Post-Concussion Endolymphatic Hydrops: The Case of the… : The Hearing Journal – LWW Journals
Dr. Prosper Meniere, a celebrated physician, and surgeon was born in France in 1799 and lived until 1862. During his lifetime, he identified several otologic conditions. As the Physician-in-Chief of the famous Paris School for the Deaf, he was the first to suggest vertigo came from the ear and not from the cerebellum as classically accepted. His presentation at the French Academy of Science in 1861 was the earliest to describe patients with both hearing loss and vertigo as an ear…….
Dr. Prosper Meniere, a celebrated physician, and surgeon was born in France in 1799 and lived until 1862. During his lifetime, he identified several otologic conditions. As the Physician-in-Chief of the famous Paris School for the Deaf, he was the first to suggest vertigo came from the ear and not from the cerebellum as classically accepted. His presentation at the French Academy of Science in 1861 was the earliest to describe patients with both hearing loss and vertigo as an ear disease. Although his colleagues accepted his ideas, they were not mainstream. It was not until 1937 when researchers discovered the pathology of what Prosper Meniere first described in 1861. Eventually, his writings became the basis for what is known as Meniere’s disease (MD) and the more contemporary endolymphatic hydrops (ELH).
HVAC Ceiling Vent Cover. Hearing Matters, post-concussion endolymphatic hydrops, Meniere’s disease.
Figure 2:
Post-Concussion Audiograms. Hearing Matters, post-concussion endolymphatic hydrops, Meniere’s disease.
THE MECHANISM BEHIND MD AND ELH
Gurkov and colleagues describe the mechanism of ELH from studies using high-resolution magnetic resonance as a …” distension of the endolymphatic space of the inner ear into areas that are normally occupied by the perilymphatic space.” 1 These changes result in biomechanical and biochemical actions disrupting the transfer function, resulting in modifications to the cochlear amplifier and the development of hearing loss. This distension can also occur in the cochlear duct/-sacculus and the utricle and semicircular canals. In trauma cases, dysfunction of the endolymphatic passage, introduction of cellular debris disrupting endolymphatic drainage, changes to cell production, or the absorption of endolymph are implicated. 2
Displacement of the apical portion of the cochlea due to its width and elasticity properties are most affected. 1 This appears to be the reason behind the development of low-frequency hearing loss. The greater the severity of basilar membrane dislocation, the more severe the disease and symptoms. In some cases of MD, hearing loss can become severe to profound, eventually resulting in cochlear implantation. Modern implant studies have shown hearing can be significantly improved without labyrinthectomy while reducing tinnitus and suppressing vertigo. 3
THE DIAGNOSIS
Contemporary studies identify MD as affecting 50-200 per 100,000 individuals, most prominent in people aged 40-60 years. 4 There is no single cause for MD, which in many cases remains idiopathic, taking months to years to diagnose. The diagnosis of MD is made clinically after ruling out other conditions producing vertigo, such as labyrinthitis, labyrinthine concussion, migraine, and BPPV, amongst others. Although vertigo is present in all these conditions, the treatments can be different. The American Academy of Otolaryngology – Head and Neck Surgery considers the …….
