was one of the causes of endolymphatic hydrops which were believed to be pathological features of Meniere's disease.

Animals↗
PubMed1991

[Electrocochleography in experimental animal model with acute hydrolabyrinth].

A desirable animal model of acute hydrolabyrinth was made by injecting artificial endolymph into the cochlear duct of guinea pigs. In 12 animals with intact Reissner membranes, the endolymphatic potential kept normal after injection of artificial endolymph, but their ECochG showed a rise of SP amplitude, a decrease in AP amplitude, an increase of SP/AP ratio, and a delay of N1 latency. In 7 animals with ruptured membranes, the EP significantly decreased. ECochG showed a decrease in hearing in all test frequencies, a distortion of SP-AP wave or even a loss of AP. Based on the results of our experiment, it can be assumed that the dominant -SP may be seen in the acute stage of endolymphatic hydrops without a rupture of Reissner membrane. Therefore, the dominant -SP may only be of value in the clinical diagnosis during an episodic vertigo and fluctuating hearing loss in Ménière disease.

Animals↗
PubMed1989

Evaluation of the monothermal caloric test.

In 1970, Torok reported that patients with labyrinthine disease showed vestibular recruitment and that patients with retrolabyrinthine disease showed vestibular decruitment on the monothermal caloric test. Other investigators have failed to confirm these findings; however, their studies did not precisely replicate Torok's test procedure. Following Torok's procedure exactly, the monothermal caloric test was administered to normal individuals and to patients with well-documented vestibular lesions. Nine of ten normal persons showed normal responses and one person showed borderline decruitment. Six of eight patients who had lesions of the vestibular nerve or central vestibular pathways showed decruitment. Two patients with active Meniere's disease showed recruitment and one showed asymmetry. Two patients with Meniere's disease who had undergone endolymphatic sac operations showed normal responses. These findings support Torok's claim that the monothermal caloric test discriminates between labyrinthine and retrolabyrinthine vestibular pathology.

Adult↗
PubMed1987

Diagnosis and management of vertigo.

Patients with vertigo may be best evaluated when the physician has the various entities that may be responsible clearly in mind. Those diseases listed in group II are more familiar to the primary care physician than those listed in group I, which belong more in the realm of neuro-otology than in general medicine and neurology. The proper use of history, physical findings, and laboratory evaluations will allow the clinician to classify the patient's problem and to initiate treatment and consider appropriate referral when indicated.

Humans↗