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Immunological analysis of IgG and other protein fractions in endolymph obtained from endolymphatic sac of Meniere patients and a control.

During endolymphatic sac surgery on patients with Meniere's disease, very small amounts (1 microliter) of the intra-sac endolymph were obtained with micro-glass pipets. An immunological assay of microanalysis of the protein by the single radial immunodiffusion (SRID) method was applied to 2 patients, one with bilateral involvement and the other unilateral. Among the protein fractions Alb, IgG, IgM, IgA, C3, C4, transferrin and alpha 2M, the concentrations of IgG were relatively higher, especially in the Meniere patient in the active stage. From 2 other patients and a control deaf patient with temporal bone fracture, the same amounts of endolymph were obtained, accompanied by a tiny specimen of the outer wall of the sac. When a radio-immunological procedure was applied to the endolymph and the homogenized sac, the specific concentration of IgG was higher in the Meniere patients than in the control.

Albumins↗

Ataxia and hearing loss secondary to perilymphatic fistula.

Ataxia is rarely attributed to lesions of the peripheral vestibular system. In 1973, the first case of ataxia and hearing loss secondary to a labyrinthine fistula was reported. Until now, this syndrome has not been reported in patients under the age of 10 years. A case is presented of a 5-year-old boy with symptoms of ataxia and hearing loss as well as vertigo and tinnitus after head trauma. Three physical findings appear to be most characteristic of patients with perilymphatic fistulas: a positive fistula response, positive positional testing with the involved ear down, and evidence of vestibular ataxia when testing station and gait. The absolute diagnosis of perilymphatic fistula can only be established by exploration of the middle ear space. If a fistula is found, it may be sealed with soft tissue and, if this fails, actual stapedectomy may be required.

Ataxia↗

Meniere's disease 1978-1982.

Over 250 reports concerning or related to Meniere's disease, published in English from 1978 through 1982, are summarized. Reports have been classified into the categories of incidence of occurrence, analysis and reporting results, pathophysiology, etiologic theories, diagnostic methods, medical management, and surgical procedures. Major emphases in reporting from 1978 though 1982 have been in the areas of pathophysiologic studies, expansion of diagnostic procedures, and the use of sac decompression and neurectomy procedures. This literature review reveals the continuing disagreement regarding the pathophysiology of Meniere's disease and the resultant continued controversies in its management.

Animals↗

[Vasoactive drugs and oxygen content in the perilymph (author's transl)].

The effect of different vasodilating drugs on the perilymphatic oxygen content in the cat has been examined by means of the polarographic method. The drugs used such as Papaverin, Rheomacrodex, Ronicol, Praxilen and Lasix have had no significant effect on the oxygen concentration in the perilymph. Histamin, 7% Na2CO3 and 50% glycerol have produced a diminution of the perilymphatic oxygen tension. Only angiotensin has produced a 20% rise of the oxygen pressure in the perilymph. This effect is, however, five times smaller than that reached by inhalation of 5% CO2 and 95% O2.

Angiotensin II↗