Ménière's Disease

Abstract

The otological practice at The London Hospital provides very large numbers of patients with Ménière's disease from a busy department. This clinical material has been utilized as much as possible, without research assistants or funds, to examine some clinical and pathological aspects of the disease which might have a bearing on aetiology. The investigation procedures which are likely to lead to an earlier and more certain diagnosis are outlined and prognostic indicators are mentioned. It would appear that there may be an hereditary predisposition to progressive idiopathic endolymphatic hydrops. Potential sufferers tend to have migraine, a family history of migraine, minor degrees of basilar impression associated with an abnormally located endolymphatic duct and sac, a more emotional personality, and possibly an association with blood group A. The experimental and clinicopathological evidence supports the view that the endolymphatic duct and sac have an important role in the pathogenesis of both idiopathic and secondary hydrops. Ultrastructural examination is continuing and may shed more light on the pathology at a cellular level. There is, as yet, no cure for Ménière's disease and sufferers will be incapacitated in varying degrees, often severely, for the rest of their days.