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Archives of oto-rhino-laryngology

, Volume 212, Issue 4, pp 301–307 | Cite as

On the mechanism of the Menière attack

  • G. F. Dohlmann
Article

Summary

Three theories are discussed dealing with the origin of the Menière attack: 1) The hypothesis of pressure induced changes is disproved. 2. The stimulation of the crista epithelium by a mechanical cupula deviation has been investigated. The results showed that the changes in action potential frequency of the ampullary nerve induced by maintained bending of the cupula, always declined and returned to resting potential frequency within a very short period of time usually within 1 min. Preventing the “elastic return” of the cupula did not change the time constant of this responce decline. This proves that a Menière nystagmus lasting for hours, can not be elicited by a mechanical deformation of the cupula. 3) The paralyzing influence on vestibular nerve fibres by K+ ions in endolymph, leaking into perilymph spaces has earlier been demonstrated by the author. When the distended membranous labyrinth ruptures at predestined weak spots, leaking endolymph may reach and paralyze different nerve branches. This can explain all the main symptoms of a Menière attack.

Key words

Menière's disease Labyrinthine pressure Cupular physiology Perineural potassium 

Zusammenfassung

Da weder die Überdehnung des Labyrinths allein, noch die Druckerhöhung im häutigen Labyrinth oder eine Anoxie der Sinnesendstellen bei gestörter Durchblutung den Menièreschen Anfall erklären können, wird ein Mechanismus dargestellt, welcher auch experimentell belegbar ist. Durch die Ausweitung des Endolymphschlauches kommt es an bestimmten Stellen zur Ruptur der Wand. Die kaliumreiche Endolymphe dringt in den Perilymphraum ein, und zwar am Helicotrema und in der Ampullenumgebung. Hier lähmt sie die durchziehenden Nerven und verursacht so das Erscheinungsbild des Anfalls in allen seinen Abarten in Abhängigkeit vom Orte der Ruptur.

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References

  1. Beentjes, B.: The cochlear aqueduct and the pressure of cerebrospinal and endolabyrinthine fluids. Acta oto-laryng. 73, 112 (1972)Google Scholar
  2. Hallpike, C., Cairns, H.: Observations on the pathology of Menière's syndrome. J. Laryng. 53, 625 (1938)Google Scholar
  3. Henriksson, N., Gleisner, L.: Vestibular activity at experimental variation of labyrinthine pressure. Acta oto-laryng. 61, 380 (1966)Google Scholar
  4. Henriksson, N., Gleisner, L., Johansson, G.: Experimental pressure variation in the membranous labyrinth of the frog. Acta oto-laryng. 61, 281 (1966)Google Scholar
  5. Schuknecht, H. F.: Pathology of Menière's disease and correlation of pathology with symptoms of Menière's disease. In: Menière's disease (ed. J. Pulec). Philadelphia-Toronto-London: J. B. Saunders 1968Google Scholar

Copyright information

© Springer-Verlag 1976

Authors and Affiliations

  • G. F. Dohlmann
    • 1
  1. 1.WestonUSA

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