Question
Asked 29th Jun, 2023

What is the precise pathophysiology of Ménière's disease ?

Ménière's disease is a disease of the inner ear that is characterized by potentially severe and incapacitating episodes of vertigo, tinnitus, hearing loss, ....

Most recent answer

Sundus F Hantoosh
Forensic DNA Center for Research and Training
Dear Doctor
Mirza S, Gokhale S. Pathophysiology of Meniere’s Disease [Internet]. Up to Date on Meniere’s Disease. InTech; 2017. Available from: http://dx.doi.org/10.5772/66388
"MD is characterized during its active phase with the characteristic symptom triad, of episodic vertigo and tinnitus with fluctuations in hearing, followed by a symptom‐free period, ultimately resulting in a more permanent dysfunction of the above symptoms. Any theory attempting to explain the pathophysiology of MD has to account for processes that result in a reversible dysfunction of both the cochlea and vestibule, with long‐term chronic deficits. Examples of reversible causes include noise, toxins such as salicylates, viral infections and immune‐mediated mechanisms, most of which do not show morphological changes unless they turn permanent.
This suggests a possibility of a final common pathway in a variety of conditions that could all result in fluctuating cochlear and vestibular dysfunction. The exact mechanisms are not clearly elucidated, with noise‐related damage being a notable exception. In all cases, a persistence of the metabolic dysfunction results in permanence. Hence, it may be inferred that MD is modeled on the pathophysiology of disorders wherein abnormalities of metabolic dysfunction result in a permanent vestibulocochlear dysfunction.
The problem in MD is thought to be malabsorption of endolymph, mainly in the duct or sac. This outflow dysfunction is usually a slow process, the inciting etiological event having occurred possibly years earlier."
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Popular answers (1)

Sundus F Hantoosh
Forensic DNA Center for Research and Training
Dear Doctor
Mirza S, Gokhale S. Pathophysiology of Meniere’s Disease [Internet]. Up to Date on Meniere’s Disease. InTech; 2017. Available from: http://dx.doi.org/10.5772/66388
"MD is characterized during its active phase with the characteristic symptom triad, of episodic vertigo and tinnitus with fluctuations in hearing, followed by a symptom‐free period, ultimately resulting in a more permanent dysfunction of the above symptoms. Any theory attempting to explain the pathophysiology of MD has to account for processes that result in a reversible dysfunction of both the cochlea and vestibule, with long‐term chronic deficits. Examples of reversible causes include noise, toxins such as salicylates, viral infections and immune‐mediated mechanisms, most of which do not show morphological changes unless they turn permanent.
This suggests a possibility of a final common pathway in a variety of conditions that could all result in fluctuating cochlear and vestibular dysfunction. The exact mechanisms are not clearly elucidated, with noise‐related damage being a notable exception. In all cases, a persistence of the metabolic dysfunction results in permanence. Hence, it may be inferred that MD is modeled on the pathophysiology of disorders wherein abnormalities of metabolic dysfunction result in a permanent vestibulocochlear dysfunction.
The problem in MD is thought to be malabsorption of endolymph, mainly in the duct or sac. This outflow dysfunction is usually a slow process, the inciting etiological event having occurred possibly years earlier."
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All Answers (4)

Alireza Bina
Starwood Audiology
  1. Meniere disease is a very mysterious disease sometimes it is is occurred secondary to an autoimmune disease sometimes it concomitant with Vestibular Migraine. The pituitary adrenocortical axis and stress is one of the main reason in some studies. You may read one of my paper which is The most important factors of causing hearing loss following central auditory system disorder and central nervous system cns disorder. Hope it helps.
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Ahmad Alkheder
Damascus University
Thank you for your response, effort, and time.
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Alireza Bina
Starwood Audiology
My pleasure. Anytime!
2 Recommendations
Sundus F Hantoosh
Forensic DNA Center for Research and Training
Dear Doctor
Mirza S, Gokhale S. Pathophysiology of Meniere’s Disease [Internet]. Up to Date on Meniere’s Disease. InTech; 2017. Available from: http://dx.doi.org/10.5772/66388
"MD is characterized during its active phase with the characteristic symptom triad, of episodic vertigo and tinnitus with fluctuations in hearing, followed by a symptom‐free period, ultimately resulting in a more permanent dysfunction of the above symptoms. Any theory attempting to explain the pathophysiology of MD has to account for processes that result in a reversible dysfunction of both the cochlea and vestibule, with long‐term chronic deficits. Examples of reversible causes include noise, toxins such as salicylates, viral infections and immune‐mediated mechanisms, most of which do not show morphological changes unless they turn permanent.
This suggests a possibility of a final common pathway in a variety of conditions that could all result in fluctuating cochlear and vestibular dysfunction. The exact mechanisms are not clearly elucidated, with noise‐related damage being a notable exception. In all cases, a persistence of the metabolic dysfunction results in permanence. Hence, it may be inferred that MD is modeled on the pathophysiology of disorders wherein abnormalities of metabolic dysfunction result in a permanent vestibulocochlear dysfunction.
The problem in MD is thought to be malabsorption of endolymph, mainly in the duct or sac. This outflow dysfunction is usually a slow process, the inciting etiological event having occurred possibly years earlier."
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Keeping Murphy's Law, the KISS principle, and Popper's Logic, right, left, and center, respectively, as well as the all-encompassing muses of insight, innovation, intuition, imagination, and insurrection (the 5 I's that holistically, through immersive-integrative multi-disciplinary contemplative approach identifies the noise or separates the wheat-from-the-chaff at the intersection of fact and fiction), and importantly and synergistically compose the whole that is greater than the sum of its parts -- in true Aristotelian fashion -- that govern progress and advance in human thinking through the synapse in all human endeavor, scientific and non-scientific.
I will put exactly 50-years of my part in one of the greatest mysteries ever faced by humans, and that will follow this species indefinitely to perpetuity, but with secure and fearless knowledge through application of principles or laws of theory and therapy, elimination of canonical or Institutional myths and assumptions, with a complete unwinding of this humungous Gordian knot of neuro-ophthalmology.
Da Vinci guarded against excessive use of words to describe any entity or anything. Migraine is an entity of excess -- incidence, words, data, statistics, analyses, meta-analyses, hypotheses, viewpoints, perspectives, Editorials, Medical Conferencing Abstracts, invited Lectures, hyper-splitting of nosology, and Letters-to-the-Editor, all claiming to know a slice of truth or presumed truth about migraine with a hyper-exponential absolutely unlimited untrammeled expansion. Quo vadis is not even a remote concept.
I, in the Third Millennium, describe the 'what' of migraine in 6-10 words, a definition that will last to perpetuity:
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06-MAY-2024
New Delhi
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